COMPONENT 9. FACILITATION OF DEVELOPMENT OF SELF-AWARENESS AND SELF-MONITORING 
SKILLS, AS THEY RELATE TO FLUENCY

Rationale: They client must be able to effectively identify, through
adequate self-monitoring skills and self-awareness, those elements 
which are interfering with his/her fluency. Development of these 
skills is crucial to the attainment and maintenance of fluency.

Research: 

Conture (1990) - has observed that as the client learns more about the
"where" as well as the "when" of their stuttering patterns, they begin 
to learn more about how these behaviors interfere with speech. 

Cooper and Cooper (1985) - strongly believe that school-age children 
who stutter must develop self-awareness of stuttering patterns and
associated behaviors as part of their intervention program. 

Ham (1986) - "elements of self-analysis should be available as part 
of the stutterer's own knowledge and be functional during any 
situation in which he or she participates" (pg.69).

Perkins (1973) - states that awareness of the specific stuttering 
behaviors that must be managed is crucial.  

Van Riper (1973)  - strongly advocates teaching the dysfluent child to
identify his/her own primary and secondary stuttering behaviors. 

Activities/Techniques:

 1. Tape record - Use of audiotaped speech samples is helpful in 
    initial identification of primary or audible secondary behavior(s)
    as well as continued identification of inappropriate rate and 
    audible tension.  Audiotaping is also helpful during the later
    stages of therapy to improve self-monitoring skills.  The client
    may be asked to assess a sample of his/her speech for 
    effectiveness of technique use.

 2. On-line identification - The clinician first identifies primary
    and secondary behaviors or easy and hard speech for the child.
    Then the child gradually begins the identification of these
    behaviors himself/herself.  It is helpful to contrast the 
    identified behaviors with easier forms of saying the word or
    describing what made the word hard.  Cooper and Cooper (1985)
    developed the "Apple Core" worksheet which provides a visual
    demonstration of one's stuttering (the apple core) and what one 
    does because they stutter (the seeds).

 3. Identifying behaviors in the clinicianŐs speech is a helpful way
    to initially increase the childŐs awareness.

 4. Contrast drills - Using word lists, the client is instructed to
    produce each word - first hard, then easy.  The clinician aids the
    client in identifying what made each word hard or easy.

 5. For the latter stages of therapy, the clinician must cue the
    client to monitor those aspects of his/her speech which may be
    interfering with fluency.  Gestural cues may be adequate; however,
    verbal cueing such as "Did that feel hard?", "Is your mouth open
    enough?", and "Did you feel that you had no air for speech?" may
    be more helpful.