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From: Michael Nawrocki
Date: 21 Oct 2004
Time: 16:03:40 -0500
Remote Name: 63.224.5.132
Dori This is my second comment (the first is buried in an above thread about support groups). Thanks again for posting your article. It was great to get such an in-depth perspective, and your devotion to your family is admirable. I think your paper highlights one of the biggest sources of friction in the field of Speech Language Pathology, and that is the miscommunication between parents of children who stutter (CWS) and these kids’ Speech Language Pathologists (SLPs). I have attended two FRIENDs conferences over the past three years and learned so much from the parents and many of them echoed your concerns (regardless of it were a school or private SLP). The irony is not lost on me that SLPs are caught in the middle of this communication breakdown. And I think this breakdown warrants further discussion because it is not as simple as “SLPs don’t spend enough time with families.” Believe me, I actually wish it were that simple. If all it took to bridge the gap between you and SLPs was for us to spend more time with you, we would be doing that in a New York minute. But the fact of the matter is that our waiting room is just as the “ideal” waiting room you describe. Sure we have Time and Parents magazine copies in our waiting room (sorry no People magazine). But we have two binders full of Reaching Out, Letting Go, and other articles we think parents would enjoy. And as Katie mentioned, we point parents to every SFA publications and videos we think they may find helpful. In addition, Katie and I have a number of parents who are very appreciative of the degree to which we bring them into the therapy process. So why did Eli’s and your therapy experience differ so greatly from the way we planned it and from other (but not all) families? How is it that you saw our Time magazines but the latest issue of Reaching Out? How did you feel left out while other families felt involved? I would love for the answer to be as simple we neglected your needs or you chose to not to be included, because those are easy problems to solve. But the truth of the matter is the communication breakdown we SLPs often experience with parents of CWS is much more complex than that. Off the top of my head there is 1) Time constraints and 2) different people communicate and listen differently. Regarding time constraints, the sad fact of the matter is insurance policies often drive our therapy. A good insurance company will pay for two 30 minute sessions of therapy a week. That’s the best case scenario, and far from ideal. You stated your ideal therapy setting in your paper. Mine includes the features you discussed as well as families with insurance companies that pay for 60 minutes of therapy 5 x/week, and this clinic is staffed with 10 therapists who specialize in stuttering, so that each family gets all of their needs met. Until that happens we have to the best we can under the current system. And as I mentioned, different people have different perspectives and communicate differently. How many times have a husband and wife made plans for the night only to have to wife thinking they will meet at the restaurant, while the husband thinks they’ll meet at home? If this breakdown occurs between spouses, you can imagine how easy it is for an SLP and a parent to have breakdowns, and yet each party believe its message came across crystal clear. We all have different styles of communicating and interpret what we hear differently, based on our life experiences and perspectives. These are just two ways communication can break down. I’m sure there are more. But the point is that your frustration is very valid. But it is the source of a much bigger problem (i.e. insurance limits on therapy, the specialization it takes to treat stuttering, time and insurance constraints) than SLPs not paying enough attention to parents. The bottom line though is what is best for Eli and his family? Keep advocating for him. Find an SLP who sees him not just as a stutterer or puts him on a pedestal as a hero. Rather find an SLP who sees him as a person. If you find an SLP who sees Eli for the great kid he is (and specializes in stuttering), then you have the common ground and trust you need for productive therapy (be it fluency enhancing for Eli, stuttering modification, or acceptance). It will still take work and you will still need to advocate for your needs and Eli’s. But to write off an SLP as someone who relegates you to the waiting room is ignoring the bigger problem in our busy and money driven society, and you may be denying you and Eli from a very rewarding therapy experience (that also takes a great deal of work from all parties). Instead, do what you can to open the lines of communication with SLPs (and all educators/caretakers in Eli’s life). SLPs and parents alike share this responsibility. Your paper taught me what we SLPs have some work to do in this area. I will hope to improve that. I hope all parents who read your paper will learn to do the same, rather than write off the whole speech therapy process. Michael Nawrocki, M.A. CCC-SLP Speech and Language Pathologist