Iceberg of Stuttering

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Re: iceberg analogy

From: Russ Hicks
Date: 10/13/03
Time: 5:44:50 PM
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Hi Julie,

I've appreciated your comments and questions on Stutt-L over the past couple of years. It's wonderful to see students participate like you are doing! Keep it up!

Your question conjures up another analogy. Your primary care physician is as important as a traffic cop as he is a doctor. My primary care physician is an internist and I've got a call into him right now to refer me to an ENT (Ear-Nose-Throat doctor) who can remove some pesky wax from my ears that is making me nearly deaf and help me with some stupid nosebleeds that have plagued me for several years. Could he do it himself? Maybe. It's a judgement call on his part - and mine. But if I had migraine headaches and he was a surgeon, he would be insane to say "Well let's cut open your head and see if we can see what's wrong!"

The moral to this story is to know your limits - and don't be afraid to refer someone to a specialist if you realize that the main problem is outside your range of expertise. Like my doctor, it's a judgement call. But professional ethics - and ultimately common sense - dictates that you will do your BEST for your client even if that means referring him to a more appropriate specialist.

Now... all that being said, you WILL probably be more capable than you think you are. LISTEN to your clients and try your best to get inside their heads. Yeah, that sounds like a psychologist, but you'll probably be good at that. You'll surprise yourself. Take as many psychology courses in school as you possibly can and learn all you can about that subject. If for no other reason, the more you know about psychology, the more informed you can be as a speech pathologist.

Yes, certainly, absolutely, for sure, without question, you WILL find a lot of other issues involved with people who stutter other than simple stuttering. As stuttering can interfere with communication - one of the basics in human experience - you'll find LOTS of other problems beneath the waterline of the iceberg. Social skills and personal rapport can be leading problems that you're likely to find. Does it take a psychologist to deal with them? Possibly. But maybe not. If you find things like parental abuse, suicidal tendencies, or hallucinations caused by drug or alcohol abuse, yep, you're out of your league and you need to refer that client to a specialist. Don't "cut his head open to see if you can find out what's wrong!" You're likely to find more black and white cases than you are the shades of gray. And if you do find those shades of gray, talk it over with other SLP or psychologist friends. Two (or more) heads a generally better than one.

From what little I know about you Julie, I'm very impressed with your interest in stuttering. You have one of the finest professors in the entire world in Judy Kuster - who has dazzled me for years. As you well know, the SHP and this entire conference are products of her creation. You talk about a pioneer! I hope you realize how lucky you are to be where you are studying under WHO you are. Couple that with your interest in stuttering, you've got a dynamite combination there.

I would go so far as to suggest that you might want to subscribe to the Covert-S group and be one of the leading students who are helping blaze the way into understanding, treating, and preventing covert stuttering. That's a whole new field in speech pathology and the Judy Kuster quality experts in this field you can count on one hand - and have several fingers left over! Talk this over with Judy, and if you're interested in this, let me know and I'll help you get started. Sounds to me like you need something else to do to keep you out of trouble! <smile>

Thanks for your question, Julie. Please keep in touch!


Last changed: September 12, 2005