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From: Jaan Pill
Date: 10/18/02
Time: 11:49:25 PM
Remote Name: 209.29.99.237
I'd like to offer a comment regarding competency of clinicians as seen from the consumer perspective.
In the field of public education, regional and national school systems around the world are involved in standardized testing of students to determine whether students are learning what the curriculum specifies they're supposed to be learning. Proponents of such testing argue that variables related to students themselves (e.g., socioeconomic status, and level of motivation) can be separated from variables related to teacher competency, when such testing is competently designed and administered.
In public education in many countries worldwide, standardized testing, despite its limitations, is not about to go away, because there's widespread public acceptance of the concept of accountability. Such testing can be useful in telling teachers, school districts, and countries what they're doing well and where they can improve.
With regard to stuttering treatment, there is naturally a wide range of viewpoints with regard to how (or even whether) the competency of speech professionals who work with people who stutter can be measured.
That said, I would argue, as a person active in the self-help movement, and as a public school teacher in Canada, that the question of competency of speech professionals is a valid question to explore. If the competency of public teachers can be explored, it would make sense that the competency of speech professionals can likewise be explored.
I'd also like to comment on treatment programs. With regard to what are at times denigrated as cookbook approaches, I would argue that there are in fact stuttering programs that can be highly effective, as measured by well-designed, long-term efficacy studies.
In my experience as a consumer, one of the qualities of an effective program is that it takes into account the individual characteristics of a client. Some but not all treatment programs are based on cookie-cutter approaches. Some programs that are highly structured, and replicable across a wide range of populations, languages, and cultures, are nonetheless also individualized, by clinicians, for each client. I would argue that it's not useful to assume that if you're looking at a given treatment program, then by definition you must be looking at a cookbook.