Stick Up For Yourself!

Speech therapy goals often assume knowledge and experience that some families do not have. This post is about one of those areas: assertive communication. As soon as a child, teen or adult learns the basics of fluency shaping, stuttering modification, or any other new way of speaking, he needs to begin practicing outside the speech therapy room. This is sometimes called "generalizing" or "transferring" new skills to real life. Generalizing a new way of speaking requires assertiveness. For example, listeners need to be educated about what the new way of speaking is all about. It is going to sound different to them. They may be confused as to how to respond in helpful ways. The speech therapy student will need to initiate the conversations that will explain to others how to be supportive.

I've found that books written for children can make learning new information quick and easy for both adults and children. I really like books by free spirit publishing at http://www.freespirit.com . One good book for learning assertive communication is Stick Up For Yourself! Every Kid's Guide to Personal Power and Positive Self-Esteem by Kaufman, Raphael & Espeland. Perhaps you can find this book or others like it at your local library. I often purchase used books on topics such as this from Amazon.com or from library book sales and yard sales. Where ever you find books, now you can be on the lookout specifically for titles having to do with assertive communication skills.

In future posts, I will address other topics to help you understand stuttering therapy in a larger context.


Newsletters for You

Here are three newsletters that can arrive in your mailbox to give you information and support.

1. Family Voices is produced by the National Stuttering Association http://www.westutter.org/. Each issue contains information from parents, speech-language pathologists, kids and teens.

2. The Stuttering Foundation mails out a newsletter packed with information about professional conferences, articles in the news about stuttering, and newly published books and articles. The website http://www.stutteringhelp.org/ is a treasure chest of valuable information you don't want to miss.

3. Reaching Out is distributed by FRIENDS: The National Association of Young People Who Stutter. The Friends site is at http://www.friendswhostutter.org/ .


The Optimistic Child

The Optimistic Child by Martin E. P. Seligman, Ph.D. (1995) offers us food for thought as we encourage children to carry-over the goals of speech therapy into real life. This book addresses the larger issue of teaching children how to approach life with a sense of empowerment and purpose. When we place the problems of stuttering in this larger context, we hope to give children the tools and mindset to overcome stuttering AND other challenges.

Parents worry about their children being teased for stuttering. They want their children to speak more fluently so as to avoid the pain of peer rejection. Dr. Seligman suggests that this desire to prevent and alleviate feelings such as sadness, anxiety and anger come from the "'whistle a happy tune' boosterism of the 1950's." (p.50) He says this strategy is actually counterproductive. "In attempting to cushion bad feeling, the self-esteem movement also minimizes the good uses of feeling bad." (p. 42) What could be good about feeling bad?

When children are challanged by stuttering or by practicing new ways of speaking, they may feel embarrassed, frustrated, and defeated at times. But Dr. Seligman thinks that "in order for your child to experience mastery, it is necessary for him to fail, to feel bad, and to try again repeatedly until success occurs." We cannot just tell our children to feel better about their speech. It is by DOING something that they alleviate bad feelings. It is active problem-solving that improves their situation. We can support children's efforts to find themselves a better way.

Today I played with Star Wars action figures. My playmate was a preschooler. As he talked about the characters in the latest Star Wars animated movie, I felt I was hearing fear mixed in with excitment, especially regarding the battle scenes. I felt the 'bad guys' in the movie looked quite frightening; so, I searched for some way to help this child feel safe. I said I liked where he placed his action figures and later described how his characters were effective in our play battles. I asked his advice for where to place clone warriors. (Is that what they are called?) I expressed confidence in the "Commander" and other leaders. Later, I would explain how he could feel safe with his parents protecting him. This little guy should not feel the need to defend himself against things as fearsome as the weaponry in Star Wars. In general, I looked for ways to assure him that his actions were more powerful than those of the oncoming menace.

To learn more about how to help your child experience and bounce back from negative emotions, visit the website of Robert Brooks, Ph.D. at http://www.drrobertbrooks.com/.


Time Pressure Challange

For many people, stuttering happens more often when there is time pressure. What is time pressure? Time pressure is when we have to do something quickly, by a deadline. All kinds of situations have increased time pressure:

*Leaving the house to get somewhere on time
*Anticipating a turn to read aloud in class
*Ordering food at McDonald's
*Answering a question
*Getting into a conversation

Using speech tools when there is time pressure is an advanced skill. That is why we begin practicing speech tools WITHOUT time pressure. This is why adult listeners wait 2 seconds before responding to children - it slows down the pace of conversation. This is why teens learn to drive in parking lots and side streets before attempting the highway!

1. Parents need to change how the family does some things in order to reduce time pressure. There are many ways to work on this, for example, preparing for events ahead of time.

2. There needs to be a peaceful time each day when children can enjoy life at their own pace.

3. Children and parents can agree on times when the child should wait to talk. When adults are busy with other important things, such as talking on the phone, children need to wait for a better time to talk with them.

4. Speech therapy includes "counter-conditioning" to time pressure. This means that the child practices speech tools in games that gradually introduce small amounts of time pressure. The child learns to 'desensitize' to the time pressure. This helps him to speak despite time pressures.

A recent study found that "...for young children and adults, broad chunks of output have been planned by the onset ...of a sentence." (Journal of Speech, Language, and Hearing Research, December 2008, Vol. 51, p. 1424, The Breadth of Coarticulatory Units in Children and Adults by Goffman, et. al.) It seems to me that this study lends support to the idea that giving a child more time to speak is giving his speech motor system the extra time it needs to plan ahead for a more fluent sentence.


Advocacy in the Schools

This year, I spoke at 2 public schools. Both were free presentations offered to anyone who would listen - teachers, teachers' aides, administrators, SLPs, parents. Many thanks to my students' parents for promoting these talks about stuttering.

Children spend so much of their lives in a school building. If every adult and child in the school environment had the chance to learn more about stuttering, how much better life would be for the child who stutters!! Some children are brave enough to do classroom presentations about stuttering. See "My Sixth-Grade Classroom Presentation on Stuttering" http://www.mnsu.edu/comdis/isad7/papers/presentations7/cahalan7.html. Others need adults in their lives to be advocating for them.

Further reading about stuttering therapy at school can be found as part of this year's International Stuttering Awareness Day Online Conference at http://www.mnsu.edu/comdis/isad11/papers/vanriper11.html.


Online Sites for Therapy Materials

Looking for workbooks, games, and other educational materials for children? Here are 2 sites that sell materials to Speech-Langauge Pathologists that will also pay for shipping. You can buy just about anything except professional testing materials.

Linguisystems: http://www.linguisystems.com
SuperDuper Publications: http://www.superduperinc.com


Well Being

In The POWERR Game: Managing Stuttering by Gordon W. Blood, the "W" in POWERR stands for well being. Well Being is the title of Phase 3 of his speech therapy program. "The Well-Being component ... addresses the ways in which clients perceive their control over their lives. It offers a good time to discuss how stuttering fits into the general scheme of their lives." (p. 32) Taking a speech therapy concept such as this one and turning it into a fun, engaging activity for students is the challange being a speech language pathologist. :)

Today my students used a scale that I found at a yard sale. This scale has 2 dishes, which, when each contains the same amount of weight, come into horizontal balance. If one dish contains more weight, it drops that side of the scale lower than the other.

On one side of the scale I placed a small red plastic bowl. This bowl represented stress. We dropped marbles into the red bowl to represent different stressful situations. I dropped in 2 marbles to represent driving in rush hour traffic. Students dropped in marbles to represent homework, forgetfulness, illness, fatigue, public speaking, using the phone, and so on. Quickly, the scale became lopsided, just as life gets unbalanced when we are overwhelmed with stressful events. Next, we brainstormed activities to relieve stress: listening to music, taking a walk, talking with friends, taking slow deep breaths, catching up on sleep, etc. We did this as we dropped marbles into a small plastic white bowl on the other dish of the scale. Gradually, the scale became balanced again.

We know that stuttering is not caused by stress, but that it can be affected by stress. And, we are not completely helpless when this happens. We can behave in ways that restore a greater sense of balance. As a student learns which stressors are fluency disrupters for him, he can change his behavior to help prevent as well as bounce back from periods of stuttering relapse. This is empowerment. This is shifting the locus of control from outside oneself, to inside oneself. This is a life long journey requiring observation, experimentation, and the adoption of a lifestyle that supports greater fluency.

This activity can also be interpreted differently. If we assume that greater fluency is not the goal at a particular time for a particular student, then we can imagine avoidance behaviors would create stress. Putting off the phone call, choosing not to participate in classroom discussion, and switching words so as not to stutter on certain sounds could all be represented by marbles dropped into the red bowl. Antidotes to this kind of stress might be informing listeners about stuttering, enlisting teacher support in order to feel comfortable stuttering in class, or practicing voluntary stuttering on feared sounds. These latter behaviors would be marbles dropped onto the other side of the scale, bringing back a sense of personal control and balance to life.

Effective speech therapy leaves a lasting, positive impression. Sometimes, the "results" of a session are not realized right away. I've heard adults recovering from stuttering fondly remember lessons from childhood that did not sink in until young adulthood. I hope that when my students recall dropping marbles onto the scale, it will remind them that they "have the right to change," as Gordon Blood writes in Phase 3 of his program.

The POWERR Program can be purchased from the Stuttering Foundation, http://www.stutteringhelp.org/ , Publicaton No. 0250.

Using "Graphic Organizers"

A "graphic organizer," the way I use it in speech therapy, is a simple drawing that helps a student 'see' his ideas in a meaningful way. The elementary school age child may be introduced to graphic organizers in the form of oval shapes connected with straight lines to indicate related ideas or a series of boxes connected by arrows to indicate a sequence from left to right.

Today I took this concept a step further by asking my student to draw a chair large enough to fill an 8 x 11 sheet of paper. This student likes to build things and at an earlier session, he explained to me how to build a chair. This is when I learned what a lathe was! :) He recalled a school presentation and we talked about how the several items of his presentation could be written as notes into the drawing of the chair. The topic of the presentation was written on the seat. A major subtopic was written on the back of the chair. Facts were written on the legs of the chair and relationships between the facts were written on the cross bars that connected the legs. Using this graphic organizer in the shape of a chair, he recalled his presentation - while using fluency enhancing strategies.

Again, taking this another step further, I gave him several children's blocks of different sizes and he wrote on each one of them an idea about a personal experience. He wrote main ideas on the larger blocks and then, by refering to the structure - this 3D graphic organizer - he recalled the experience 3 times. The first time, he simply said what was on the blocks. The second time, he provided more details than had been written down. The third time, he added words of emotion to the story. By the time he was finished, he had quite a lengthy narrative with which to practice whatever 'speech tools' he chose.

Graphic organizers are visual cues for big ideas. Imagining a chair (or other object)and the information each part of the chair represented may be an effective way for some children to study and recall infomation. The student who learns from hands-on experience may find that labeling small blocks, stones, shapes of colored paper, or other objects helps him to organize, study, and remember information. Now he also has a way to practice speech goals in a meaningful narrative.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.