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From: Ed Feuer
Date: 10/11/03
Time: 8:32:17 PM
Remote Name: 142.161.180.27
SLPs should not be treating stuttering if they lack the competence the do so. As far as professional ethics are concerned, I don't understand how such people can keep pretending.
Furthermore I think it is high time the SLP profession reexamined the treatment of stuttering. I posted the following in an exchange with Anders Lundberg after his Significance! article. It is also relevant here. With all due respect, I suggest that to sincerely consider what I suggest SLPs would have to put the needs of the stuttering clients first in place of ego, bankrupt traditions and professional jealousies.
My view is that there are people outside speech pathology who have the tools which could be applied to the treatment of stuttering, as needed, under the coordination of an SLP whose specialty is stuttering.
For example, the great failing in stuttering therapy is the lack of genuine and thorough desensitization, touching the untouchable as Van Riper called it. Think how beneficial it would be for the client if the SLP could utilize the services of a clinical psychologist with a specialty in desensitization!
The SID-4 movement is an admission by ASHA that most people out there claiming to be able to treat stuttering lack the necessary competence.
I believe that the SID4 movement does not go far enough given the nature of stuttering. If stuttering were "solved," I would have no argument. But stuttering has not been solved. Now, a multidisciplinary team is used for the treatment of other conditions. Why not stuttering?
The treatment of epilepsy, as an example. I did a "Google" on multidisciplinary team approach and the first thing that came up was the multidisciplinary team treating epilepsy at the department of neurology at Wayne State University’s Detroit Medical Centre at: http://www.med.wayne.edu/neurology/ClinicalPrograms/Epilepsy/multi.html
"The program provides comprehensive epilepsy care through the activities of a dedicated multidisciplinary team that includes four adult neurologists/epileptologists, one pediatric neurologist/epileptologist, one adult neurosurgeon, one pediatric neurosurgeon, adult and pediatric neuropsychologists, adult and pediatric epilepsy nurse coordinators, neuroradiologists, and psychiatrists. Highly trained EEG technologists, epilepsy nurses, and social workers complete the epilepsy program’s team."
Last time I looked at the SID4 fluency specialty area on the ASHA site I saw under professional issues something called "multidisciplinary interaction." I would like to take that seriously and hope the SID4 people begin to pay more than lip service to this long overdue idea in the treatment of stuttering.
Consider Van Riper's credo — on page 201 of The Treatment of Stuttering in his chapter headed Our Therapeutic Approach: "We feel that stuttering needs a global therapy, a total push, if it is to yield to clinical intervention and that it must be attack from every quarter with every available weapon."
From every quarter and with every available weapon. That is not happening in the status quo. It could, if progressive SLPs had the courage to reach out to those with the relevant expertise.