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From: Charlie Healey
Date: 10/25/01
Time: 9:13:40 AM
Remote Name: 129.93.94.3
I'm pleased that you find this model helpful in planning therapy. Your question about when to switch to a decontextualized level is an important question. Usually, you can switch to that level once they are reliably successful with the highest level of contextualized materials. I would try fading out the contextualized materials and see how the child manages his stuttering. If he/she is successful, then move to more decontextualized materials. You can also go back and forth between contextualized and decontextualized materials within a session and across sessions. You also asked if the speech can be generalized to other settings and situations. Hopefully, we didn't imply in our paper that generalization from discussion of a topic in a therapy will create a natural generalization to other speaking situations such as talking with friends, on the phone, answering questions in class, etc. Certainly, situations that give a child particular difficulty, like talking on the phone, might have to be addressed directly by spending practice time on the phone. However, the intent of using this model is to structure the different levels of communication that can take place in a variety of speaking situations. Talking about a topic the child enjoys, we believe, will facilitate more natural communicative interactions. Through practice with speech contexts that mirror real conversation and discourse, we believe the model will assist the child to learn how to manage speech in situations beyond the clinic. But, there is no guarantee that will happen and if not, then the clinician needs to address transer and generalization more specifically.