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From: David Shapiro
Date: 18 Oct 2011
Time: 14:24:41 -0500
Remote Name: 152.30.155.29
Hi Ashley, I LOVE working with preschoolers. What an opportunity to see through eyes that we used to have! Preschoolers see things we no longer see and ask questions we no longer consider. Indeed modeling evenness, gentleness, and naturalness is very important, but takes a lot of practice for the clinician. Try it; you’ll see that when it is done well it looks easy, but it is harder to do than it looks. Your question actually is quite complex. It is hard to respond briefly. In my book (Stuttering Intervention, 2nd ed., 2011, proedinc.com), I reviewed the prognostic factors indicating whether a preschool child’s stuttering is more likely to recover or persist without treatment (i.e., prognostic factors were reviewed both from cross-sectional/retrospective investigations and from longitudinal investigations). Then I reviewed what I refer to “parent intervention” procedures. These enable the parents (or other responsible adults) to manage the child’s communication environment by increasing the child’s opportunity for fluent communication without drawing unnecessary attention to the disfluency. These procedures are distinctly different than “ignoring” the disfluency, unfortunate advice often given to parents. If these procedures do not result in a reduction in disfluency, then a more “direct intervention” approach is used. This subsequent step is more direct than working through the parents alone, but still done relatively indirectly (in the context of play) when compared to procedures for school-age children or others for whom stuttering has begun to interfere with the thoughts and feelings related to communication. You should be aware of the Lidcombe Program as well, which trains the parents to be the provider of treatment in a far more direct fashion than I recommended earlier. I reviewed both my own methods for working with preschool children who stutter and those of the Lidcombe Program in my book. Let me know if you have any follow up questions, or if I might address your question more directly, after you’ve seen the description of these different methods. Good luck. David Shapiro