Email adresses From: email@example.com Date: 10/4/99 Time: 1:32:53 PM Remote Name: 126.96.36.199 Comments Darrell, louise and Lucy can I get your E-mail addresses please? Send it to my address not to this article avoiding prejudice From: Lieven Grommen - Belgium Date: 10/4/99 Time: 1:44:48 PM Remote Name: 188.8.131.52 Comments How can an SLP-PWS avoid prejudice in treatment of other PWS? Re: avoiding prejudice From: Gert Reunes Date: 10/4/99 Time: 4:23:50 PM Remote Name: 184.108.40.206 Comments Strange I think something went wrong here. I think that Lucy and I have given our answer yesterday, but now it is gone... So my personal view is that it is better that a stutterer becomes a speech therapist than that he gives therapie with no university background. Then at that point he will learn more about himself and his problem and together with the experiences he has got he will be a more better therapist than persons who had not this problem. Re: avoiding prejudice From: Darrell Dodge Date: 10/5/99 Time: 1:16:23 AM Remote Name: 220.127.116.11 Comments Hi Lieven: Thanks for your very pertinent question. I agree with Gert that the discipline of speech-language studies and clinical practica is essential to avoid confusing the symptoms, stuttering loci, needs, prognosis, and beneficial treatment techniques, etc. of other people who stutter with one's own. In fact, this has been one of my pet peeves about the amateur "speech therapists" who often provide unsolicited advice on the Internet and that has motivated me to be alert for that tendency in myself. I would extend that also to the therapy "programs" that provide a canned approach for every client. Projecting my own reactions and stuttering characteristics onto others could lead to some very frustrating experiences for the client and for me. For example, if I focused a client's attention on high jaw tension and limited jaw mobility (two of my own characteristics) and the client's loci of tension are actually more in the neck and upper chest area, then a lot of the modification work we do is not going to be as beneficial as it could be. A very real example of this is my attitude toward using voluntary bounces in therapy. Because they never helped me very much, I began my practica with a prejudice against using them. But one supervisor in particular was very influential in getting me to see how useful they can be for some people. In some young children, I've seen slow easy bounces literally seem to "melt" laryngeal blocks after a few weeks. While in others, they are absolutely the worst thing you can use. How does one avoid prejudice? It starts with developing an ability to observe and listen (which all of us can always be better at) and is enhanced by exposure to many kinds of stuttering and many different people who stutter. It is essential to attempt to understand the particular characteristics of one's own stuttering as much as possible and to continually be alert for differences in others. This activity in itself can be very beneficial in the assessment and diagnosis of stuttering. Despite the many differences, I think there are some broad similarities across the population of people who stutter, and that PWS can be more genuine in their empathy for other PWS. For example, statements like "even I sometimes stutter" made by fluent therapists who have only experienced occasional disfluency always ring false to me because that is usually very different than stuttering. On the other hand, if I try to convince a client who has no difficulty with phone calls that he "really does," then I am not going to have much credibility either. There is also a "gut feeling" that I have when someone is really stuttering -- even though the external manifestation is very fleeting and may not be noticed by others. But I suspect that nonstuttering therapists can also develop this sense if they are observant and empathetic. The most damaging prejudice, of course, would be judging the progress in recovery of a client by comparison with oneself, and measuring or judging motivation only through progress in fluency, technique acquisition, or ability to confront or accept stuttering. This would be similar to the prejudice of many fluent people that stutterers are just not trying hard enough to control their speech. But my own tendency here has been to be too accepting at times, perhaps due to the difficulties I had making progress in the past. That is yet another kind of prejudice that requires awareness, clear sight, introspection, and modification. For a more extensive discussion of this essential topic for PWS becoming SLP's, I'd direct you to Bob Quesal's Web site, which is listed on the Stuttering Home page. Perhaps the other participants here will hae some comments as well. Regards, - Darrell Dodge Re: avoiding prejudice From: Lou Heite Date: 10/6/99 Time: 8:34:57 PM Remote Name: 18.104.22.168 Comments Hi, Lieven. Can you be a little more specific in your question? By what do you mean "prejudice?" I can think of several ways to interpret that. Lou Heite Re: avoiding prejudice From: Lieven Grommen Date: 10/8/99 Time: 9:10:22 AM Remote Name: 22.214.171.124 Comments Hi Lou. Sorry for the brief question, but I've been too busy these days and have asked too much from my forces. I intended questioning how your own stuttering influences the way you look at other PWS. First emotionally. Secondly in understanding the specificity of each PWS. There is another article about diversity in stuttering syndrome on the conference... I am sure you already dealt with all these questions from what I've read in your postings on Stutt-L. Sincerely... Re: avoiding prejudice From: Lou Heite Date: 10/10/99 Time: 7:03:27 PM Remote Name: 126.96.36.199 Comments Hi, Lieven. Apologies for my tardy response, but I'm busy too. Too busy! Better busy than bored, though. > I intended questioning how your own stuttering influences the way you look at other PWS. First >emotionally. Secondly in understanding the specificity of each PWS. Ah. First of all, I feel very comfortable about my own stuttering, which is negigible nine days out of ten; and the tenth day it is just a nuisance. I am not afraid of stuttering. Many people are, and that includes speech clinicians who have not spent a lot of time around it. I know very well that stutterers don't break. I have great respect for most stutterers, because even the most distressed have engaged in daily small heroics for a large part of their lives. The initial advantage that comes from knowing stuttering "from the inside" is an initial advantage only. It allows you to share the insider's handshake with the client, but beyond that, you'd better concentrate on the client's situation and not your own. Your own experience can, and should, inform the client-clinician relationship but it should not govern therapeutic judgment. Where there is a real correspondence of experiences it is OK to touch on that correspondence, but I think it would not only be inefficient but somewhat insulting to the client for the clinician to champion his or her own solution to the problem. That is a good way to set the client up for failure and guilt . "After all, the solution worked for my clinician, so what am I doing wrong?" You'll get farther faster by asking the client how he or she thinks they ought to handle the circumstance, and by offering a range of possible approaches. Your own personal one might, or might not, be among the choices depending on the client's needs and situation. In short, I believe that one must divest oneself as much of possible of prejudices and expectations based on one's own experience with stuttering. Every client is a person who has a unique history and a unique constellation of strengths and problems. My job as clinician is to observe the person, understand the problem, and build on the strengths. It's not easy to maintain this kind of objectivity. I have the advantage of having been a classroom teacher for a long time, at every level from first grade through lower-level university (Gymnasium level in Europe). Over the years I have learned that one cannot make assumptions about how any individual is going to react to any particular learning situation. Nothing surprises me. This classroom skill that carries very well into the therapy room. It occurs to me that the obverse of this question is whether someone who does not stutter can understand stuttering well enough to treat stutterers. That is just as much an assumption of prejudice as expecting the experience of stuttering to give one a leg up in designing therapy. Although our fluent colleagues don't know the secret handshake, they can also observe, understand, and build. Some do that very well. Lou Re: avoiding prejudice From: Lucy Reed Date: 10/11/99 Time: 9:25:39 PM Remote Name: 188.8.131.52 Comments Hi Lieven, Yes, I did reply to this last week, however the message was lost due to a computer problem. The issue of imposing what helped me on my clients is something I am conscious of. Fortunately, my professor at Temple Univ. teaches us to approach therapy by asking the client to describe what he or she feels, physically as well as emotionally, during the moment of stuttering. Because every person who stutters is different, an individualized approach must be taken for each client. The client is the only one who can guide the clinician to the appropriate course of treatment because only they can tell us what they experience when they stutter. Changing Careers From: Candy Smith Date: 10/5/99 Time: 6:59:32 AM Remote Name: 184.108.40.206 Comments To those of you who stutter and have now changed careers to become speech-language pathologists, do you feel that your stuttering inhibits the therapy progress for your clients? When a client sees that you as their clinician has not been "cured" of stuttering, does this discourage them or inhibit therapy in any way? Re: Changing Careers From: Gert Reunes Date: 10/5/99 Time: 1:59:24 PM Remote Name: 220.127.116.11 Comments Hello, My stuttering in therapy rooms is nihil. So I can say that I am fluent when I want to be fluent. The persons who I met in the selfhelp groups find my attitude a good example for their own progress. They see someone who GOES FOR IT. They need to have good examples to build there own progress. Often I stutter for fun so they can see how it was of is in other situations with me. To be an example is not so easy because you have to deal with a lot of good questions about your own struggles you have had. The contact with parents is mostly extreem possitive because they see that you can be anything if you go for it. I think also that there has to be a changing in attitudes concerning to 'cure' stuttering. About 50% a 90% has a fall back when they follow therapy. So you have to be honest with your future clients that changing your fluency is a war you have to fight for. We only can be an example and give some hints to do. If you want to change yourself you have to be prepared for the worse. Do not expect any help of others but you can rely on a 'therapist who has been there...'and who understands your feelings!!! Re: Changing Careers From: Lucy Reed Date: 10/11/99 Time: 9:15:29 PM Remote Name: 18.104.22.168 Comments To answer to the question "When a client sees that you as their clinician has not been "cured" of stuttering, does this discourage them or inhibit therapy in any way?" , I would say than on the contrary, my clients have been empowered by me because they see how it is possible to lead normal, successful lives without being "cured of stuttering". The most valuable thing I can show my clients is that 'chasing the fluency god' is counterproductive to recovery from stuttering. People who stutter as therapists From: firstname.lastname@example.org (Allison King) Date: 10/6/99 Time: 10:39:51 AM Remote Name: 22.214.171.124 Comments This is in response to Gert Reunes article discussing the benefits of a stutterer as a speech therapist. Personally, I have to agree that a stutterer has the best insight to give a patient who stutters. In my opinion, someone who does not stutter will never be able to truly identify with their client who stutters, no matter how many articles they read or conferences they attend. However, I have a feeling that some clients might feel discouraged when they learn that their therapist stutters as well. My question is, is this a true assumption? And if so, how do you handle this possible discouragement, and reassure them that they will get effective therapy, if not better therapy. I think parents of stutterers especially might have a problem with their child's clinician stuttering. How do you account for this problem? Allison King Re: People who stutter as therapists From: email@example.com Date: 10/6/99 Time: 12:55:28 PM Remote Name: 126.96.36.199 Comments Hi, Thank you for the support and believing in the power of therapist-stutterers. When you have adult stutterers you have to be honest of the prognosis. The prognosis isn't real good for them BUT (and here you have to be an example) if you can show them how they have to act and what efforts it has cost you for achieving more fluency then they can also change in more fluent speaking. The efforts are heavy the commitments you have to make are also very hard but if you can let them into your world, your war and your personality-changing they can also proffits of this occasion. Parents of young children are therapy shoppers, they are willing ONE THING MAKE MY KID FLUENT. After they have shopped a long way and they become frustrated the therapist has to work on the acceptance of the child that stutters. And then you can make progress with the kid and his parents. Progress can be a simple thing, e.g. that the parent do not say things instead of the kid etc etc Some parents find it very good thar you are so honest and when you can do your story they will find you a real example. I can understand that there are parents who are searching for a 100% solution for their child, and then it is a difficult battle to confince the parents that this way of thinking effects negative on the child instead of have good results. When you are a stutterer-therapist SLP you have the guts and the power to tell the parents what it is to be a stutterer. They will listen to you, and one day they will reach out to you IF anyn other therapy has failed. Best regards gert Re: People who stutter as therapists From: Walt Manning Date: 10/7/99 Time: 11:40:26 AM Remote Name: 188.8.131.52 Comments Hello all- One advantage (maybe the biggest) of being a PWS who is also a clinician is that we KNOW about the culture of stuttering. We understand what if feels like to be out of control and helpless during the stuttering moment. We know what it means to get "the look" from our listeners and we know first hand, the fear that leads to avoidance and word substitution and escape behaviors in geneal. We are often a little wiser than those that are not brothers and sisters of the tangled tongue (As Dr. Van used to say). I suspect that it's a lot like having a therapist for drug & alcohol rehabilitation who has also been there, it's much more difficult to fool such people. On the other hand, as some have already pointed out on this list, there is a tendency to see all stuttering and people who do it through the filter of our our own experience. Finally, although it can be an inspiration to clients if you are a fluent PWS, it can sometimes lead to questions such as "What was your method?" or "What is your secret of success?" People don't always want to hear about the complexities of therapy and the associated practice and persistence over a long time. Re: People who stutter as therapists From: Lucy Reed Date: 10/11/99 Time: 9:08:19 PM Remote Name: 184.108.40.206 Comments In my limited experience treating clients who stutter, it has been my experience that my clients feel very comfortable with me and welcome having a clinician who also stutters. I think the thing I've been most helpful in has been in helping them feel better about stuttering, which helps them to be less avoidant, which is a big part of recovery. peer/professional and client relationship From: michael sugarman Date: 10/9/99 Time: 6:50:18 AM Remote Name: 220.127.116.11 Comments In the 8th grade I went to the school slp for my stuttering. The slp stuttered. I left the room immediately. I thought,do i speak like that. I work at the county hiv/aids clinic as a social worker. A couple of years ago attended a workshop for mental health practitioners "Professional and Client Relationship". One of the presenters talked about his experience as a peer/professional. He indicated once identified by his client as a gay psychologist. The dynamics in therapy changed-clients did not disclose life experiences and used phrases such as "you know how i feel" or "you've been there". He further stated, he learned not to self-identify his peer status with a client. (He was booooed by the participants at the workshop). Consumers who become professionals may have insight into the experiences of the client. However, has there been objective studies on the client and peer/professional therepuetic relationship? kindly, michael Re: peer/professional and client relationship From: Darrell Dodge Date: 10/9/99 Time: 1:40:06 PM Remote Name: 18.104.22.168 Comments Hi Michael! Great to hear from you. And thanks for your part in helping to inspire this online conference. With regard to your question, I think the response of the client to peers (PWS) would probably vary with the client and with the specific relationship between client and therapist, just like everything else does. In my brief period as a therapist, I've already had client-peers make very important, difficult, and detailed disclosures about their experiences that have helped them move forward in therapy. Perhaps others may not want to do this, but I wonder if the need to disclose and discuss is strong enough to overcome any assumption that the therapist already "knows." I know the sense of total acceptance I felt walking into my PWS therapist's office was incredibly restorative. Not that a non-PWS can't create this holding environment too. At any rate, this is the counseling and spiritual aspect of therapy, and though it's seamlesslessly interwoven with the speech modification aspects, of course (in fact, it cannot be otherwise) the speech aspects need to take precedence. In that area, seeing another person who stutters successfully demonstrate fluency techniques is a powerful motivator for most people and -- in this area-- can be worth all the counseling one could ever do. Again, I suspect there may be different reactions, but I've found this to be true of clients I've worked with. I suspect that reactions to stuttering PWS such as you had in 8th grade (and which might have been my reaction too, BTW) might just be indicating that the person is not ready to make the commitment to therapy. Beyond a certain age, that requires a loss of hope in miracles. Of course, once you've lost hope and plunge ahead into the abyss, that's where the miracles really begin. I think direct experience with this last understanding is just one of the things that stuttering SLPs can bring to the therapy process. Thanks for your comments. I hope this response was pertinent to them. Warmly, Darrell Dodge Changing Career Paths From: Jeff Shames Date: 10/10/99 Time: 10:08:49 PM Remote Name: 22.214.171.124 Comments What a touching paper, Lucy Reed! I have known you for several years, but have spoken with you about mainly about stuttering and personal issues. I knew only the barest details about your previous professional life. Thank you for telling us your story. One of the best parts of being involved in the stuttering self help world has been the wonderful people I have come into contact with. I value knowing you, Lucy, and feel even more so now, in knowing even more details about your journey. Re: Changing Career Paths From: Lucy Reed (For Jeff Shames) Date: 10/11/99 Time: 8:26:20 PM Remote Name: 126.96.36.199 Comments Thank you, Jeff Shames;-) You were one of the first people I came into contact with in the stuttering community. I want you to know that you've inspired me more than I can say by showing me that it's ok to stutter and that people who stutter can be effective communicators. My recovery has been paved with the friendship and inspiration of people like you. Cure you own stuttering? (for Lucy) From: Russ Hicks Date: 10/11/99 Time: 5:04:16 PM Remote Name: 188.8.131.52 Comments Hi Lucy, Great paper! Very honest and open. I really enjoyed it! One item in particular that caught my eye was your comment: "É I thought that by studying speech pathology I'd learn all the secrets about stuttering that SLPs know and would be able to be cured of stuttering." Ah ha! I'd always suspected that, and yours was the first time that I'd ever heard anyone admit it. On the surface that sounds so obvious. Doctor, heal thyself! Of course if you knew all there was to know, the cure would be easy. But by admitting that, you came face to face with the reality of life - and there ain't no cure! And that's SUCH an important thing for people who stutter to know! And coming from another person who stutters has SO much more impact than coming from a fluent person who has only intellectual knowledge of stuttering. I've thought so often that people who stutter have a HUGE head start on the rest of the field. But they need to be able to SHARE that knowledge and experience, not to simply use it for their own benefit. Sounds like you made a terrrrrific choice! Great paper, Lucy! I hope more people read it! Best regards, Russ Re: Cure you own stuttering? (for Lucy) From: Lucy Reed (For Russ Hicks) Date: 10/11/99 Time: 8:43:57 PM Remote Name: 184.108.40.206 Comments Hi Russ! The realization that there is no "cure" for stuttering, but lots of effective ways in which to reduce the impact of stuttering on my life has been the most important lesson I've learned. The realization that 'it's ok to stutter' was without a doubt the turning point in my recovery, because I had spent almost 40 years fruitlessly trying to supress stuttering, in a misguided attempt to do what I thought I was supposed to do. You are one of the people who have shown me that a person can achieve just about anything they want in life and stutter while doing it. Lucy:-) Helpful Advice From: Cheri Smith Date: 10/11/99 Time: 7:35:34 PM Remote Name: 220.127.116.11 Comments Hi! I really enjoyed all of the papers. It was interesting to hear someone who "has been on both sides of the fence". Your stories were really beneficial because they provide insight into how a person who stutters feels not only about stuttering but also about therapy. I was wondering if there were any specific techniques that you found helpful when you were in therapy? Thanks, Cheri Smith Re: Helpful Advice From: Lucy Reed Date: 10/11/99 Time: 8:52:02 PM Remote Name: 18.104.22.168 Comments Hi Cheri, Without a doubt, the technique that has been most beneficial to me has been voluntary stuttering. This has helped me lose the fear and shame that had me held me back from doing what I wanted in life. It also enabled me to change the way I stutter by allowing me to reduce struggle and tension in my speech. The fluency shaping techniques I had learned earlier left me feeling helpless when they didn't work. Stuttering modification helped me to gain voluntary control. Lucy Re: Helpful Advice From: firstname.lastname@example.org Date: 10/12/99 Time: 12:50:32 PM Remote Name: 22.214.171.124 Comments Hello Cheri, I was very much helped with: 1) motivation (started when I was 32 years old) 2)an intensive therapy methode ( 2 following weekends) 3) the book positive thinking from Norman Vincent Peale. 4) being straight with myself 5) going to congresses of stuttering 6) reading books about stuttering 7) the thougt that I have to LOVE myself and not to HATE myself... Those 'simple' things can do a lot. best regards Gert Re: Helpful Advice From: email@example.com Date: 10/15/99 Time: 5:10:45 PM Remote Name: 126.96.36.199 Comments Sorry I can't answer this one. I never got sent to therapy. I came from a classic "hippopotamus in the living room" family. Since I became a masterful avoider before third grade, there was no reason to do something. I know that has had an effect on the way I approach the disorder, and its treatment. LH therapy From: Salena Date: 10/11/99 Time: 8:11:51 PM Remote Name: 188.8.131.52 Comments I am curious how many of you were asked to go into therapy for your stuttering before you entered, or while you were in, your graduate programs? What do you think about being asked to do so? Re: therapy From: Lucy Reed Date: 10/11/99 Time: 8:59:33 PM Remote Name: 184.108.40.206 Comments Hi Salena, I was never asked to seek therapy, either before or after being admitted to my program. Personally, I don't think students should be asked to do so, because except in certain extreme cases, I don't believe an SLPs speech fluency has to much bearing on his or her ability to administer speech therapy effectively. People can stutter and still be effective communicators. Lucy Re: therapy From: firstname.lastname@example.org Date: 10/12/99 Time: 12:57:58 PM Remote Name: 220.127.116.11 Comments Hello Salena, There were schools that didn't accept me when I wanted me to subscribe me... So I went to the university. Some SLP find it very strange and not good that a PWS will become a SLP... In Belgium I am the first who will have an SLP degree (university). Some ask me to be fluent when I do practice. I find it unbelievable to ask someone to follow thyerapy because only the brave stutterers will go for it and have the good guts and attitudes to be a professional with a good basis!!! So, we have to open our horizon and see that it is a good thing (also for research projects) that stutterers may learn about stuttering from the books. Best regards gert Re: therapy From: Darrell Dodge Date: 10/12/99 Time: 11:28:26 PM Remote Name: 18.104.22.168 Comments Hi Salena: I was not asked to go into therapy. However, a year before I entered grad school I had completed private therapy, which involved learning how to be my own therapist. And I was given the opportunity during my make-up (or "leveling") year to participate as a client in an adult therapy group (for people who had completed individual therapy) conducted by student clinicians, which I did. This was great experience for me because it provided a "half-way" place to 1) observe how the students were handling the challenge of providing therapy (they were really impressive), 2) think about therapy techniques and strategies and assess my own responses to and feelings about therapy activities while taking a graduate-level stuttering course, 3) work some more on desensitization and modification techniques in another setting, which is always valuable, 4) get used to the idea of being videotaped and observed through one-way mirrors and on TV monitors, which was not usually part of my private therapy. That's my personal experience in this area and it's been interesting reading the responses of my esteemed colleagues. From a more general perspective, I can't imagine how any person who stutters and who is training to be an SLP could not have had formal therapy at some point (unless his/her stuttering was *extremely* mild, he had successfully treated himself, or had a remarkable turn-around). I also can't imagine a stuttering therapist expecting stuttering clients to do something that he/she had not done, unless it was not really necessary for one of the previously cited reasons. None of this assumes, as I'm sure you understand, that an SLP who stutters won't still stutter. Thanks for the question. - Darrell Dodge Re: therapy From: Lou Heite Date: 10/13/99 Time: 9:32:38 PM Remote Name: 22.214.171.124 Comments No, I wasn't asked to enter therapy, either. I don't think that it would be appropriate to ask a student to do that. As one of my colleagues on this paper pointed out, the person who stutters who enters this field is probably self- contained enough that requiring therapy would be pointless. Fluency is not communication, and when it is turned on and off for someone else's purpose, it becomes little more than a parlor trick. LH. I wonder From: Ed Feuer Date: 10/13/99 Time: 2:53:40 AM Remote Name: 126.96.36.199 Comments A question for PWS who become SLPs: It seems to me that if one wanted to focus primarily on stuttering, a better way would be to get training in clinical psychology and then take specific fluency courses in stuttering at a communications disorders department (assuming one could find a department that would cooperate.) To go the SLP route, one must absorb such things as aphasia, voice problems, infant communication, cleft palate, cerebral palsy, articulation problems, language delay, autism, swallowing disorders, etc. These are serious problems in themselves but are far removed from stuttering. The "party line" turf-protection answer is that some clients present with stuttering and these other disorders. But such multi-disorder clients could be sent to a traditional SLP. Is a more satisfactory answer available? Ñ Ed Feuer email@example.com Re: I wonder From: Gert Date: 10/13/99 Time: 12:25:10 PM Remote Name: 188.8.131.52 Comments Hello Ed, Following a SLP program in Belgium was a better choice because 99% of the clients who stutter go first to a SLP not to a psychologist. So, if they look in the golden pages you will hardly get a client who stutters. Also when you follow the slp program you get more info on stuttering then when you do first psychologist. Psychology + stutttering program takes 5 + 2 = 7 years study. SLP 'only' 4. Some people also have pushed me to a degree of psychologist, but then I proove that I am affraid for the slp program...and I'm not!!! best regards gert Re: I wonder From: Darrell Dodge Date: 10/14/99 Time: 1:33:44 AM Remote Name: 184.108.40.206 Comments Hi Ed: If you'll remember, I addressed this topic in a lengthy article last year on this conference because it was something that concerned me as well. I concluded and still conclude that it is vital for the stuttering therapist to have an in-depth understanding of the entire field of speech language pathology, if only to avoid confusing stuttering behaviors and etiology with other disorders. In fact, I think that the stuttering therapist needs to take MORE speech courses than any other specialist -- including courses relevant to the full range of ages: birth to adult. Stuttering is primarily a speech problem because therapy requires addressing and working through the modality of speech. I have discussed stuttering with clinical psychologists and neuropsychologists who taught my psychology courses (which were all extremely worthwhile.) They all felt helpless to even discuss stuttering because they didn't understand the clinical issues associated with other speech disorders. There is NOT a turf problem here. Clinical psychologists are often (usually?) terrified of stuttering clients, just as many SLP's are. I totally reject the notion that you seem to have that stuttering therapists who are PWS should restrict their activities to people who stutter. We need to be competent in all areas because we need to know when to refer and when not to refer and when to involve clinicians with specific expertise in other areas (such as articulation or psychology or voice) in the therapy team. Personally, I am very interested in communication problems related to sensory integration disorder and developmental apraxia of speech and am finding working with children with these challenges very rewarding. In fact, now that I think of it, I wonder about your assumption that SLP's who stutter are only interested or competent in treating stuttering. - Darrell Dodge changing career paths From: Cassandra Kearson Crear Date: 10/14/99 Time: 2:41:33 PM Remote Name: 220.127.116.11 Comments I'm a graduate student at Southern University persuing my Master's Degree in Speech Pathology. I'm currently enrolled in a Dysfluency course. I find it to be one of the most informative courses I've taken. I learn back in undergrad that there was no cure for stuttering and the cause is very broad. There is still so much I feel I can learn about stuttering. My question to you is What questions did you ask you Speech therapist that she could not answer? I'm sure we all will be face with a question we can't answer right away that why we referr back to our texts. I would like to challenge myself and see if I could answer those same questions. If not I would love to research and find the anwsers. Good luck in your new career and hope you enjoy becoming an SLP. P.S. How is your sons attitude about his stuttering? I wonder From: Ed Feuer Date: 10/16/99 Time: 5:20:10 PM Remote Name: 18.104.22.168 Comments You say: "There is NOT a turf problem here. Clinical psychologists are often (usually?) terrified of stuttering clients, just as many SLP's are." It's hard to see how it wouldn't end up as turf question. Let's say he or she (perhaps a PWS) weren't "terrified"? What if that clinical psychologist were able to take specific fluency courses on stuttering at a communications disorders department? Can you deny that such a person would be better equipped to treat stuttering than the common garden variety SLP? Rather than being terrified of treating stuttering clients such a person would be rarin' to go. He or she would be able to make better use of the works of Van Riper, whom I believe was also a clinical psychologist. Ed Feuer firstname.lastname@example.org Re: I wonder From: Darrell Dodge Date: 10/17/99 Time: 2:40:47 PM Remote Name: 22.214.171.124 Comments Ed: It was my point than no one can understand stuttering and be competent to treat it unless they understand the full range of speech and communication disorders. There are simply too many things that can go wrong in treatment if the therapist starts mucking around with speech modifications he/she doesn't understand. And there are too many varieties or sub-types of stuttering (including stuttering in the presence of various co-occurring conditions) to get everything from a stuttering course or two. If a clinical psychologist wanted to quit his/her job and get an MA in speech pathology (which would take 3 years), then he would be an SLP and possibly a better stuttering therapist than many others (assuming he is a good clinical psychologist and could revise his previous -- probably erroneous -- assumptions about stuttering.) I used to think myself that there was a possible turf issue. And you will sometimes hear experienced SLPs speculate about this question. But SLPs sometimes don't realize how much they know, and how much clinical psychologists don't know, about speech. Of course Van Riper was a clinical psychologist. In his day there wasn't such a thing as a "speech-language pathologist." He was also knowledgeable of the diagnosis and treatment of the entire range of speech and communication disorders. - Darrell Dodge Re: I wonder From: Bob Quesal Date: 10/22/99 Time: 4:29:01 PM Remote Name: 126.96.36.199 Comments Van Riper wasn't a clinical psychologist. At the time he got his Ph.D. at the U of Iowa, the program was housed in the psychology department. So, folks like Van Riper, Johnson, and even Dean Williams got their degrees in "psychology" even though they were trained to be speech pathologists. BQ Louise Heite From: Gay Camagong Date: 10/17/99 Time: 3:32:52 PM Remote Name: 188.8.131.52 Comments I enjoyed reading your article. I imagine that must have been a struggle for you growing up with having little therapy. But, I am glad to hear that you realized you can help other people who stutter because you have been where they are. I think you will be a great model for the clients you work with since you can relate to each other. Re: Louise Heite From: email@example.com Date: 10/19/99 Time: 10:33:03 PM Remote Name: 184.108.40.206 Comments Gay: Thanks for the kind words. I hope I can use my own experience to reach others, but I don't want to overvalue it. To tell the truth, as a kid I was pretty proud of myself for burying something that I was quite sure would be a soure of pure shame and dishonor for me and all associated with me. I don't know that I suffered superficially, but I do know that some of the things I did to bury the stuttering were very harmful in the long run. It was a false security that crumbled rather easily, and left me defenseless often. That is not good. I don't think I really began to truly accommodate the stutter until I was quite grown. LH. Louise Heite From: Johanna Wallace Date: 10/17/99 Time: 3:41:25 PM Remote Name: 220.127.116.11 Comments I found your article to be very informative. As a graduate student, studying to be an SLP, it is always good to hear an experience like yours. Your determinism is a great encouragement. It's amazing to hear that you were able to go through most of your life interiorizing your stuttering. But I am glad that you decided to deal with it and help others with it. Re: Louise Heite From: firstname.lastname@example.org Date: 10/19/99 Time: 10:27:54 PM Remote Name: 18.104.22.168 Comments Joanna: A lot of people carry around a burden of covert stuttering for years. I consider myself fortunate to have found something that made me open up. A friend who is a severe stutterer once said that he would much rather stutter as he does than hide it most of the time, because the mild and covert stutterers he knew wasted so much energy trying not to stutter. I appreciate his sentiment, because it is dreadful to live under the threat of that much self-directed judgmentalism. When you get out in the working world, do remember to take the concerns of the less severe stutterers seriously. It's easy to forget that the seemingly collected surface might be hiding a problem that is far more disruptive to the speaker than it looks from outside. LH I wonder From: Ed Feuer Date: 10/18/99 Time: 3:03:51 PM Remote Name: 22.214.171.124 Comments Click twice on the BACK key on your browser and scroll down to Stuttering Research in the United Kingdom: Activities in the Psychology Department at University College London's Speech Laboratory. You will see there is indeed another way of doing things concerning stuttering and psychology. I have tried to encourage thinking outside the box. I've offered other concepts such as the coordinated multidisciplinary team and joint practicums involving grad students from speech language pathology, psychology and counselling sharing stuttering clients under the coordination of their liaising profs. But a sort of defensive zero-sum game mode often seems to appear in these arguments with SLPs. It's akin to arguing with devotees of any orthodoxy. There's a fear the whole structure could crumble if anything were conceded. My aim solely is to advance the treatment of stuttering. I have no vested interest in the status quo. Experience has shown that stuttering is too big for SLPs, alone. Ñ Ed Re: I wonder From: Darrell Dodge Date: 10/21/99 Time: 3:50:54 AM Remote Name: 126.96.36.199 Comments Ed: You say, regarding our discussion: "It's akin to arguing with devotees of any orthodoxy. There's a fear the whole structure could crumble if anything were conceded." This exactly describes the experience of discussing these things with you. You have your own box and your own orthodoxy of one. Your personal experience may indicate to you that stuttering is "too big" for SLPs. But that doesn't match the experience of many many other people. It certainly doesn't match mine. At our NSA chapter meeting tonight, we discussed our therapy experiences for the benefit of SLP students from a local graduate school. The most important ingredient of successful therapy cited by almost everyone was the feeling of personal acceptance that the SLP created, and which was systematically expanded to more and more activities in the treatment room, and increasingly, out into the world. Most of the SLP's discussed were not people who stutter. They were Masters-level SLP's who specialize in and have dedicated their lives to providing stuttering treatment. I feel priviledged to be entering the ranks of these people. Your well-meant, but pointless and even hurtful personal crusade, which corrupts all of the interactions you have with anyone (as I have seen for 5 years now), does not serve you well. It certainly doesn't help people who stutter because it seems calculated to deprive them of better access to competent services. Before you go off again about "teams," consider this: no one is denying that referral to a psychologist or (more likely) a personal growth counselor is not appropriate for many people in therapy, particularly during the tough transfer period. (Many people have given you this "consession," which you always reject.) But subjecting a person who stutters to a big "multidisciplinary team" at the beginning of therapy would not only deprive them of the important initial bonding experience with the therapist, but would also do two additional things: 1) take the responsibility for directing recovery out of the stutterer's (or parent's) control and vest it in the team, and 2) firmly identify the stuttering problem as a medical disorder or disease. Neither of these is desireable because the goal of therapy should be to enable the client to be his own therapist and the single-therapist approach is best for facilitating self-efficacy. Multidisciplinary teams are important for medical conditions like cleft palate and for the various syndromes and other conditions which may require medical management or intervention. They are simply not appropriate for problems like stuttering, which experience has shown can be handled most efficiently by one or two well-trained and experienced SLP therapist(s) with occasional targeted support from other specialists. Im glad you've participated here because your presence on the lists was one big argument I had against proceeding with my career change. I wondered about your concept of clinical psychologists treating stuttering but quickly found as I proceeded with my studies that it was simply not a useful idea. When I read the raw hatred in your responses (something about "SLPs driving stationwagons in the suburbs") and saw the corresponding bile in articles by SLPs who were reacting to your insults, it made me wonder if there were many people like you out there. Fortunately, I didn't let this stop me, because I find that you represent a very small minority. And a minority that seems to be shrinking more and more as time goes on. - Darrell Dodge Re: I wonder From: Ed Feuer Date: 10/22/99 Time: 6:23:34 PM Remote Name: 188.8.131.52 Comments I think the posting I'm responding to is a fine example an ad hominem attack. Meanwhile stuttering is by no means "fixed". The tongue-jockey, token therapy approach is bankrupt. To those too well invested in the status quo to see it, I say: "If the shoe fits, wear it." Ñ I see it is claimed that I call for subjecting a person who stutters to a big multidisciplinary team at the beginning of therapy. In fact I have always maintained those others with relevant expertise would only be brought in as required. Ñ Ed Feuer Changing Careers by Lucy Reed From: Kimberly Smith Date: 10/18/99 Time: 8:20:12 PM Remote Name: 184.108.40.206 Comments I would like to congratulate you on your new career. Do you feel,as a stutterer, you can resolve some of the hidden reasons why stuttering begins? I feel as a stutterer you have an advantage over the non-stuttering Speech-Language Pathologists. You have an inside view, while non-stuttering SLP's are relying on data and experiences in clinical sessions. Again, Congratulations and Be Encouraged, God will guide you through. Avoiding Prejudice From: Terisita Carter Date: 10/19/99 Time: 4:37:10 PM Remote Name: 220.127.116.11 Comments Hello Lou, I would like to comment on your response to avoiding prejudice. First of all, I would like to congratulate you on your success for learning to control your stuttering. I do believe that the key to overcoming stuttering is learning to control the stuttering. Most of all, you stated that you have become comfortable with your stuttering. I truly believe that the the first step to overcoming this problem is to become comfortable with who you are; a stutterer. Once you accept that, the journey to fluency becomes second nature. Re: Avoiding Prejudice From: email@example.com Date: 10/19/99 Time: 10:20:05 PM Remote Name: 18.104.22.168 Comments Thank you, Teresita. I'm not so sure I have overcome the stutter so much as made friends with it. And gotten older - the serenity that comes with age is not universal, but if you can achieve it, it is a real bonus. The thing is, although my stuttering is slight and unobtrusive most of the time, it is very much present. Chances are that people who don't know what to look for would miss it altogether. That's nice, but it also doesn't really matter in the long run. LH Changing Careers From: Terisita Carter Date: 10/19/99 Time: 5:16:30 PM Remote Name: 22.214.171.124 Comments Hello Gert, I admire your technique for approaching stuttering therapy; being honest with your clients as to the prognosis of therapy. I feel that stutterers as therapists can be advantageous. No one better than you can identify with your client. If your client has the opportunity to see you as a stutterer and then again see your progress, that alone would have a positive impact on their lives. LOUISE HEITE From: Daphne Richmond Date: 10/20/99 Time: 11:47:39 PM Remote Name: 126.96.36.199 Comments I enjoyed reading about your personal experiences of coping and dealing with stuttering, and I especially enjoyed your experiences teaching children who stutter. I am in Grad school and working toward becoming a SLP. I am currently taking a fluency class and my eyes have been opened wide to so many aspects of stuttering that I never knew existed. Throughout each class session I have learned the most about stuttering from the personal experiences of PWS. I look forward to the time when I will be able to work with PWS and find myself almost jealous that I don't have the level knowledge and experience that people such as yourself have. Thank you for sharing your story and adding to my increasing knowledge of stuttering. Re: LOUISE HEITE From: firstname.lastname@example.org Date: 10/21/99 Time: 6:50:43 AM Remote Name: 188.8.131.52 Comments Daphne: I am glad you have been able to learn from my words. I am sure you will make a fine clinician because you seem to be unafraid of stuttering. That is worth a lot. You wrote: "...I...find myself almost jealous that I don't have the level of knowledge and experience that people such as yourself have. Thank you for sharing your story and adding to my increasing knowledge of stuttering." Don't waste time being jealous! "Been there, done that" helps only a little, because each person who stutters is as unique as he or she can be. It is possible to tap into the sense of frustration and the self-consciousness through more indirect means. Everyone has some place where s/he is vulnerable. If you don't have the immediate experience of stuttering to build understanding on, you can use your own vulnerability to understand the psychological part of the disorder. And of course, you will listen to your clients. Even if they don't consciously know what they need, they ofte have ways of expressing it. You will come to recognize what is important to them, and learn to become their guide, not their rescuer, as they hack their way through the jungle of behaviors and beliefs that has grown up around their stuttering. LH PWS From: Cheyra Simms Date: 10/21/99 Time: 7:56:59 PM Remote Name: 184.108.40.206 Comments I would like to know how do other SLP's perceive PWS as SLP's? Also do SLP's who stutter only specialize in stuttering? Re: PWS From: email@example.com Date: 10/22/99 Time: 3:13:37 AM Remote Name: 220.127.116.11 Comments Hi, Thanks for the question... You make a good point at that. The most SLP I met are realy not so happy with my choice to study for SLP, because they find that you have to be a example for your clients...what ever it means. My goal is to do research on stuttering and to help stutterers, i have no intention to do other work, like dysfagie, afasia, alzheimer etc etc... but say never never in your life...;-) Best regards Gert Parent Reactions From: firstname.lastname@example.org Date: 10/21/99 Time: 9:36:34 PM Remote Name: 18.104.22.168 Comments Mr. Dodge, I was very impressed with your "passion" (for lack of a better word) for the profession. To leave your comfort zone to pursue a field in Speech-Language Pathology as a stutterer took guts. Do you find that parents are reluctant to bring their children to you for treatment because of your stuttering? Tanya Re: Parent Reactions From: Darrell Dodge Date: 10/22/99 Time: 2:35:27 AM Remote Name: 22.214.171.124 Comments Dear Tanya: Thanks for your question, which I'm sure is on the minds of many others as well. I am just interning right now, so the situation is not yet the same as an SLP acquiring new clients. But my stuttering has not been raised as a negative issue at all, maybe because of the educative influence of the (non-stuttering) therapists who run the clinic where I'm interning. Some parents brought their children to the clinic at my university because of the presence on the faculty of a therapist who stutters. And the supervisor of one of my school internships asked me to write a personal biography, discussing my stuttering, which was sent to the parents of most of the children I'm working with. In short, no parent has (to my knowledge) complained that I am a person who stutters. If this issue is ever brought up in a negative way, I expect I'll explain that some of the most effective therapists are people who stutter and that I received effective therapy from a PWS. If that fails, I'd give them an excerpt of an article by the PWS therapist Carl Dell, which would win over even the most adamant worrier. That's my experience so far. Again, I won't presume to speak for other PWS clinicians. Thanks again. - Darrell Dodge speech model From: email@example.com Date: 10/21/99 Time: 9:49:35 PM Remote Name: 126.96.36.199 Comments I am a Black female from Mississippi, and I grew up around people who didn't necessarily speak "standard" English. I am also a graduate student in Speech-Language Pathology. I sometimes feel an awesome pressure to be a good speech model, because it seems that is what is expected. Do you as stutterers in this field of study also feel the same pressures? Re: speech model From: firstname.lastname@example.org Date: 10/21/99 Time: 10:45:53 PM Remote Name: 188.8.131.52 Comments Tanya: I wouldn't presume to understand fully the pressure that educated Blacks must feel to model standard English. It must be terriffic, though. I don't feel a lot of pressure to model fluent speech, though that is also not much of a problem for me. It seems to me to be more important to model acceptance of and patience with stuttering, whether mine or someone else's. I am interested in your comment because I presently have a gentle, intelligent Black man as a cliet, whose concern about using standard English is one component of his stuttering. He probably puts more speech pressure on himself because of this concern than anyone else around him does. I'm not claiming that this concern is a direct cause of his stuttering, but it is part of the mix. Can you provide any insights I might use to lessen the burden for him? LH Re: speech model From: Tanya Date: 10/22/99 Time: 6:21:20 PM Remote Name: 184.108.40.206 Comments LH, I'm not really sure of what could be done to lessen his pressures about using standard English. Those pressures are probably as deeply rooted as grade school, when the teacher and students ridiculed him for saying "I be", then he goes home to hear everyone that he comes in contact with in his community saying it (Sometimes I'm very dramatic). I feel most comfortable when I am speaking to someone who I don't feel is dissecting every word I say, and who is also using comfortable speech. By comfortable speech I mean so what if I slip and say "goin'" instead of "going" (accepting eachother's dialects). I also feel comfortable when I am not really thinking about how I am speaking. I wish I had the answer to that question, then I could help myself. Thanks for your answer. Re: speech model From: email@example.com Date: 10/22/99 Time: 3:20:17 AM Remote Name: 220.127.116.11 Comments Hi, No I do not feel the pressure to do better, when there is pressure this will results in forced speech behaviour... So let it go, be yourself, do not play the role of a perfect person... there is no such ting like being PERFECT. In the case of articulation therapy ... this is an other story, because in that case you have to speak with some articualtion rules in your mind... but there is always such thing like dialects. In my country what is very small you have a lot of dialects, so sometimes 'perfect pronounced speech doesn't excist!!! Best regards Gert Re: speech model From: Darrell Dodge Date: 10/22/99 Time: 2:00:09 PM Remote Name: 18.104.22.168 Comments Hi Tanya: I would hope that your graduate school teaches that dialects are not "incorrect," just as stuttering is not "bad." Nevertheless, I think it's important for me to use the speech modifications I ask my clients to use, including voluntary or open stuttering when we go out to stores and do "transfer" activities. I model slower rate, stretches, bounces, pull-outs and even cancellations in the clinic. I think it's valuable for parents to see me modeling these speech modifications and for clients to see me using them when I speak to their parents. If I don't use them, how can I possibly expect them to? At the same time, I just can't have the attitude that I'm going to totally "control" my speech and make it perfect. And that in itself is another type of modeling for parents and clients. At the same time, it's important to acknowledge that the way I speak is in no way an indication of what the client may be able to achieve. I've worked with people who will probably be able to achieve near-perfect fluency, and others for whom that may be an unrealistic goal -- at least right away. I would think that there's a corollary to this in your situation with dialectic speech. An important part of your grad school experience will be working out how you present yourself and working on the balance between providing clients with the tools they need to make the changes they want and helping them accept and function productively with what they actually achieve. I am personally charmed when I hear dialectic speech, and some of my professors even made a point of exaggerating the speech differences that made them special and showed their connection to their roots. It's great that you're open about this because that means you're facing and working through the the issue. Given that, I'm sure you'll be great. Thanks for your good questions. - Darrell Dodge Gert Reunes From: Pete Hawkes Date: 10/21/99 Time: 10:21:10 PM Remote Name: 22.214.171.124 Comments Gert, I think that a stutterer is not only his best own therapist but is also in the best position to help other stutterers. I have had therapists in the past and they totally miss the point and have no understanding of what it is like to be a stammerer. In my opinion we need more PWS as SLP's and then maybe us stammerers will get the help and support that we need. Best wishes to you in your studies and remember I will be your first client! Hey that is no joke, I am serious. We will meet again in Judys room! Bye , Pete. Re: Gert Reunes From: gert Date: 10/22/99 Time: 3:09:50 AM Remote Name: 126.96.36.199 Comments Ok pete that's great you are supporting me, BUT you have also support yourself!!! Be + and BELIEVE in improvement cheers Gert Peeling layers off From: Anita: firstname.lastname@example.org Date: 10/22/99 Time: 1:07:40 PM Remote Name: 188.8.131.52 Comments I'm about to begin my first job after college, in a scientific field. Much like your case, I find myself doubting the sincerity of my passion for this work. Some of it is there... but something is out of tune. What's more frustrating is that, when I try to pinpoint what it is I have a passion for, it's almost impossible. There seem to be layers that I can't peel - emotional and other adaptations to stuttering, which create a distance between what I enjoy and what I do... I know it's up to me to peel those layers, but I was wondering whether you have some insight (from a professional and/or personal point of view) as to how I can help myself through the process. Thanks!