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From: Steve Hood
Date: 10/17/03
Time: 8:32:58 PM
Remote Name: 152.163.252.102
Hello Sarah
Thanks for your comments.
Let me say that I am impressed that as a second year graduate student, you have been exposed to stuttering theory and therapy. I am pleased that you have learned techniques of both stuttering modificatin and fluency shaping. I am especially pleased that you have not only learned about them-- but HAVE USED THEM in therapy. Even though the current ASHA standards to not require that all students have clinical experience with stuttering, we still require this of our students. Many universities do not, to I am glad that you are gaining first-hand experience.
The issue you raise is somewhat like the issue of the chicken and the egg-- e.g., which comes first. I think there is necessarily an overlap, and both can occur together. I do not think that the cognitive, emotional and behavioral issues should be dealt with sequentially; rather, they should be dealt with simultaneously. As there are changes in one dimention, there can be related changes in the other two.
So: reductions in the frequency and severity of stuttering become a behavioral outcome. Reductions in fear, anxiety and frustration would be an outcome related to affect and feelings. Developing more openness, acceptance, tolerance of stuttering (e.g., stuttering is ok, I have permission to stutter) would be related to cognitive changes.
You raised an interesting issue-- maybe others will add their ideas on this.
Steve Hood