The Background Basics

Third edition, also known as the PFCT-C

This tool was originally put out for commercial use in 1976 as the first comprehensive stuttering program commercially available to clinicians. The third and last edition was released in 2003. The children’s version costs $158 and the adolescent and adult version is only $67.

This children’s version consists of a clinician’s manual, assessment diagnostic and treatment plan, and some child directed materials that can be used for therapy.

About the Coopers

Dr. Eugene Cooper and his wife Crystal Cooper designed this assessment and therapy. Both Coopers are Fellows of the American Speech-Language-Hearing Association. They are the authors of over 150 publications primarily in the area of fluency and professional issues and have held numerous positions and done extensive research in relation to stuttering.

The Coopers also produced a computer program called the CASS-C in 1999. The CASS-C, which stands for Cooper Assessment of Stuttering Syndrome- for children, is a computer program designed to allow a complete fluency assessment of a child's speech while simultaneously preparing an assessment analysis and report. The program was found difficult and distracting to use with a four-year-old child, being too cumbersome, inflexible and with questions on affective and cognitive subjects that were inappropriate for small children. I do not think it is commonly used.

About the manual:

The manual is really extensive. It contains 7 chapters on the Coopers’ definition of stuttering, assessment, treatment, school-based strategies for children who stutter, intervention ideas, counseling parents, and how to be an efficient clinician. Additionally, there are appendices with reproducible assessment protocol worksheets; treatment related forms and guides, and intervention materials as well as support services, which includes a listing of websites.

The primary focus of the Cooper Program is to help the client to feel in control, indicating that the end goal of therapy should be that the client should develop a feeling of control regardless of whether or not that individual becomes fluent.

The first chapter elaborates on the Coopers’ view of stuttering as a syndrome that has ABCs (affective, behavioral, and cognitive components). The manual states that “stuttering is a clinical syndrome characterized most frequently by abnormal and persistent dysfluencies in speech accompanied by characteristic affective, behavioral, and cognitive patterns.”

Stuttering is divided into 3 different major syndromes:

Developmental Stuttering:

*2 of every 5 abnormally dysfluent children under 7 years of age.

*Typically without significant professional help but with knowledgeable and supportive parental assistance achieve normal fluency by age 7.

*Few can actually recall stuttering

*Typically do not feel loss of control or at least unable to verbalize these feelings. They may indicate awareness of dysfluency but give little evidence that they view it as a problem.

Remediable Stuttering:

*2 out of every 3 children who are abnormally dysfluent after the age of 7

*Typically are able to make adjustments to the ABCs to achieve fluency with professional assistance and a supportive home environment.

*As adults, generally recall stuttering but do not consider themselves to still stutter

*Experience some feelings of loss of control during times of dysfluency but dysfluency is episodic and frequently associated with change in environmental, physical, and mental situation

Chronic Perseverative Stuttering (CPS):

*1 out of every 3 stutterers who have abnormal fluency problems beyond age 7

*Acceptable level of fluency may require a lifetime of coping

*Hope for a complete cure or total remission of symptoms seems remote

*However, with assistance these individuals are able to develop and maintain a feeling of fluency control

Controversy of A diagnosis as a CPS:

The idea that stuttering could be incurable strikes some stutterers and speech pathologists as defeatist. Cooper has been accused by colleagues of presenting a "doomsday message" and, by claiming that for some a cure is impossible, violating professional ethics. Others SLPs and clients who support this idea have been accused of taking the easy way out.

On the other hand, the idea that stuttering is not curable has been a positive step most, especially for those who are believed to have CPS. Charles Van Riper is quoted to have said that the Coopers’ presentation of the condition of CPS as “not only courageous but magnificent” and they received many letters from people who believed they have CPS Syndrome. The idea removes feelings of guilt and discouragement from the client who has had no success achieving fluency even after years of therapy.

The idea that achieving fluency may be impossible for some clients is one of the main reasons that this CPFT program aims toward feelings of control rather than normal fluency.

Treatment:

This is a stuttering modification approach.

Stages of PFCT-C Treatment à “STAR”

Structuring – Clinician structures treatment process by teaching the language of fluency… the child learns to talk about stuttering and treatment.
Targeting- Child’s feelings, behaviors and attitudes that impede or facilitate therapy are targeted for treatment and strong emphasis is put on building a client-clinician relationship in which the child feels comfortable expressing feelings and attitudes about stuttering.
Adjusting- Child is guided in adjusting feelings, behaviors, and attitudes that maximize the enhancement of fluency. After the child has learned to self-reinforce he is introduced to the FIGS (Fluency Initiation Gestures) and can learn to gain control and to stutter fluently. EXPLAIN THE FIGS HERE
Regulating- Child guided in regulating ABC patterns for long-term maintenance of the feeling of fluency control. The child is assisted by the clinician in planning and using the FIGS in speech situations. Regularly scheduled therapy sessions are ended when the child feels as though he can maintain fluency control even in a difficult speaking situation.

This Manual also includes:

*There are additional chapters on how to work individuals from the student’s school to ensure a team approach to help the client earn fluency control, intervention ideas and activities, how to counsel parents of children who stutter, and things that a clinician must keep in mind to become an efficient clinician who uses the Cooper methods.