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From: Dale Williams
Date: 10/10/03
Time: 8:10:12 AM
Remote Name: 131.91.248.210
Katie:
In general, 4 seems pretty early to do stuttering modification. It sounds like you’re looking for ways to better manage what goes on at home. Can you brainstorm with the parents re. increased situations where they can model & elicit the type of speech you’re after? You could also consider the Lidcombe treatment as a way of adding structure to the home program.
Fluency/phonology is, as you note, a tricky combo. My greatest worry in these situations is that direct artic. therapy often increases disfluency. I always meet with the parents & lay the cards on the table—I can work on the stuttering & handle the artic indirectly (which I recommend) or work more directly (and effectively) on artic, which seems to be making the stuttering worse (and is inconsistent with easy speech techniques-if that’s what you’re using with him—in that the SLP could spend half the session teaching relaxed speaking & the other half forcing the kid to focus on articulator placement, manner, etc.). They always choose the former.
The 17 year old is unlike any case I’ve had. I would have thought that with a minor, his parents could be told, particularly since the behaviors are illegal and harmful. I suppose you could ask ASHA first.
Hope some of this helps.
Dale