The presenter of this paper has consented to have a personal email address
posted here if you wish to raise further questions and/or comments. Contact Lynne Shields at
lshields@fontbonne.edu 

Therapy

From: Andy Floyd
Date: 10/1/99
Time: 10:34:36 AM
Remote Name: 205.188.196.34

Comments

Hi! First, it sounds like you give a great class and seem to use tons of extras (stutt-l, support group, adults who stutter,
etc). One thing I wanted to ask about is when you actually teach the techniques to the students. My wife (who is in grad
school for SLP (speech-language pathology) and I (just graduated with my MA in SLP) have noticed that professors
don't always teach the actual techniques - like have the students put them into their own mouths. For your
pseudostuttering experiences, have you ever had the students put the techniques they'd be teaching their clients into their
mouths instead of pure stuttering (which is great by the way). McKeehan (1994) in a Journal of Fluency Disorders article
(vol. 9, 113-123)had students use "fluency facilitating speech strategies" in the outside environment and listeners reacted,
often negatively. I thought this probably was a great learning experience for the students since they may see why some
PWS (people who stutter) would be hesitant to use their techniques in transfer situations. Sorry for the long post :) great
article, Andy Floyd

Re: Therapy

From: Lynne Shields
Date: 10/4/99
Time: 9:59:41 AM
Remote Name: 199.217.208.162

Comments

Hi, Andy. Thanks for the compliment. I am familiar with the McKeehan article, and am in the process of addressing the
issue that you and she bring up. Last year, I had the students do some practice with treatment techniques in the following
manner: I assigned small groups of students to become familiar with one session from Dorvan Breitenfeldt's "Successful
Stuttering Management Program", trying out the techniques used in the session. I then had each group share a summary
of the session they learned, making comments about the techniques used. While this worked out well, and the students
stated that it helped them understand the program better, it isn't nearly enough. This year, as we watch segments of the
9-videotape series of van Riper working with Jeff, I am planning to stop the tape at various points and have students
practice the same thing that van Riper is having Jeff attempt. I also plan to have them practice fluency shaping techniques
when we talk about them. I still have in mind to develop an assignment where they will be doing some of this outside of
class, but it won't be ready for this year's class. Perhaps, as you suggest, it might be piggy-backed on the
pseudostuttering assignment they are already doing. 

I am also thinking about some types of practical experiences that may help students understand better how one deals with
attitudes and emotions in therapy. Everything I've come up with so far seems too contrived. I do have them keep a journal
as a part of the pseudostuttering assignment, and we discuss feelings quite a bit in class, but that's about it at present. 

Thanks for your input. Congratulations on completing your degree. 

Lynne

A Student's Comment

From: Sarah Pauling
Date: 10/5/99
Time: 3:34:30 PM
Remote Name: 208.25.244.81

Comments

Thank you, Dr. Shields, for writing on something so close to my heart right now. I am a first year graduate student in
SLP, and I have an adult who stutters as my first patient in the clinic. At the same time, I'm enrolled in the first-year
Fluency Disorders class. So, I've had to overcome any kind of trepidation very quickly this semester. You really have
some great ideas for making stuttering therapy and theory a little less scary to your students. As a student, I have to say
that my primary fear comes from the overwhelming history of stuttering, and seeming lack of a "cure". I have been taught
so far that the worst thing a future SLP can do is to make one approach the cure-all with every patient you see. This
makes sense to me. The only problem, is that it is hard to really believe in any therapy technique, and it can be too easily
discarded as not working, when it wasn't given a decent chance. Do your students have these concerns, too? I really want
to help my patient overcome his stuttering, but inside I feel like I am doomed from the start. Again, thank you for your
paper. It made me realize that my feeling are not uncommon and that there are people who are working to change things
for us. ~Sarah Pauling, East Carolina University, Greenville, NC

Re: A Student's Comment

From: Lynne Shields
Date: 10/6/99
Time: 10:02:46 AM
Remote Name: 199.217.229.70

Comments

Sarah, I'm so glad to hear from you. You certainly are jumping right on in to the area of fluency treatment, with class and
a client all at the same time. While I'm sure that this is a bit scary, you will probably learn more from your class with the
immediate chance to put some of the information into practice. What a great opportunity! 

Now, to address your concerns. They are, indeed, rather universal, so please know that you are in good company.
Perhaps a shift in the way you are looking at treatment with an adult may be helpful to you. I think you hit the nail on the
head when you say that there seems to be no cure for stuttering. What about helping him learn to manage his stuttering?
There is good evidence to support the notion that those who stutter can learn ways to manage their speech, allowing them
to communicate very effectively. Just reading some of the other papers at this conference should help you gain confidence
in that goal. 

It seems to me that most of the problem for someone who stutters is not so much the stuttering behavior itself, but all the
stuff that they do to try to stop stuttering. Working to reduce those add-ons can make a big difference in the amount of
effort a person spends in speaking. And, there are some great techniques, from both the stuttering modification and
fluency shaping traditions, that can be quite useful to a person who wants to address those stuttering events, as well. A
little 'bibliotherapy' may be helpful in giving you some ideas and a more positive attitude. There are many excellent
resources available. A few of my favorites are Barry Guitar's "Stuttering, an integration of contemporary therapies", Walt
Manning's "Clinical decision making in the diagnosis and treatment of fluency disorders, and Woody Starkweather and
Janet Given's "Stuttering". 

I wish you the best as you move forward in your studies. Do remember to look for the little successes in therapy-and give
yourself and your client a 'goodie' when you find them. Being aware of and rewarding the good stuff can really help
change your outlook, and that of your client. Therapy is a two-way street-you two are in this together. 

Regards, 

Lynne 

Idea

From: Kelly Birken and Rebecca Hubbling
Date: 10/7/99
Time: 4:38:20 PM
Remote Name: 134.29.30.64

Comments

We are two students in the field of communication disorders. We are currently enrolled in the graduate level stuttering
seminar course. We just thought we would mention a project our class is currently working on. Our professor, Judy
Kuster, receives numerous requests for advice from people through her email every day. Each week one of her requests is
fowarded to the class, with all identifying information deleted. Each individaul in the class is then responsible for finding
correct information and/or advice to give the individaul. This sometimes just means telling the person where they can look
for further resources. We have found this very beneficial for two reasons. The first is we are learning to deal with "real
life" situations and the second is it usually facilitates a very interesting class discussion. It teaches us how to be careful in
our choice of words as well as cautious not to diagnose or treat through correspondence. Our answers are first screened
by Mrs. Kuster, before being sent to the individual. This has been a really great learning experience. It has taught us how
to search for information and make use of a wide range of resources. 

Re: Idea

From: Lynne Shields
Date: 10/8/99
Time: 10:14:04 AM
Remote Name: 199.217.208.162

Comments

Kelly and Rebecca, 

Thanks for posting your class assignment. What a good activity to get you working on real problems and/or questions.
Judy sounds like a great teacher. Of course, I don't get the kind of e-mail that she does, since I'm not the queen of the
Stuttering Homepage, but the basic idea of giving students a variety of problems to research is easily adapted to other
formats. I will definitely file this away for future use. I appreciate your sharing the idea, and wish you both the best in
your studies. 

Regards, Lynne

Course content

From: Sheree Reese
Date: 10/11/99
Time: 6:19:22 PM
Remote Name: 205.188.208.38

Comments

Hi Lynne, 

I enjoyed your article...I felt as if I could have written it, we've had such similar experiences.I also found comfort levels
didn't really change as students went from the course to clinical experience (I think they just got better at answering
survey questions) and I too have included all you mentioned. Two other experiences that have been helpful were actually
doing therapy in front of the class with a live client (I was lucky to find one) and inviting practicing slp's to come to class
with videotaped samples of clients they were stymied by and working with the class to problem solve. I'd love to talk to
you about it some time.

Re: Course content

From: Lynne Shields
Date: 10/13/99
Time: 11:41:57 AM
Remote Name: 199.217.219.197

Comments

Sheree, Thanks for posting your comments. I like your idea of having working SLP's come to class with real clinical
problems to solve--wish I'd thought of that. I used a variation of that when I did a workshop for school clinicians on
fluency treatment last spring. I had those who wished submit a problem they were experiencing with a fluency client from
their caseloads on index cards, including a list of questions. After a short presentation, we spent most of the time working
as a group on those problems, and I think it was a good way to address treatment with a group of practicing clinicians. I
have typically done case studies in class, and particularly talk with the class about clients currently being treated for
fluency disorders, following them for the semester and discussing solutions to problems that occur over time. To bring in
others from outside of our clinic would greatly expand the possibilities. 

I'm not sure I'd ever convince one of my clients to do therapy in front of class--you found a brave individual! How lucky
for your students. 

I'd love to chat further with you. Please feel free to contact me by e-mail (lshields@fontbonne.edu). And, thanks for
taking the time to respond--I appreciate the feedback. 

Regards, Lynne 


Desensitizing SLP Student

From: Steve Hood
Date: 10/11/99
Time: 8:24:39 PM
Remote Name: 205.188.198.174

Comments

BRAVO, Dr. Shields, BRAVO 

Thank you for trying to SENSITIZE your students to issues related to stuttering, to people who stutter, and to the
fears/uncertainties faced by clinicians in general, and SLP student in particular. Thank you for your efforts to help
desensitize them to their own insecurities and fears. Indeed, there are many clinicians who would prefer to work with
clients other than those who stutter. And alas, ASHA really dropped the ball and made a tragic mistake when it no longer
required students to have at least a bare minumum of clinical experience in the area of stuttering. (But my beef with ASHA
is food for another table.) 

It is relatively easy to teach students about stuttering. It is difficult to "teach" students about the PERSON who stutters:
child, adolesent adult. I share your enthusiasm for introducing students to the NSA, SFA, groups such as Friends.
Students need to know about these valuable resources, as well as autobiographes such as Marty Jeser's. Like you, I show
portions of the Van Riper/Jeff video, and show videos from the NSA and SFA. I invite members of our local NSP
chapter to visit class. 

I also have student assignments where students engage in pseudostuttering and go into real situations in order to work to
learn and produce such modification techniques as cancellations. 

Recently, on STUTT-X, there have been several threads regarding the pros and cons of these outside assignments for
students. Indeed, there are many students who would avoid these assignments if possible, and I think this is regretable.
In order to be effective, students must develop as much empathy as possible, and must be able to "go first and
demonstate." They need to be able to model the desirable targets. 

One of the common worries of the students in my class who do the pseudostuttering assignment is being able to do it
realistically. If you ever have the same problems, here are a few ideas I'd suggest: 

You do not need to be the most severe person who stutterers that ever lived. You need to do enough stuttering to be
realistic. There are four basic ways to look at the overt/behavioral characteristics of stuttering. Here they are, and here are
my suggestions: 

Frequency -- try to stutter on about 15%-20 % of words spoken 

Effort -- Try to have moderate amount of tension/struggle. 

Maybe have some increase in loudness/pitch, or maybe show some tension in your jaw or slight tremor. 

Duration -- Shoot for stuttering of about one second duration 

Type -- Various types of of sound and syllable repetitions, some prolongations. These reps and prols can be both voiced
(vvvvery) and voiceless (ffffast.) Or like p-p-p-paper -- or buh-buh-baseball. 

Try some hard contacts/tense pauses, and some blocks. 

For my own students, we practice some of this in class. I demonstrate, and they break into groups of two or three
students to practice with each other, IN CLASS, and in front of each other. I encourage them to practice on their own -- to
tape record themselves, and to watch themselves in the mirror. These students, individually and collectively, get to be
pretty good judges of being realistic. 

Lynne, I think your students will benefit greatly from the kinds of things you are trying to do to help them to be more
emphathic, more understanding, and more knowledgeable. 

I enjoyed your article. I agree with your article. And, I am glad you shared this with the ISAD visitors. 

After ISAD is over, and as you continue to develop your course, I hope we can continue to exchange ideas. We can try to
develop creative ways to help expose students to these important concepts. 

Thanks for sharing, Lynne. This is an important contribution. 

Steve Hood

Re: Desensitizing SLP Student

From: Lynne Shields
Date: 10/13/99
Time: 2:09:30 PM
Remote Name: 199.217.219.197

Comments

Steve, Thanks for your comments and support. Your online course information has certainly been a great source of
inspiration for me as I've gone about working on my course, so I can officially thank you now for all of the help you've
been to me. And, thanks, too, for the suggestions about the pseudostuttering assignment. I'll share that with my class.
One of my students mentioned just last week that she sounded so unnatural when stuttering. We did some in-class
practice and talked about ways to "improve" our stuttering. Your suggestions will help there, I think. I also talked with
them about the nature of making changes, that it SHOULD feel a bit awkward to do something that your speech
mechanism doesn't ordinarily do, and that I suspect many of the clients feel awkward, too, when we ask them to make
changes. I rather like future SLP's to "get" that concept of change and why it can be so hard to do. Old shoes always feel
so much better than putting on those stiff new ones. 

I would really like to see more interaction among all of us who teach fluency courses. Sheree Reese mentioned the same
in her post right before yours. I am gathering that a number of us have been down the path of working out how to teach
more effectively in this area. Having a vehicle for sharing ideas could be quite useful. Do you know if anyone has used
the SID-4 listserv in the past for that purpose? I just recently signed onto that one, but haven't seen one posting on it to
date. 

Regards, Lynne 

Re: Desensitizing SLP Student

From: steve Hood
Date: 10/14/99
Time: 9:17:20 AM
Remote Name: 199.33.133.50

Comments

Lynne -- 

Use of the SID-4 listserv would be a good idea. So far as I know, it has not yet been used in the way you are suggesting.
Maybe after things settle down after the conclusion of the ISAD events, we can do some things like this. 

Maybe some other folks will pick up on this theme and offer additional ideas. 

Cheers, 

Steve Hood

One of the /crowd

From: Janell Larsen
Date: 10/12/99
Time: 10:14:05 AM
Remote Name: 204.72.75.234

Comments

When I read this paper I felt that you were writing about me, a SLP with 15 years of experience. I wish I had some of
these experiences and I know of others who feel the same way. Thanks. 

Re: One of the /crowd

From: Lynne Shields
Date: 10/13/99
Time: 2:53:16 PM
Remote Name: 199.217.219.197

Comments

Janell, 

Thanks for your comment. For those of us who have been in the field for some time, I think that there are many more
avenues for increasing our knowledge base and comfort level with fluency therapy now than in the past. I have attended
some excellent sessions at ASHA over the past few years on fluency, some with a very practical focus. NSA and SFA
both have some wonderful resources for clinicians. There are also so many opportunities for learning on-line, through
listservs, The Stuttering Homepage, this conference, and so forth. There are often folks in our field who have good
expertise in fluency right in our own communities. I hope that SLP's who want to learn more about treating stuttering will
feel free to call them up and pick their brains. I used to be afraid to do that--how would it look if I admitted that I didn't
know something? I do it shamelessly now, and I learn so much from my colleagues. It makes the person you call on feel
good, too, to be of help, so it's a win-win situation in most cases. 

Regards, Lynne 

Densensitization

From: Ed Feuer
Date: 10/13/99
Time: 5:01:21 PM
Remote Name: 216.81.20.236

Comments

The recent battle on the Stutt-X newsgroup between students who reject pseudo-stuttering with highly transparent excuses
and PWS who tell such people to never have stuttering clients reveals that something certainly is amiss. It's my
impression that at most universities, pseudo-stuttering is treated at best by profs and students as a token assignment. The
fluent students' situation is a mirror image of that of the PWS. Many of the students resist, sabotage and avoid for the
same reasons PWS do it in therapy. Both lack adequate desensitization. While Lynne is headed in the right direction, I
would urge the creation of much more comprehensive and structured systematic desensitization hierachies for the
students. They gain crucial empathy including gauging listener reactions. It will also prepare the students for helping
stuttering clients set up a systematic desensitization hierarchies. Modelling of behaviours by SLPs outside the clinic room
is also essential in desensitization. Pseudo-stuttering should be regarded as a valuable learning opportunity, not as
something to fear.  Ed Feuer edfeuer@escape.ca

Re: Densensitization

From: Lynne Shields
Date: 10/14/99
Time: 9:52:32 AM
Remote Name: 199.217.219.197

Comments

Hi, Ed, 

I'm glad that you brought up the issue of the pseudostuttering assignment. I would disagree with you that it is considered
a token assignment, at least for my own class. It is a credit-bearing assignment, and is set up to cover a period of five
weeks in the middle of the semester. I do have some heirarchy of difficulty built into it, beginning by stuttering only with
their partners, then phone calls that are scripted, then unscripted phone calls, followed by outside situations. All along
they are to be meeting with their partners for practice and support. But, I agree with you (and your previous post to
Stutt-L on the issue) that it can be made more systematic. Now that you've got me thinking about this, I'm considering
having the students set up their own heirarchy, actually, with several components required to be included. In this way,
they might learn more effectively how to go about developing a heirarchy with their clients, by evaulating their own and
making revisions. 

In addition, after talking with students this semester, it is apparent that I need to spend more time working with them in
class on pseudostuttering before they begin the assignment. They seem to be having difficulty getting the stuttering
behaviors down to begin with, and I may be able to remedy this by having small group practice in class. I do
pseudostuttering for them during class fairly often, to demonstrate, but they need to get it into their own mouths earlier
on. 

I appreciate your suggestions regarding the assignment. The suggestions I have received in response to this paper,
including yours, are already proving quite helpful to me as I begin planning for my next class. 

Thank you, Lynne 

Re: Densensitization

From: Sheree Reese
Date: 10/15/99
Time: 8:40:10 AM
Remote Name: 205.188.193.151

Comments

I too have been watching the controversy on the listserv over the pseudostuttering assignment...it crops up every now and
then. I can honestly say that looking back at over 100 students who have done this assignment in my classes, I can only
think of one who did not learn a valuable lesson from it...and my guess (and my hope) would be that she will opt never to
work with a person who stutters ...I've been very impressed with how seriously my students take the assignment, how
diligently they try to learn from it and how sensitively they examine the experience afterward.

Re: Densensitization

From: Steve Hood
Date: 10/15/99
Time: 10:35:20 PM
Remote Name: 152.163.204.36

Comments

Ed--- While I tend to agree with much of what you said, e.g., that too few students in classes on stuttering get full benefit
from pseudo-stuttering and desensitization assignments, I must disagree with part of what you said this is a "token
assignment." When done correctly, it is far from a token. 

Some of my past and present students are either actively participating in this ISAD conference, or are passively lurking.
Maybe they will respond. I hope so. 

Stuttering in public, engaging in mofication exercises such as cancellations, pullouts, high stimulus speech, using
exaggerated continuous phonation, etc, -- and modeling "Turtle Talk" with REAL CHILDREN is hardly a token
assignment. Having students demonstrate their pseudostuttering in class is not a token assignment. I think you again
make a grave error in overgeneralizing on this issue. 

As part of the final examination, I am considering having an oral component, in my office, wherein the students will need
to make a phone call, to demonstrate some of the stuttering behaviors and/or modification procedures they have
learned...... Yes, I know you would like me to take them to the Mall, and do this in public, but realistic fact is, that there
are time constraints. 

I hope that if there are students reading these posts about pseudo-stuttering, that they will feel free to enter into the
discussion. I hope that these discussions will stimulate thought and action. 

Ed and I have discussed and debated this issue in the past, so this response is really not directed to him..... Rather, to the
rest of you who might be reading, and hopefully THINING, about the importance of the issues of desensitization and
pseudo-stuttering. 

AND -- To Lynn Shields. My continued appreciation for bringing this topic to the ISAD forum. 

Steve Hood

Re: Densensitization

From: Lynne Shields
Date: 10/18/99
Time: 10:56:37 AM
Remote Name: 199.217.208.162

Comments

Thanks for the added comments, Sheree and Steve. I'd like to add some feedback that my class gave me last week as we
discussed how their pseudostuttering assignments were going. Most of them have done their second set of phone calls.
While none reports that they are easy to do, several of them indicated that they feel a real sense of accomplishment (as
well as relief) when they have finished. There is no better way to demonstrate how good it feels to carry out a specified
task successfully. I hope they all remember this when they begin to work with clients on outside assignments! One
student reported a near hang-ups when she blocked on the first word she attempted, while another said she was put on
hold forever, and is convinced it is because of her stuttering. I think that they are beginning to understand how easy it is
to feel insecure about speaking situations when one stutters. 

This assignment gives them that very important taste of stuttering, but I see them accomplishing so much more than that
as they work through the difficulties that are inherent in such a task. 

Regards, 

Lynne

I know how they feel

From: Laura Kriniske
Date: 10/14/99
Time: 2:56:38 PM
Remote Name: 128.147.91.147

Comments

I am a graduate student at the University of Pittsgurgh studying with Scott Yarus. I found your class set-up very
intersting, especially the pseudo-stuttering assignment. I am happy to report that Scott has us complete the same type of
assignment and I expereinced many of the same emotions that your students report. I am glad that professors take the time
to make students aware of the desensitization process and encourage us to take the time now to become more comfortable
with stuttering, before we work with our first clients.

Re: I know how they feel

From: Lynne Shields
Date: 10/14/99
Time: 4:01:41 PM
Remote Name: 199.217.219.197

Comments

Laura, 

Thanks for posting your comments. It is nice to hear that students do understand the purposes behind the assignments,
particularly the pseudostuttering assignment, and see the benefits, even when it isn't necessarily fun to do! Be sure you let
Scott know, too. We need feedback from our students, so that we can continue to work on improving our courses. 

Best wishes as you complete your graduate studies, and in working with fluency clients. 

Regards, 

Lynne 

Fluency -facilitating techniques

From: Gail Lind, Ed. SLP
Date: 10/17/99
Time: 4:22:50 PM
Remote Name: 63.11.58.142

Comments

I was curious about a comment in the last paragraph concerning techniques you want to try in the future - Could you
expand a bit on the fluency-facilitating techniques regarded positively by the graduate students mentioned? Thanks! 


Re: Fluency -facilitating techniques

From: Lynne Shields
Date: 10/18/99
Time: 10:22:46 AM
Remote Name: 199.217.208.162

Comments

Gail, 

Thanks for your question. I am planning to add more practical content into my course next Fall, including something
similar to that reported by Ann McKeehan in the article I mentioned. She taught students to use fluency facilitating
techniques such as lengthened vowels, frequent pauses, and short utterances. As you are probably aware, these are
among the techniques that can be used to improve fluency for people who stutter. The students were asked to use these
techniques at all times when they spoke for a period of one week, and keep a record of their contacts. They reported on
listener reactions and their own reactions to their use of the techniques. McKeehan concluded that students learned how to
use speech modification techniques, and came to better understand listener reactions to these techniques and how difficult
it is to apply and self-monitor the techniques in everyday speaking situations. Not a bad lesson to learn for future SLP's. 

I am currently having students do some in-class practice with both stuttering modification and fluency shaping techniques,
but I would like to increase the time spent in practice, so that they get some idea of what is involved in trying to make
changes in their speech over a longer period and in a setting similar to what their clients will experience during carry-over
practice. 

Hope this answers your question. 

Regards, 

Lynne

Reducing the Fear

From: Meghan Telitz
Date: 10/18/99
Time: 10:23:23 AM
Remote Name: 204.72.77.97

Comments

Dr. Shields, Last spring, I took a course by Jerry Halverson through the University of Wisconsin at River Falls. While
reading your paper, I felt as though I was reading the course syllabus for his course. I learned a great deal through this
method of teaching. By having people who stutter come in and tell their own stories about fluency therapy and various
levels of effectiveness, I was able to put my own fears aside and concentrate on each individual. Another approach that I
feel is very helpful, is to watch therapy sessions either in person or on videotape. This allows a student to see how
different techniques are employed. It is refreshing to see more professors step away from the 'typical' class formats and
incorporate lessons that are so important for students to learn. Thank you for your time.

Re: Reducing the Fear

From: Lynne Shields
Date: 10/18/99
Time: 11:08:53 AM
Remote Name: 199.217.208.162

Comments

Meghan, 

Thanks for your comments. I'm glad to hear from students who have had similar experiences in fluency courses. I am
hopeful that with more faculty trying to de-mystify fluency therapy, there will ultimately be more SLP's working who are
good fluency therapists, and who LIKE it! 

Your point about being able to watch fluency therapy, either live or via videotape, is a good one. I agree that it is so
important to see the techniques being used. It certainly makes it much more concrete for students, as opposed to simply
reading and hearing about the methods. 

Best wishes to you as you complete your training and move into the workforce. 

Regards, 

Lynne

Desensitization Paper

From: Susan Olson
Date: 10/18/99
Time: 9:06:26 PM
Remote Name: 209.32.211.237

Comments

I was glad to read that many other clinicians are uncomfortable working with stuttering. I have taken courses on stuttering
and have also attended several workshops. Part of the problem for me, is that I work in the public schools and I will often
times go many years with out a stutterer on my case load. I have also found that each student I have had usually is very
different from other stutterers. One may also have the characteristics of apraxia, autism, or many social-emotional
problems. It is very difficult to stay up-to-date with therapy techniques in the many areas of speech-language. I am
excited, however, about the many opportunities that the internet will provide!

Re: Desensitization Paper

From: Lynne Shields
Date: 10/19/99
Time: 10:36:50 AM
Remote Name: 199.217.208.162

Comments

Susan, 

I'm glad to see you at this conference. This is one very good way to increase your knowledge in the area of stuttering.
There are many good resources available in the form of books and internet sites. I would also encourage you to make use
of personnel resources that may very well exist in your own community. Find out the names of any SLP's in your area
who specialize in fluency treatment. They can be an excellent source of help for you when you have a fluency client on
your caseload. Consult freely! Visit with them and learn from them. Ask them to do a workshop for SLP's in your
district. If one of them works in your school district, then consider trying to arrange for this individual to work directly
with the client, at least for a time, or serve as a co-therapist, while you learn from them. I can hear you say that the
administrators won't allow for such an arrangement. However, there are both ethical and legal issues that arise from
treating a client in a case where you do not feel fully qualified to treat--it is referred to as malpractice in the medical
community. While school administrators may not be inclined to buy this, you need to be sure that you make this point
clear and document it. Whether or not you are successful in gaining what you request, you will be pushing home the point
that school districts need to: a) provide for continuing education for their SLP's and other staff, and, b) make sure that
they provide appropriate services for all of their students. 

I am not suggesting, Susan, that you are incompetent to treat stutterers. (rather, the above is my plug for school SLP's to
give those districts a push in the right direction!) You have many of the skills necessary to work with fluency clients,
gained from your work with many other disorder types. In addition, you are working to gain further knowledge by
attending workshops, taking courses, and reading the papers at this conference. I applaud your efforts and encourage you
to continue gaining competency in working with children who stutter. The time spent will make you feel more confident
and able to treat fluency clients, and I think you'll find that the skills you gain can be applied to children with other
disorders to whom you provide services, as well. 

One additional resource that I'll mention in closing--all of the SLP's who have participated in this conference. If one of us
lives in your area, I'd bet that person would be happy to consult with you when you have a tough case. You are welcome
to contact me, though I don't promise to have answers to all questions. :-) I can be reached at: lshields@fontbonne.edu. 

Best wishes, 

Lynne 

psuedo-stuttering

From: Debra Blanton
Date: 10/19/99
Time: 7:35:48 AM
Remote Name: 209.214.44.95

Comments

Lynn, I am a graduate student of Dr. Hood's. I am so happy to have this assignment. My undergraduate course at a
different college taught me nothing and I worked in the schools for two years with NO ability to work with PWS. I have
attempted to stutter to strangers and have lost my nerve so far. I feel anxious and guilty about bothering the listener. I will
succeed at stuttering, but I have a small taste of the emotion already. I know it will take years to become a good stuttering
therapist, but I feel these assignments have at least set the right direction. 

Re: psuedo-stuttering

From: Lynne Shields
Date: 10/19/99
Time: 10:47:01 AM
Remote Name: 199.217.208.162

Comments

Hi, Debra, 

I think that you are very lucky to be able to learn from Steve Hood. You'll gain so much from participating in his class.
I'd like to sit in on his classes myself. 

You certainly are having some common reactions to the pseudostuttering assignment, and you'll remember it when you
work with fluency clients, I'll bet. So, don't worry that your nerve is suffering at the moment. You're in good company,
and you'll do it, and do it well when you get down to it. 

Perhaps this is a good time to set yourself up with a heirarchy, like Ed Feuer suggested, to help you move on more easily.
If stuttering with a stranger is too aversive at the moment, who could you stutter with and feel less nervous? Your
mother? Best friend? The dog? An ant on your windowsill? Go for it! 

best wishes to you in your studies and in your future career. I'll be looking to see your name on one of these papers,
maybe at the 10th Annual ISAD conference. 

Regards, 

Lynne 

Re: psuedo-stuttering

From: Walt Manning
Date: 10/19/99
Time: 5:15:25 PM
Remote Name: 141.225.97.53

Comments

Debra- I've enjoyed following along with with comments about Lynn's paper. I also have my students do a rather lengthy
series of voluntary suttering experience...much of it follows the system that Steve Hood developed. I have then rate their
anxiety and score their clinical abilities on a self-efficacy scale that we developed a few years ago. 

You mentioned that you feel bad about "bothering" listeners and I fully understand. But one of the things that I encourage
my students, and especially my clients, to do, is to alter their attitude about this and actually "use" listeners in order to
change their speech. I know this could sound a bit harsh but, within limits, it's actually rather healthy, I think. One good
example is to "use" the people who call you on the telephone when you are busy or about to sit down for dinner. This is a
perfect opportunity to practice your voluntary stuttering since they "used you first". Responding to listeners in a more
assertive manner is a reasonable part of the treatment process. 

Re: psuedo-stuttering

From: Lynne Shields
Date: 10/20/99
Time: 3:53:56 PM
Remote Name: 199.217.208.162

Comments

Walt, 

Good to hear from you, and thanks for the encouragement for students (and clients) to get bolder about pseudostuttering.
I may take you up on the idea of pseudostuttering with those irritating home sales calls--even though I don't have an
assignment to do it! 

You remember, of course, having helped me work on my pseudostuttering assignment some years ago. I'm so thankful
for your suggestions, which were of great value in shaping the assignment. I'm still working on it! Now, can I borrow
from your self-efficacy scale?? 

Regards, 

Lynne

I wish I could take your course

From: Suzanne Danforth
Date: 10/19/99
Time: 8:36:21 PM
Remote Name: 24.218.91.126

Comments

It is always heartening to hear an experienced clinician discuss their practice as a work in progress especially re: fluency. I
have treated stutterers of all ages intermittently, but only felt somewhat comfortable with 4 and 5 year olds. The format of
your curriculum is terrific and I hope your students avail themselves of all the opportunities you provide.

Re: I wish I could take your course

From: Lynne Shields
Date: 10/20/99
Time: 4:05:37 PM
Remote Name: 199.217.208.162

Comments

Suzanne, 

Thanks for the compliments. You, too, can do some of the activities I use with my class, even though you are no longer
in school. And, I'd encourage you to do so. I set up the class with the idea of exposing them to some of the experiences
that I found most helpful to me when I started working on my own desensitization process. The videos I use are those
that I think have some good, practical suggestions. The ones available from the Stuttering Foundation of America are
VERY reasonably priced--$5-$10 for most of them. Pseudostuttering is a great experience to do, too--you can learn right
along with your clients on that one. This semester, one of my graduate students was assigned to work with an adult
fluency client. I think on the first or second day of therapy with this man, I walked in and asked the student to do some
pseudostuttering with him. She may have been a bit taken aback (we hadn't yet begun to do this in class), but I
demonstrated and she jumped right in, learning to imitate the client's stuttering. 

If you are planning to attend the ASHA convention this year, I know there are quite a few sessions on fluency, and many
of them look to be very good, practical sessions. Hope to see some of you there! 

Thanks for posting your comments. 

Regards, 

Lynne

Desensitization for SLP students

From: Celeste Ruebl
Date: 10/20/99
Time: 12:57:57 PM
Remote Name: 204.169.193.61

Comments

Lynne, Thanks for your great article!! I wish I could take your class...any plans to go around and do the
inservice/conference circuit? I did go to a workshop that Kristin Chmela did in St. Paul last February and it really helped
my comfort level. I currently have a graduate student working with me and she has been very honest about how
uncomfortable she is working with stutterers. I am sharing your article with her and I have also been sharing the
information from Kristin as I use that with a client of mine. We also have two stuttering referrals 'in process'. I think she
is seeing what a big job it is evaluating, planning, and working with the students in addition to counseling the parents and
school staff involved. Thanks again for a great article! 

Re: Desensitization for SLP students

From: Lynne Shields
Date: 10/20/99
Time: 4:13:41 PM
Remote Name: 199.217.208.162

Comments

Celeste, 

I don't have any plans to take my class on the road at the moment, but thanks for asking! Get someone to invite me to
come to St. Paul--one of my sisters lives there. I'm pleased that you think my article worth sharing with your student.
You all might want to do some of the same types of activities that I use in class together, tailored to fit your clients. 

I, too, think that Kristin Chmela has some wonderful ideas with regard to working with fluency clients. I have her SFA
tape on working with attitudes and emotions, and it is one of those that I show in class-and watch periodically for myself.

Best wishes to you in your practice, and a big THANKS to you from an SLP in a college setting for your willingness to
take students. You provide a great service for training, and we couldn't do it without you. 

Regards, 

Lynne

your previous students

From: Faith Sansone
Date: 10/20/99
Time: 5:30:43 PM
Remote Name: 141.225.97.60

Comments

I really enjoyed reading your article and it sounds like you teach a very informative class. I was just wondering if you've
done any recent research with your previous students or current students that shows their comfort with stuttering clients
before and after your class?

Re: your previous students

From: Lynne Shields
Date: 10/20/99
Time: 10:32:30 PM
Remote Name: 199.217.219.197

Comments

Faith, 

Good question. I have done no formal studies on the effectiveness of the fluency course, although I do make an attempt to
collect some information that will help me evaluate and make changes in the course. I ask students at the beginning of
each semester that I teach the fluency disorders class about their background in stuttering and their comfort level. At the
end of the semester, each student completes a course evaluation, which is one that is used across all courses at the college.
For the past three years, I have added my own second sheet of questions to the standard form, and this includes questions
asking about their perceptions of the course assignments and content, and whether they feel prepared to work with
fluency clients. I then compare the early responses, which I keep notes on, with the end-of- semester evaluations. 

I have never directly surveyed former students to find out whether or not they were actually sufficiently prepared. I do get
feedback from former students that indicates that they feel confident and successful with fluency clients. I'd say I've
heard from maybe 15 former students on this subject in the past five years. In addition, some of my former students in the
fluency course will later have a fluency client while they are still enrolled in the master's program. In our on-campus
clinic, I generally supervise these clients, and I have been very pleased to see student clinicians who have a good idea of
how to go about selecting treatment methods, who appear comfortable in working with their clients, and who ask good,
focused questions of me as their supervisor. Of course, I have no way of determining how much is due to their having
taken the class, and how much is due to their having a supervisor (me) who is also more comfortable in working with
fluency clients now, compared to 10 years ago. I suppose I should give up doing the supervising and get feedback from
another supervisor to help me tease that one out, but I'm too selfish. We don't get scores of fluency clients, and I like to
work with them myself. 

Hope this answers your question. If you have any other ideas about how I might go about gathering data, I'd be happy to
hear about it. 

Regards, 

Lynne 

Desensitization

From: Janet Hartman
Date: 10/21/99
Time: 10:31:23 AM
Remote Name: 206.10.49.101

Comments

Your course sounds terrific! Upon completion of a degree, one feels that they should have at least some of the answers.
My limited experience with clients who stutter leads me to believe that I have few if any answers. One course in fluency
disorders at the undergraduate level, twenty years ago and four clients later does not make me an expert. I continue to be
fearful when a student is referred for fluency. Desensitization for clinician should be included in any course dealing with
fluency. Thank-you for your article. It made me feel that although inadequate and fearful, I am not alone. 

Re: Desensitization

From: Lynne Shields
Date: 10/21/99
Time: 1:27:49 PM
Remote Name: 199.217.208.162

Comments

Janet, 

I'm glad that you found my article useful and encouraging. I hope my paper will give working SLP's a push to take the
bull by the horns and do as much self-education as possible--reading, attending sessions at conventions, participating in
on-line discussion groups on stuttering, and picking the brains of SLP's in their area who do have skills in working with
fluency clients. 

Best wishes to you in your work and, here's to having a great adventure in learning with your next fluency client! 

Regards, 

Lynne 

desensitization

From: Amy Rosonet
Date: 10/21/99
Time: 12:26:49 PM
Remote Name: 199.33.133.81

Comments

My name is Amy and I am a first year graduate student attending the University of South Alabama. I am currently enrolled
in a graduate fluency class. Our class also has several assignments of psuedostuttering. I am very nervouse about this
assignment, but I am grateful to my professor for "making" our class complete the assignment. I feel that I will be more
confident when working with a person who stutters. I will have a little knowledge regarding the feelings experienced by
stutterers. I enjoyed commenting on this article.

Re: desensitization

From: Lynne Shields
Date: 10/21/99
Time: 1:32:53 PM
Remote Name: 199.217.208.162

Comments

Amy, 

Thanks for your comments. I'd like to point out that most of us who assign our students to do pseudostuttering know that
it is not fun, and feel very much for you as you work through the assignment. But, we are also convinced that it is a
worthwhile activity, and that you will find the rewards really do outweigh your discomfort. 

Good luck to you in your training. I hope you are able to work with a few fluency clients while your are in school, so you
can apply some of the great skills you are learning in class. 

Regards, 

Lynne

Desensitization

From: Hazel Camagong
Date: 10/21/99
Time: 12:36:00 PM
Remote Name: 199.33.133.81

Comments

Your article was very interesting. Some of the assignments you mentioned apply to our fluency class as well. For the past
few weeks, Dr. Hood has shown us the Van Riper series with Jeff. It was interesting to watch him improve! We have a
few assignments where we have to stutter while asking people for directions, and practice repititions,prolongations, and
canelling. Good ole Dr. Hood is preparing us and letting us get a little feel of the emotions experienced (postponement,
anxiety, etc.) I feel all of those now and we have an assignment coming up where we have to tape record ourself in Van
Ripers third stage of stuttering. I just wanted to comment on how our syllabi are similar. Interesting that we are not the
only ones (graduate students) who have to voluntary stutter in public! Wish me luck, I'll need it. 

Re: Desensitization

From: Lynne Shields
Date: 10/21/99
Time: 1:37:11 PM
Remote Name: 199.217.208.162

Comments

Hazel, 

I appreciate your taking the time to comment on my article. And, I'm glad that you can now feel in good company--there
are SLP students all over the country pseudostuttering along with you, and participating in a variety of assignments
designed to help you gain experience and confidence in working with fluency clients. 

I do wish you the best as you get out there and stutter. It's the old 'no pain, no gain' philosophy, right? Take care. 

Regards, 

Lynne

Website Resources

From: Karla Becker
Date: 10/21/99
Time: 3:38:58 PM
Remote Name: 207.109.214.34

Comments

I appreciate the effort that you have made to prepare your students for working effectively with stutterers. As a school
speech/language pathologist,I have had only limited experience/exposure with stuttering students myself. I plan on using
some of your teaching ideas to help reduce my own anxiety surrounding my ability to provide effective services to these
children. Could you provide a listing of the specific web- sites that you feel are excellent resources of in- formation.
Thanks!!

Re: Website Resources

From: Lynne Shields
Date: 10/21/99
Time: 3:48:28 PM
Remote Name: 199.217.208.162

Comments

Karla, 

I'm so pleased to read that you are planning to do some self-desensitization! Wonderful--GO FOR IT! 

The best website for getting information for yourself and your fluency clients is Judy Kuster's Stuttering Homepage,
which I assume you have been using to access this conference. Two other sites that I have found to be most useful are the
websites for the National Stuttering Association (http://www.nspstutter.org/) and the Stuttering Foundation of America
homepage (http://www.stuttersfa.org/index.html). I encourage you to explore all of these, and make use of the resources
you find there. You may want to consider joining one of the various listservs on the topic of stuttering--several of them
are listed on Judy Kuster's web page. That is a good way to learn, either by lurking or by participating actively. 

Best wishes to you, and thanks for your comments. 

Regards, 

Lynne

Another Dr. Hood student

From: Julie Estis
Date: 10/21/99
Time: 4:53:25 PM
Remote Name: 199.33.133.81

Comments

Hello! I have enjoyed reading your article and the comments/questions that have followed. I am another one of Dr.
Hood's gradute students. As you have heard from my classmates, we are working on some pseudostuttering
assignments. I hope that as I practice stuttering and approach it head on, I will gain some understanding of how people
who stutter think and feel. I know that I can never fully grasp the emotions of a person who stutters, but pseudostuttering
will give me a reference point to work from. Thank you for your insight and helpful suggestions! Julie Estis

Re: Another Dr. Hood student

From: Lynne Shields
Date: 10/21/99
Time: 6:05:58 PM
Remote Name: 199.217.208.162

Comments

Julie, 

It is great to hear from some of you who are currently studying under Steve Hood. You've are correct when you say that
approaching the assignment head on will help you gain some understanding of stuttering. And, it will really help you
understand how hard it is to do those assignments that you suggest to your fluency clients. 

I'm pleased that you are approaching the assignment with such a positive attitude. I know you'll succeed! 

Thanks for posting your comment. It is good to hear from students at other programs. 

Regards, 

Lynne

Addressing our fears.

From: Katharine M. Foster 
Date: 10/21/99
Time: 7:29:32 PM
Remote Name: 209.12.238.24

Comments

Ms. Sheilds, It was very good to read your paper on Desesitization. I worked last year in a rural school system. I had one
client who stuttered severely and also had Down's Syndrome. Needless to say - as a person working with only my
bachelors degree I felt very inexperienced in general. I had no idea that there were so many resources that I could have
explored/used to be a better clinician last year. I found your paper very helpful in relating resources and other activities as
a way to combate inexperience. This year I am blessed to be in a graduate program instead of practicing with so little
knowledge. Dr. Hood's class has helped a great deal. We have wathched the Van Riper series and we will also do the
pseudostuttering assignments. I know that even with all this exposure this fall in fluency class- it is only a drop in the
bucket in terms of becoming a good clinician. I am encouraged to know that I am not the only one who feels
inexperienced and that there are resources to help along the way. Thanks for working to make your class a more tangible
and lasting experience. 

Sincerely, 

Katharine M. Foster 

Re: Addressing our fears.

From: Lynne Shields
Date: 10/21/99
Time: 10:48:23 PM
Remote Name: 199.217.219.197

Comments

Katharine, 

Being in Steve Hood's fluency class is a great start toward learning what it takes to do good fluency therapy. I was just
showing portions of two of the videos of van Riper working with Jeff this evening in class. I'm finding that every year
when I show them, I see more of what van Riper was doing and why--so I'm still learning from those tapes myself. 

Best wishes as you continue in Steve's class, and as you take part in the other activities that he has assigned the class.
And, thanks so much for your kind words. It is encouraging to hear from students who are seeing the benefits of being
more active participants in their education. 

Regards, 

Lynne 

Desensitization

From: Kelly Gibson
Date: 10/21/99
Time: 11:39:44 PM
Remote Name: 205.188.197.27

Comments

I found your article to be both insightful and rewarding. As a first year graduate student at the University of South
Alabama, I too, like your students, feel inadequate in providing therapy for stutterers. I have had a fluency class in my
undergraduate work and am now currently taking the advanced fluency class under Dr. Stephen Hood. He has
incorporated many assignments, lectures, video tapes of Jeff and Van Riper, as well as having an actual classmate who
stutters, all to enhance our knowledge and understanding of stuttering. I think the greatest gain that we can receive as
students is for us to have as much opportunity to work with individuals who stutter, to engage in outside stuttering
(which makes us all gain a greater appreciation for individuals who stutter) and to receive as many insightful tips, advice,
and personal experiences from our teachers. I also wanted to say that I admire that you felt discomfort, apprehensive, and
indadequate in providing therapy for these individuals. It makes students,like myself, feel better about ourselves as
clinicians when we understand that our professors once felt the same way. Thank you for sharing your experience.
Sincerely, Kelly Gibson

Re: Desensitization

From: Lynne Shields
Date: 10/22/99
Time: 9:39:52 AM
Remote Name: 199.217.208.162

Comments

Kelly, 

I appreciate hearing from students. Thanks for your comments. You express so well the views that I hope all students
have in approaching a course of learning in their field. And, I think you are right when you say that it makes it easier to
know that one is traveling a road that others have been down before. 

Best wishes to you in your studies, 

Lynne

Dear Students ------------

From: Steve Hood
Date: 10/22/99
Time: 1:03:49 PM
Remote Name: 199.33.133.50

Comments

As students, and this goes for practicing clinicians as well, you have been exposed to some very important concepts. I
hope you have made a copy of Dr. Shields's fine paper, and I hope you will read it again when you have your first
stuttering client, read it again when you start having your client do outside "stuttering assignments." Read it again before
you take the ASHA/CCC exam. Read it again when you finally receive your CCC-SLP. 

Most of the questions and comments also deserve to be printed and reviewed from time to time. 

If you will be working with "brothers and sisters of the tangled tongue" you will want to do all you can to reduce your
own sensitivity, fear and apprehansion. You will need to do all you can to learn to stutter openly and honestly yourself.
You will need to be prepared to go with your clients on outside assignment, to be able to model the targets you are hoping
your client will achieve. You cannot sit passively by the road and require that your client run past you. No, Indeed, you
need to join with your client and run the race together. 

You students of today are the clinicians for the next century. Please do all you can to accept the challenge, and strive to be
up to the task. 

You have before you a wonderful opportunity, and an asesome responsibility. 

Best wishes, and good luck !!!! 

Steve Hood

Thanks, Steve, and all who have read my paper

From: Lynne Shields
Date: 10/22/99
Time: 4:42:06 PM
Remote Name: 199.217.219.197

Comments

Steve, 

I can't thank you enough for your support on this discussion. You have added much to the content of my paper, and
given so many words of encouragement to students and working clinicians. 

TI also want to thank all of you who have read this paper, and especially to those of you who took the time to respond to
it. I am pleased to find so many who are doing some of the same things that I have tried to do with my course, and that
there are so many of you who see the value in addressing this topic. 

With regard, 

Lynne