|About the presenter: Diane C. Games, M.A. is a licensed and certified Speech-Language Pathologist and co-owner of Tri-County Speech Associates, Inc. a private practice in the Cincinnati area. She is a Board Recognized Specialist in Fluency Disorders and part of the Initial Cadre of fluency specialists. Professional activities have included the presidency of the Ohio Speech-Language-Hearing Association and honors of OSLHA in 1994. She also teaches a graduate level course in Fluency and Fluency Disorders at Miami University. She has presented several workshops on the treatment of fluency disorders and has coordinated the Fluency Friday Plus project in the Cincinnati area for the last ten years.|
David Shapiro, in his book "Stuttering Intervention," discusses the following factors that need to be considered when working with adolescents, adults, and senior adults who stutter: 1) "teens & adults have been stuttering for a long time...many for a number of years". In addition, 2) "the age of the stuttering is thought to be a more significant prognostic factor than age of the person who stutters." Furthermore, 3) "the stuttering behaviors, thoughts and feelings tend to increase in complexity the longer one stutters". Treatment approaches for this population must deal with behaviors, beliefs and thoughts that have developed over a long period of time. Activities for this population must also address long-standing emotions and thoughts about communication. The clinician somehow must find ways to approach these complex and long-standing responses to stuttering.
Recently, one of my friends emailed a PowerPoint presentation by George Carlin called "Philosophy for Old Age!" To be honest, I almost deleted it! However, the messages Carlin conveyed about life and aging were applicable to some of the ideas included in this paper. Here is part of his message delivered in synopsis form:
1) Pat's Reactions to Giving a Speech. At the time of treatment, Pat was a college student who had stuttered mildly for several years. He had no treatment prior to entering college. He had managed his stuttering by changing words or avoiding speaking situations. In college, he had to take the dreaded "public speaking" class as part of a graduation requirement. This class prompted him to seek treatment. In preparing for a speech, I videotaped Pat. The attached handout was developed from Pat's initial comments while watching the video. Most were negative. In treatment, he altered these statements into positive comments. Pat (on his own) talked to his professor about his stuttering. She also set up practice sessions with him and provided support to help him improve his public speaking skills. I use this worksheet with other teens/adults using Pat's comments as starting point for discussion.
2) Strategies to Deal with Stress. This handout review concepts related to breathing and body tension. Body positions and postures that promote a relaxed stance are reviewed. In addition, breathing techniques are reviewed.
3) Fearlessness. This handout begins with a quote on "Fearlessness" (O magazine, April 2007). The client lists personal strengths and then moves to the emotional and cognitive aspects of stuttering. Again this is a worksheet of self-discovery. I have listed a few, sample responses from a client.
4) The Inner Games of Tennis (Gallwey) This handout was formulated from a chapter in Gallwey's book that I have used in treatment (and for my tennis game) for several years. Gallwey links the mental/emotional side of performance to the physical aspect. This worksheet summarizes Gallwey's concept and has been adapted for use with teens and adults who stutter.
5) Which Skills should You Develop? This handout focuses on developing positive thinking by going through a process of analyzing accomplished skills and potential skills to develop. The client then relates these skills to positive thinking and activities to acquire new skills.
Gallwey, W. Timothy, (1974), The Inner Game of Tennis, New York, Bantam Books.
Jensen, Eric, (2006), Enriching the Brain. Jasey-Bass.
Shapiro, D. A., (1999), Stuttering Intervention: Collaborative Journey to Fluency Freedom. Austin, Tx. Pro-Ed.