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From: Ann B
Date: 02 Oct 2006
Time: 20:37:54 -0500
Remote Name: 141.154.178.121
This is exactly an issue that I am dealing with right now, and was one year ago. I truly feel that the attitudes and reactions, and punitive implications that are passed from parent to child are the biggest obstacle to change. It is very difficult to claim to “know” that a parent is the obstacle, when they adamantly avow that they are fully supportive, but you can see in their behavior and the way they treat the child that they are the largest roadblock to success! How can one tactfully address this, when they haven’t been to the home, or seen a day in the life of this child and parent and family first hand? How can one address the issue without sounding like they are judging parenting skills? I believe that the parent may feeling the guilt for having a child that stutters, a child that mars the perfection of the beautiful family with two other children, and the only way they know how to behave is to react in a way that they really don’t want to, but can’t help themselves. How does the clinician work through this cycle?? The parent is in denial that she is not being supportive, yet says things like “Cherie is fluent when she remembers to use her speech tools” or “She did her whole presentation with no stuttering”, or “she didn’t practice this week, so her fluency is up”. But you know that is not true (she is not supportive), because the % of disfluent speech is 9-11% in the clinical setting, and the child lowers her eyes and drops her head when this conversation is occuring. Then the mom hugs the child and says “tell Ann what happened to you…..” avoiding talking about what she has done or not done to promote her child’s successful communication. I have thought about my ethical responsibilities - therapy seems to be going no where. I can achieve fluency for the hour in the clinic, but it stays there. Sure, it waxes and wanes, depending on the reinforcers, but for such a young child, I feel progress is very slow. Then, I think that I may be the only positive influence on the child’ emotional feelings regarding his fluency, and if I discharge, what will this do to her? Any suggestions? I don’t want to alienate the parent, but sometimes they really do think that all they need to do is bring the child to therapy and pay the fee.