**SPHP 219 class—there are a few slides with **
on them. These slides will NOT be on test 3.
Basic Counseling
Confidential
Non Judgmental
Active Listening
Effective Feedback
Culturally Sensitive
Age of Client
Education of Parents
Family Values, Resources
Effective treatment of families and PWS means
addressing all aspects of stuttering
Physical, Cognitive and Emotional Aspects of
Stuttering.
SLP job
provide appropriate therapy
Counsel you about the feelings that you experience
Develop a framework for thinking about stuttering
Develop practice exercises that fit your lifestyle and
personality
Develop a healthy attitude about stuttering
Provide resources (NSA,SFA)
sort through media hype
conference with family, school, work
Are you desensitized to stuttering?
Your skill set is limited
So is mine
Be honest with yourself, your client and your supervisor about
your strengths and needs
Obtain support from mentors, CEU courses, outside agencies
to craft a program that works
Establish credibility with honest exchange of information
I will provide treatment for you/your child as long as I feel you
are receiving the
best services. Like most SLP’s we rarely see PWS because
only 5% of children and 1% of the adults stutter. Its very
unusual for any SLP to have the opportunity to treat a large
number of PWS.
Establish your treatment goals and when/if you will refer out.
Plan in the beginning for the transition to the next phase of
growth.
An outside referral may be for a limited time or may be a
permanent transition.
Sample wording for transition:
I know you appreciate the services I have provided. As we
discussed when we started working together my professional
obligation is to refer you to others when needed.
I have taken you as far as I can and your needs will be better
served if I refer you to an expert who may support your goals.
Counseling
Be Honest about Stuttering
Unless you are a PWS, admit you don’t know how it feels to stutter.
Ask most PWS and they will tell you they get pretty upset when a
therapist nods and says:
Gee, I know how it feels.
It’s okay, don’t be nervous.
Don’t worry, when I’m nervous I stutter too.
Acknowledge they are the experts regarding the experience of
stuttering
You might say:
I can imagine how frustrating it might be.
I don’t stutter can you share with me how it feels to
stutter?
If you were to share with your
parents/spouse/employer what its like to stutter
what would you tell them?
Establish top three goals for the PWS
Establish top three goals for associated
support network.
For PWS
Establish the range of their stuttering symptoms.
What happens most often?
Provide chart with range of symptoms and samples.
Use their language, terms and descriptions.
For PWS
Acknowledge the sadness, the grief, the lost opportunities
and the effect on their life.
Do they accept their stuttering?
Do they feel its their fault?
What do they feel before, during and after the moment of
stuttering?
For PWS
Establish goals regarding advocating and advertising that they
stutter.
Be careful not to minimize their feelings.
Create a positive goal for homework
My wordinglet’s build from there
That’s a good start
For Spouse or Parent of PWS:
Ask about origin, progression, what helped, what didn’t work,
techniques, technology, behavioral cognitive strategies, community
resources, groups, reading, videos, movies, intense programs,
NSA, SFA, friends, support network, finances, coping skills, family
history of stuttering, cluttering, learning issues, research, drugs,
counseling, emotional concerns, Toastmasters.
For a child who stutters review:
Their strengths, activities they enjoy, do they know why they came
to see you today, do they like the way they talk, show pictures of
how they feel, have they been bullied or teased, do they know
anyone else who stutters, what do they call their bumpy speech,
use art, building, make books, play therapy, watch videos if child is
ready.
Don’t videotape or play back tapes of PWS unless they are ready.
For SLP
Do the clients goals reflect your needs or theirs?
No guinea pigs
Example: “I want to work on _____.” (you open the 1 st page of the therapy
book you just purchased.)
Instead build on past positive experience:
“You mentioned you successfully used vowel prolongations in past therapy,
let’s start using that with rote activities, then use vocabulary specific to your
occupation.”
Let me know if any task is too easy, it’s too difficult, or if it’s just a little
challenging.
For SLP
Show client chart with numbers to establish common rating
system.
Ask client to provide feedback using numbers or colors.
Assure client that while you work with them you will always
model techniques first ,use techniques as a team and when
they are ready they will practice technique alone.
Wording: prefer that ______, ready for ______, in or out of
comfort zone, ready to risk.
When your with me, you’re safe, our discussions are
confidential and you’re free to stutter.
For SLP
Do You Have Preconceived Ideas About PWS
That Hinder Your Treatment Effectiveness?
Examine Your Beliefs About PWS.
Review Current Research Before and During
the Treatment of PWS.
For SLP-what to expect
Which of the following statements is likely to be spoken
by a PWS?
I know what I want to say and wish others would just wait
for me to finish talking.
I feel like my head is going to explode if one more person
tells me to slow down.
What’s wrong with me-why can’t I control my stuttering?
For SLP-what to expect
Which of the following statements is likely to be said by an
adult PWS?
I wish that I had been treated for stuttering at an earlier age.
I am frustrated with all the misinformation about stuttering.
Most SLP’S know a lot about PWS.
People with autism, aphasia and physical disabilities are
treated and understood better than PWS.
For SLP-what to expect
The parent of a child who stutters usually:
Is concerned that they caused their child’s stuttering.
Wonders if they are doing anything to prolong stuttering.
Feels guilty that they can’t help their child.
Have tried their own solutions.
For SLP-what to expect
Parents often react differently to child that stutters based on
their own Hx, mental health and coping skills
Mom – May not help child due to Dad’s resistance
Dad who stutters– May be resistant due to guilt, blame, shame
“I gave this to my child.”
For SLP-what to expect
Discuss with parents
What if you knew in advance that:
your child would stutter?
Have dyslexia?
Win a gold medal?
What have you learned from your child?
For SLP-what to expect
The parent of a child who stutters usually:
Feels embarrassed and confused about what to do when
someone comments about their child’s stuttering.
Feels frustrated and confused about treatment-they consulted
three SLP’s and all three provided conflicting advice.
For SLP-what to expect
The Parent of a child who stutters is comforted and served best
when you:
tell them the truth.
provide concrete examples of stuttering.
help them to recognize all aspects of stuttering.
help them to respond to the comments of others.
reassure them and strengthen their skills as their child’s
stuttering fluctuates.
provide the most current research, techniques and tools for the
efficient management of stuttering.
For PWS
Explore their feelings about stuttering.
Use therapy tools which explore their feelings.
All feelings are okay.
It’s what you do with the feelings that matter.
For PWS
How much pain has stuttering caused in their
life?
Do they feel it has altered their education,
social life or choice of occupation?
For PWS
If you could change one thing about your
experience with stuttering what would it be?
What character traits have you developed as a
result of stuttering?
Explore their strengths.
For PWS
Things I like about myself.
Things I would like to change.
Increase PWS awareness of perceptions
Are their perceptions accurate? Distorted thinking is common
Complete these sentences:
People think that kids/PWS are _____
My Teacher thinks kids who stutter are _____
My employer thinks PWS are _____
I think that PWS are _____
My Friends think that PWS are _____
Don’t ignore the negative, rather, channel into
more productive statements.
Channel negative energy into positive.
Provide written, tactile and verbal
resources for home assignments.
As an SLP you have the power to impact the
life of a PWS, their family and our society
As an SLP you have tremendous power to
influence PWS
Students who stutter are still alone in an
articulation group
Articulation is addressed over stuttering
Stuttering gets worse, the window is closed
Articulation vs. Stuttering treatment
PWS are more vulnerable because of low
incidence
Less money, less research, invisible disability,
not great for TV or radio spots
PWS & NSA**
Group Attendance
Nice to belong
Place to practice
Learn from others
Help others/mentor
Understand spouses experience
Appreciated for true self not as PWS first
PWS & NSA**
No Group Attendance
“Not joiner”
Private person
Not ready to admit they are part of “that group”
Group Distance
Resources are limited
Embarrassed to be PWS
Angry with SLP’s, MD’s
Tired of talking about stuttering
Summary
Treatment needs to be about PWS goals
Evidence based
Timely
Combined eclectic approach
Not cookbook therapy
Individual, group and real world
Over learn skills to speak under stress
You are critically important
You have power
Enhance PWS’ life by providing the best care
Stuttering Resources **
FluencyCoach Free Software-AAF
Online Metronome-Pacing
SpeechEasy-FAF in or behind ear
MySpeech-personal AAF device
Friends – The National Association of Young People who Sutter
National Stuttering Association (NSA)
Roseville-Sacramento NSA Chapter Group
Stutter Talk
The Stuttering Home Page
Toastmasters
California Department of Vocational Rehabilitation