Question

From: Patricia and Amanda
Date: 01 Oct 2009

Comments

This is a great idea and we believe this technique will work with almost anyone. But what if the parent or caregiver does not have two weeks to prepare the individual? Will a shorter time span work as well?

 

Re: Question

From: Vanessa Sacchi

A shorter time will work too! Two weeks or ten days was used with the advent of school, but three to five days will also work. The thing that makes this strategy so successful is the open, ongoing, conversation that occurs paired with the visual reminder. Additionally, many of my parents that used this strategy this year also found themselves preparing their children for transition in other ways. For example, starting the school schedule early so that the kids could get used to getting up earlier, and bringing the kids to play at their new playground.

 

A great idea!

From: Karen Kumar
Date: 02 Oct 2009

Comments

Hi Vanessa! I like how you applied a simple activity to helping young kids who stutter with transitions. I appreciate your specific instructions as to how parents are to converse with their child. There is a young child in my practice who will be moving into a new home and this will be a helpful activity for both he and his mom.

 

Re: A great idea!

From: Vanessa Sacchi
Date: 05 Oct 2009

So glad it can help! It is amazing to think such a simple activity can have such a big impact on our kiddo's lives. With a move, I would also recommend that they continue the paper chain maybe a week into the move, so that the daily conversation can continue to discuss some of the unforeseen feelings or fears that can be associated with a new living environment. With this type of preparation I have found that fluency remains more stable, and if a down cycle occurs it is characterized as only a change in an increase in frequency of the predominant pattern, and is typically much shorter in duration. Additionally, in many cases the next up-cycle is much stronger and this propels the child to a higher level of fluency.

 

Fears vs. Excing events

From: Britta Larson
Date: 02 Oct 2009
 

Comments

I love this activity! It is such a simple way to prepare a child for future change. I am wondering if there should be a balance of changes the child fears and looks forward to in the paper chain? Have you seen any children become more anxious or afraid due to constant reminders of the event they fear?

 

Re: Fears vs. Excing events

From: Vanessa Sacchi
Date: 05 Oct 2009

I have not seen any children become more anxious because of doing this activity. I think that the reason why it is so effective is because kids can work through and process the range of emotions associated with transition. Always it is important to validate the child's feelings. However, in my experience with using this strategy- most fears that the children express have to do with them worrying about doing things wrong. For example: a kiddo was happy about hot lunch, but he was very anxious about not knowing what to do, and if he did not get his ticket for hot lunch, would that result in him not having lunch? Parents in this situation were able to go over the lunch time process, and also quell fears that if something happened he should talk to this person, and the situation would not result in him not getting lunch. If a child fears introducing themselves, or if they are worried about their peer's making fun of them, this process provides a wonderful opportunity to discuss ways to deal with these types of situations repeatedly. Child and parent (or speech therapist) can practice what to say if people make fun of their speech by role playing. Also, discussing what the child should do if they feel like the situation is becoming too much. Having them identify who (what teacher or trusted adult) they will talk to in a specific amount of time after an incident occurs. In my experiences with using this strategy thus far, the result has only been positive, and children who stutter feel more capable and empowered to deal with the unexpected events that can come up during any transition.

 

Hands-On Activities Always Good Idea

From: Pam
Date: 04 Oct 2009

Comments

I am a PWS, and not a SLP. I try to visit local schools a couple of times a year, to teach kids about teasing and bullying prevention strategies. I use my stuttering story as an example, as I was teased quite a bit as a kid when I did dare to stutter openly. I use hands-on activities for the kids to teach about stuttering. Even kids who don't stutter love activities like this, and learning is much more apt to occur as they experience the feeling or concept. Great idea! And I know all about covert stuttering. I did it for more than 30 years, until I finally found the courage to just be me.

 

Re: Hands-On Activities Always Good Idea

From: Vanessa Sacchi
Date: 05 Oct 2009

That is great, Pam! I hid my stuttering for many years as well because in my family it was just not something that was okay to talk about. It must be so empowering for you to go into the schools and discuss stuttering so openly. I know that I feel empowered every day when I help kids discuss and feel good about their stuttering because that was not what I experienced growing up. I also do school presentations, and have used the paper chain idea to list things that peers can do when their friend is stuttering (keep good eye contact, no interrupting etc.). I have also used paper chains to show how much we have learned, put all of the important factiods on rings and debrief at the end... put them together and have kids hold it up, and out stretched that is how much they now know about stuttering! It's powerful, and I thank you personally for all the lives that you positively effect because with knowledge there is a decreased desire to tease.

 

back to school stuttering significantly

From: Lourdes Ramos-Heirnichs
Date: 06 Oct 2009

Comments

Will suggest this activity to the mother of my second grade student who has fluency relapses over the weekend. This venue should guide discussion about school concerns. Thanks for the idea.

 

Transition Difficulties

From: Shayna Baker (MSU)
Date: 07 Oct 2009

Comments

Your strategy is very interesting. It sounds like it would be a lot of fun for the child who stutters as well as the parents. It allows for more bonding time between the two. One thing I was wondering, Is the child anxious about the upcoming event because of their tendency to stutter? For example: Is the child thinking, "I don't want to start a new school year because I stutter"? Thank you!

 

Re: Transition Difficulties

From: Vanessa Sacchi
Date: 13 Oct 2009

The anxiety associated with the advent of a new school year is not because they stutter, but more has to do with the personality profile that accompanies a person who stutters. It is not that we do not want to start the new school because we stutter, it is more of all of the unknowns that come along with the advent of a new school year, new teacher, new classmates and a new set of expectations. People who stutter find a great deal of comfort in routine, and knowing what to expect. The more predictable we can make the transition for them, the more that they will feel comfortable with the upcoming transition. That is why the routine of the goodnight procedure with visual reminder; paired with discussing the variations of the same transition each night is so successful. Additionally, with the repetition, kids get the opportunity to discuss the range of emotions, and problem solve situations that they might be worried about before they occur.

 

Very Good Idea.

From: Irina Ponomarenko
Date: 07 Oct 2009

Comments

Hello Vanessa, like your idea very much. It is a great way to reduced tension and anxiety as well as for parents to communicate with their children. From your experience, what is the optimal amount of days should this technique be started before an event?

 

Re: Very Good Idea.

From: Vanessa Sacchi
Date: 13 Oct 2009

From my experience... it all depends on the kid. However, I like to start the transition about ten days before the anticipated event and continue it through the transition four to seven days after. Continuing this procedure after school has started, or the move to the new house has happened allows for this procedure to be a permanent venue to discuss anything that the child is feeling. And for parents it is one of the few times of the day that they are not multi-tasking and can truly give their child their full, and undivided attention. I have also had great success with seven days before and seven days after the anticipated event. Hope that helps, and thank you for your question.

 

I like it!

From: Katherine Thayer
Date: 08 Oct 2009
 

Comments

I think this is such a great idea! Not only is this helping to relieve anxiety for the child which helps the stuttering, it seems that it would help the parent and child bond and build upon their communication and openness with one another about feelings. Do many parents report that they feel closer to their child during and after this experience? Also, do you see general reduction of anxiety and tension in these children?

 

Re: I like it!

From: Vanessa Sacchi
Date: 13 Oct 2009
The results have been astounding! Especially from the parents. All parents reported that they felt much closer with their child, and some parents were astounded about the information that was discussed during this time. One parent said that she thought that she knew her son so well, his likes, dislikes, his fears and the things that he enjoys. From this experience she was shocked to learn that the things that she thought her son feared about the advent of school- he was fine with, and the things that he was worried about included things that she would have never thought of! Insight into the mind of a third grader is a beautiful thing. Additionally, parents reported that through this process they became better listeners. Parents also reported that because of this activity, they thought of different ways to support and ease the transition. For example, one family did school morning schedule practice, where they actually got up, got dressed, and then drove to school before school started. Other parents brought their kids to play on their new playground, or let their child participate in the meeting with the teacher before school started. I collaborated with mom and the child to prepare them to discuss their stuttering. We make it really fun and take the angle of, "you get to teach your teacher about stuttering... how cool is that?" During this meeting with the new teacher the child and mom talk about their stuttering. What helps, what does not help (like interrupting), and ways that the teacher can support the student. It is amazing process that let's the child advocate for themselves and feel really empowered, and great about their talking. All in all, it has been extremely positive.

 

When to fade this reinforcement?

From: Maria H.
Date: 08 Oct 2009
 

Comments

Great idea! One question, however, would be when to fade this reinforcement? It seems like this idea would only work with smaller children; what other things would work with the older child that isn't quite as reinforced using paper chains?  

 

Re: When to fade this reinforcement?

From: Vanessa Sacchi
Date: 13 Oct 2009

I have used the paper chain activity with kids up to the third grade with positive response. For older kids, I like to take the angle of "celebrating their growth". Especially for kids that are entering middle school. Celebrating that this this a new beginning, with new people, new teachers, and new expectations. That they are getting older, and more responsible is a great thing, and that the parent believes that they can handle all of the new challenges that will come their way during this new school year. Additionally, it provides the parents with repeated opportunities to tell their child that they are always there to talk to... because pre-teens and teens new to hear that a lot!

 

Paper Chains

From: Amber Martin
Date: 10 Oct 2009
 

Comments

I really enjoy your idea and love how visual it is. In my fluency disorders class we discussed how parents should model the gentle, easy natural speech for their children. We also discussed how hard this is to accomplish in our fast paced lives. Often a solution to this was to set aside a certain amount of time to use that model of speech. This activity is a great way to do this as well as discuss and validate any thoughts and feelings they may have. I was actually just wondering, did you have a range of ages in mind for this activity?

 

Re: Paper Chains

From: Vanessa Sacchi
Date: 13 Oct 2009
I use this activity for pre-K to third grade mostly, and their are some variations that you can do up to fifth grade. I also encourage parents to do easy talk with their children in the morning, because the mornings are inherently stressful... multi-tasking, and rushing about.

 

Paper Chains

From: Monica (MSU)
Date: 10 Oct 2009

Comments

What an excellent idea! This is such a great way to spark communication between a child who stutters and a parent or family member. It is so great because the emotional side of stuttering is so huge so having this opportunity to express themselves could be extremely beneficial. You talk about starting this chain 2 weeks before the event occurs (i.e. school starting). What kind of other events have you seen clients use this chain for? Thank you for sharing this with us!

 

Re: Paper Chains

From: Vanessa Sacchi
Date: 13 Oct 2009
Depending on the event, like moving to a new house, we would do the paper chain at least a week or two before the move and a week or so after the move. This is important because feelings can develop while the child gets used to their new surroundings. I have also used this activity for vacations to Disney World. Other scenarios have included: Traveling to see a sick family member- where the person they are visiting was going to look different (as a result of chemo) than the last time that they saw that person. Another time that I used this activity was when Mom and Dad were going out of the country, and Grandma and Grandpa were going to stay with the child. In that case the grandparents were thrilled with the activity because they learned so much about their Grandchild in a matter of two weeks, and never did the child ask, "when are Mom and Dad coming home" because they counted the rings until they came back each night before bed.

 

Chain as visual/tangible coping tool

From: Jen S.
Date: 12 Oct 2009

Comments

I am a graduate student who just found out about ISAD this semester. I really like the idea of the paper chain as a therapy tool for open communication and confidence building. I can imagine how beneficial it would be for a child to have something tangible that provides a visual support leading up to an anticipated event. It seems like an effective and easy way to prompt the types of conversations that provide children with strategies helpful for preparing for big events.

 

Paper Chains

From: Dave Williams
Date: 14 Oct 2009

Comments

Another good clinical technique in the therapist's armamentarium! This should be a useful procedure for lessening the young stutterer's anxiety about a prospective change in the child's environment or in the 'significant others' with whom he interacts. Good article!

 

Paper Chains let go of strains

From: Ruthann, San Gabriel, Ca-USA
Date: 18 Oct 2009

Comments

Dear Vanessa: This is a great bonding project for home and well as school. Seems with the older middle school students, this could incorporate changing emotions regarding social issues and the likes. There is lots of opportunity to learn and grow here. Thanks!

 

Simple but effective idea

From: Lori Garscia
Date: 19 Oct 2009
 

Comments

Hi Vanessa. I really think that using paper chains as a tool for fluency could be very effective, yet so simple. I like how it does two things at once with helping to ease stress about the upcoming event and also promote the easy talk technique, not to mention the quality time it supplies for the parent and child as many posts have mentioned. I would think that modeling other techniques could be incorporated as well. Perhaps  audio taping these talks be beneficial to the therapist for future sessions. The therapist could possibly do a follow up after the event takes place and explore the childŐs current feelings about what occurred.

 

I'm adding it to my resources!

From: Kathy Sexton
Date: 21 Oct 2009
 

Comments

One of the reasons I like this idea so much is because it provides a tangible reminder for a child, of the time they will have to share their feelings with a loved one each night. I also think that allowing the child to choose the colors, create the chain, and then voluntarily dismantle it, would give them a greater feeling of control over the way they will deal with the upcoming event. This would be a nice activity for any child, whether they stutter or not, to help them through significant transitions. I will definitely be adding this to my resources!

 

Paper Chains

From: Jaime
Date: 22 Oct 2009

Comments

I think this idea of making a paper chain prior to major events is a great twist on simple count downs or schedules. This could be used in various situations with many different types of clients. I really liked this concept.