6/17/10

Wild Speech Monsters

It can be helpful for some children to illustrate their stuttering. This gives them a way to separate the behavior called stuttering from who they are as people. The child stutters - it is something that he/she does, not something that is inherently a part of who the child is. With this approach to therapy, the child takes the stuttering and puts it outside of him/herself in the form of a picture, sculpture, craft, or project. Some children may make friends with this depiction and negotiate a truce as his/her speech improves. Some children may benefit from releasing anger and frustration at it by destroying it in some way, such as smashing a playdo figure or ripping up a drawing. In both cases, children may experience a greater sense of control over their 'speech monster.' *

Where the Wild Things Are, the original cartoon version of the book, could be a helpful story when teaching this point of view. One simple description of the story is that a little boy finds a way to manage his angry emotions. They are monsters that he tames, plays with, and leaves behind. Perhaps in the same way, we can teach children to play with and tame their speech.**

*http://www.mnsu.edu/comdis/isad7/papers/shields7.html
**http://childrensbooks.about.com/cs/picturebooks/fr/wildthings

6/9/10

Scaffolding

"Scaffolding" is support. In education, scaffolding refers to the amount and type of supports children need to succeed. (1) In speech therapy for stuttering, scaffolding, to my way of thinking, is when a parent schedules time for speech homework, praises a child's efforts, looks for creative ways to practice speech goals, offers tangible rewards, asks about her child's feelings, helps him plan for speaking situations and educates others about stuttering.

Scaffolding occurs at every level of a hierarchy of goals. Practicing 'slow/gentle sounds' (my term for easy onset) at the one-word level is one step in a hierarchy. At the one-word level, a child completes a variety of speech therapy activities. Hopefully, the activities are designed to be games that parent and child play together. In my practice, these games include language processing tasks: auditory memory, phonological processing, word finding, vocabulary building, auditory comprehension and reading. There are many possible activities at each level of a hierachy.

The rules of each therapy game describe how the adult will provide scaffolding. Before a child responds, the adult gives a prompt. The prompt is a form of scaffold. The prompt may be a direct instruction like, "use slow/gentle beginning sounds." When the child is able to use slow/gentle sounds more automatically, instructions become less direct. The adult may only need to say something like, "Let's play a speech game." The fact that it is a speech game will cue the child to use whatever skill she is practicing. After a child responds, the adult gives some kind of feedback about the correctness of that response. The feedback is a form of scaffold. It is often a token. Tokens come in many forms: pennies, check marks, stickers. How much and how often a child earns tokens gradually diminishes and tokens are replaced by verbal praise.

Scaffolding should also increase empowerment and independence. For example, there will be times when the parent determines the time for speech homework and sits down with her child to compete activities together. Then, gradually the parent does something else, such as making dinner, while the child performs speech homework in the same room as the adult. (Stuttering varies with each speaking situation, so, homework should almost never be completed alone. The child needs to talk with someone while practicing speech skills.) Eventually the child should be responsible for approaching her parent and saying, "Let's play a speech game now." It is important for a child to learn to take responsibility for his own speech homework, because there will come a time when he will need to choose when to try out his new speech skills in everyday life.

This concept of scaffolding in my own life became apparent when I attended a student's graduation party. This young man's progress was accomplished with the assistance of other speech language pathologists in addition to myself. So, I was surprised to learn that I'd made an significant difference in his life and I was delighted to be invited to his family celebration. But I was also anxious because I am not a 'party person.' I really enjoy one-on-one and small group interactions, but fail at larger group gatherings. I typically hover at the fringe at such occasions and eventually meet other guests doing the same. An additional complication for this event was that I would need to avoid any break in patient confidentiality. After introducing myself, I would have to dodge any questions about what this student and I had done in speech therapy.

I was the first to arrive. That meant I could share his parents' pride right away. As more guests arrived, I soaked up the sunny afternoon in what was a beautiful location and sampled from a delicious buffet. After a while, it became apparent that the adults were distancing themselves from the teens by gathering on an elevated deck. I realized that finding my conversational partner(s) was going to be too much of a challenge with this arrangement. After some time, someone offered me the scaffolding I needed by bringing two guests over to chat with me. I appreciated this gesture and shared in several minutes of conversation. When these guests said their goodbyes so did I. This was a carefully prepared party, but I needed more scaffolding in order to mix with the other adult guests. But, then again, this was a family affair, and there really was no need for me to linger long. I left satisfied with my visit and gratified to have made a difference in someone's life. Its what all SLPs truly hope to do.

(1) http://condor.admin.ccny.cuny.edu/~group4/
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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.