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From: Laura Imbriale
Date: 15 Oct 2004
Time: 12:36:18 -0500
Remote Name: 24.168.124.234
As a speech pathology graduate student, I found this article to be enlightening in regards to the important aspects of assessment and counseling for fluency disorders. The article emphasized the instability and unpredictability of fluency in people with fluency disorders and stressed that clinicians working with this population be aware that a comprehensive assessment is necessary to capture the essence of the dysfluency problem. The impression that I received is that an assessment of speech fluency should include obtaining speech samples from several different times and places, where the demands and levels of stress vary. Then, the information obtained should be integrated to create a profile that is representative of the client's fluency. However, as stated in the article, the clinician should remember that fluency is indeed like a "roller coaster" with ups and downs and that the client's fluency is subject to change for reasons that may or may not be known. I also enjoyed reading that clinicians working with clients with fluency disorders have a responsibility to counsel their clients on the instability of fluency. Just as it is important for the speech pathologist to fully understand the variability associated with the disorder, so too is it equally if not more important for the client to understand this variability. The client may set unrealistic expectations for him or her self which ultimately may lead to feelings of failure and low self-esteem. However, if the client is properly informed on the nature of the disorder and is working in accordance with the clinician in setting realistic goals, the client may take greater pride in his accomplishments and retain good self-esteem even when there are times when his or her fluency is not at the level he or she desires.