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From: Scott
Date: 16 Oct 2012
Time: 18:05:34 -0500
Remote Name: 108.17.124.241
Hi Gunars -- I'm assuming you already know my position on this question, as we have talked about it quite a bit (though it has been some years since we last interacted). Thus, I assume you're asking the question so that others can also have the opportunity to see my opinion. Thanks for that. Of course some children can benefit from psychological counseling in addition to or perhaps in lieu of speech therapy. That seems rather obvious to me. As I am a speech-language pathologist, however, it is within my scope of practice to provide comprehensive treatment to children who stutter...and as a professor, it is my job to teach others to do this, as well. As you know, we have growing evidence that treatment can improve the lives of children who stutter. We also have ample evidence that there is plenty of bad therapy out there. Out goal should be to educate clinicians so that there is more good therapy and less bad therapy. We have lots of work to do, and there are many professionals who can participate in this comprehensive effort. Psychologists are among them, and both Nina and consult with psychologists as needed to ensure the well-being and improvement of our clients. It is important to note that not all children need this, though some could certainly benefit from it. At the present, however, you probably know that most SLPs, particularly in school settings, are simply fighting for the ability to see the kids they need to see... There is simply no funding available to support a routine recommendation to psychologists for all children who stutter. (Again, I maintain that it is not necessary in all cases.) The funding issue is certainly a political one - funding levels are determined by elected officials, so anybody who is concerned about the amount or nature of treatment (and education) that children get should think about this in this heated political season. Here in PA we're facing severe cuts to all educational budgets -- SLPs are barely going to be able to see children who stutter, let alone refer them to psychologists. As you no doubt know, a school clinician can't make a formal recommendation to a psychologist outside the school lest the school be required to pay for that treatment (they won't), and the school psychologist is already engaged in other activities with an entirely different population. SO, though there is certainly enough blame to go around, I don't think this one can be laid entirely at the feet of the SLPs. As for case studies -- I think you probably already know the answer to that one, too, but in any case, a simple pubmed search will give you what you're looking for right quick. Back to the purpose of this particular paper - we seek to encourage clinicians to view stuttering in a different light. Trying to convince them that they can't do it isn't in keeping with that message...Especially when we know that significant gains in clinicians' abilities - and in children's communication skills - are definitely within our reach. Is there more that we can do? Sure, but you don't build by tearing down. S