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From: David Shapiro
Date: 11 Oct 2011
Time: 06:25:39 -0500
Remote Name: 152.30.155.29
Hi Sarah, You’re asking a really good question. I think the first and most significant thing we did that enabled George to “break the cycle” and realize that this experience could be different was to construct opportunities for him to experience fluency freedom. In other words, I did not want for him to rely on what I told him or what I predicted. It seemed that he had this experience previously and felt disillusioned. Rather, I wanted for him to experience success for himself. If “seeing is believing,” then experiencing for oneself is even more convincing. We engaged in choral reading and faded my role to the point that George was talking on his own using fluent controls, we transferred the fluency from choral reading into conversation, we established situational hierarchies so that he could increase the level of speaking challenge in small steps while remaining successful, we identified the significant fluency that he already possessed and taught him how to do more of what he already was doing (behaviors, thoughts, and feelings) that was facilitative of fluency, we designed extra-clinical assignments to enable him to focus on and practice his fluency controls more than he ordinarily would, we shared responsibility for all aspects of treatment, we met regularly with his family and others within this communication system, we addressed communication challenges that were real to his life (in school, at work, with friends), we assessed the treatment process regularly (i.e., not only the outcome but how he thought the process was going, entertaining and implementing revisions), and more. I should add that initially we invited his assessment of what he hoped to accomplish as a result of treatment. The above procedures (and many more) were designed for George to experience and maintain success. Other key themes were to remain collaborative (at first I designed procedures for George, but soon we designed them together and ultimately he designed them for himself; we transferred responsibility for the clinical process – and focused on transfer – from the beginning, not at the end, of treatment) and to have fun (we genuinely enjoyed working, learning, and being together). You may want to take a look at my book that was just released in revised form (Stuttering Intervention: A Collaborative Journey to Fluency Freedom, 2nd ed., 2011, proedinc.com). In it I go into far more detail about how I design treatment and why I design it the way I do. BTW, you entering one of the most fascinating and rewarding careers imaginable. Work really hard as you prepare to serve others. You’ll be amazed at how much you can learn in the process throughout your career. Feel free to follow up with me. Good luck. David Shapiro