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From: Greg
Date: 10/7/02
Time: 2:03:44 PM
Remote Name: 68.105.255.171
Hi Elizabeth,
Thanks for your kind words; you raise an issue that—in hindsight—I wish I had included in the manuscript.
When we’re talking about stuttering therapy, we need to first clearly delineate our therapeutic goals. Only from these goals can we then begin to discuss specific management techniques to meet these goals.
So if there’s a client wishing to stutter less without constant cognitive attention to speech production, then a prosthetic device alone may suit their needs. However, if a client shows interest in how to best learn to live with stuttering, then a prosthetic device in conjunction with Sheehan’s approach/avoidance therapies may be ideal. (SSMP is also applicable in this example.)
So to answer your question, a prosthetic device is nothing more than an appliance that can be used to lessen the frequency of stuttering behaviors. It doesn’t “cure” or “remove” the disorder; instead, a prosthetic just lessens the frequency of the disorder’s manifested symptomotology. Thus, it seems to me that it could be used solely as a stuttering management, and also in conjunction with stuttering modification and/or avoidance methodologies – it all depends on the personal therapeutic goals of each individual client. While we all have our own opinions as to which implementation of ASF is the “right choice”—it’s ultimately the client’s decision, which should be based on their personal values and realistic therapeutic objectives.