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From: Scott
Date: 10 Oct 2012
Time: 10:38:03 -0500
Remote Name: 108.17.124.241
Thanks for your post! Congrats on having your first stuttering client... it's always a bit nervy at the beginning, but you'll get more comfortable with all of this as you get more experience... In terms of your question, it's a good one... How do you help people see the true nature of stuttering so they can expand their goals beyond just "child will be x% fluent in such-and-such a situation..." I wish I knew THE answer to this question - there isn't one. You'll see that there are differences of opinion on the topic, even at the level of researchers and master clinicians... For example, look at the articles just published yesterday in LSHSS which reflect two approaches to the role of counseling in the scope of practice for SLPs. You'll be able to tell which side we fall on ;-). In my opinion, clinicians need to move beyond focusing on fluency - not to leave fluency behind, but to bring other aspects of the experience into the mix. That means that we need to start considering the child's experience from the very beginning - at the time of the evaluation. If the child you're working with hasn't participated in a comprehensive assessment - one that looks at not only his speech but also his ability to communicate, the adverse impact of stuttering on his life, etc. - then of course it will be difficult to write goals in these other areas. So, I'd encourage you to ask your supervisor if you could do some additional assessment to understand how stuttering affects the child's life. There are tools available (e.g., the BAB, the OASES) that help you focus on more than just the surface characteristics. And, this can be done through interview and discussion, focusing on what stuttering means for the child. (Disclosure: I am coauthor of the OASES and receive royalties for its sale.) note that I'm not trying to get you to use the OASES per se, but to encourage you and others to think about the big picture for the child's communication. As you do these things, you'll find it easier to write goals that address the entire disorder. I see that there's another question about goals a bit further down, so I'll address that part down there... So, for your client, perhaps you can think about him/her as a person first, a person who is struggling with an issue second, and the fact that the issue is disrupted speech third. If you can relate to him/her at the first two levels, you're more than 2/3 of the way there ;-). The specific knowledge about stuttering will come... Thanks again for your post... S