About the presenter: Tim Mackesey, SLP, Atlanta, GA. In addition to owning a full-time private practice dedicated to fluency disorders, Tim Mackesey has taught the graduate-level Fluency Disorders course at Georgia State University. An SLP since 1992, he travels internationally presenting workshops on early intervention, stuttering treatment, and cognitive therapy. Tim is published and has been interviewed on a number of television and radio programs related to stuttering. He has been selected as a Board Recognized Specialist in Fluency Disorders and Specialist Mentor by ASHA. As a certified master practitioner of Neuro Linguistic Programming, Tim integrates numerous unique strategies into therapy and teaching.

You can post Questions/comments about the following paper to the author before October 22, 2009.

Combination Locks and Stuttering

by Tim Mackesey
from Georgia, USA

Unlocking stuttering has many metaphors and one I use is the combination lock. I will dial in on two major analogies. I bet you can think of more than two applications.

The first metaphor to stuttering is the fact that each person who stutters (pws) has his own combination for recovery. Stuttering has overt and covert symptoms that make up this combination. Some pws have few obvious symptoms but have a long list of avoidance habits. A young pws may have very physical symptoms (i.e, tight speech blocks) but few negative thoughts or feelings connected to the stuttering. An integrated model of therapy will address the whole person and prioritize which "numbers of the combination" need the most attention: behaviors or cognitive and affective issues.

Parents, teachers, and SLPs can relate to this combination lock metaphor. We must examine closely the overt and covert symptoms that make up the combination. In the classroom, children who have developed anticipatory anxiety about stuttering and fear oral reports and oral reading may benefit by going first. Another child who has been bullied requires protection from the school. A child asking his parents to order food for him has a fear of stuttering. A preschooler with a stutter may be an easy combination to dial and fix the stuttering. A personalized, integrated approach should be provided for each pws in therapy. I have found the combination lock metaphor to help parents grasp the process of therapy.

The second metaphor revolves around the working of a lock mechanism. You have to slow down just before each number of the combination to be accurate and unlock it on the first try. If you speed by the digit, you have to start over again.

Patience achieves more than force - Edmund Blake

With adolescent, teens, and adults who stutter I hand them a combination lock. I have them experientially turn and learn. The lesson helps integrate the concept of an easy onset or light contact: you simply MUST slow down to coordinate the fine-motor muscle groups (tongue, lips, larynx). The SLP can pick a feared word or sound as an example to show the pws how slowing and easing into the word unlocks the speech block. Many pws would prefer to talk fast and miraculously get better. My 25 plus years of severe stuttering taught me the cold, hard facts. The hands-on experience with the lock integrates the learning.

Grab a lock and have some fun teaching.

You can post Questions/comments about the above paper to the author before October 22, 2009.

July 26, 2009
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