tag:blogger.com,1999:blog-36988665225772656512024-03-08T19:10:44.329-05:00Comments on Speech TherapyThis is a blog by Judith V. Butler, M.A., L.L.C., Licensed & Certified Speech Language Pathologist, ASHA Board Certified Specialist in Fluency for 14 years. This blog is Attribution-NonCommercial-ShareAlike 4.0 International Licensed. (CC BY-NC-ND 4.0) Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.comBlogger83125tag:blogger.com,1999:blog-3698866522577265651.post-15396106415327830392020-02-20T09:34:00.000-05:002020-02-20T11:06:52.111-05:00Voluntary Stuttering: An Oxymoron?<br />
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<span style="font-size: 14.0pt;">This
is a revision of the original<span style="mso-spacerun: yes;"> </span>post "Voluntary Stuttering?" posted 12/12/08<o:p></o:p></span></div>
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In this opinion piece, I <span style="color: windowtext;">ponder the use of voluntary stuttering in speech
therapy. For example, I wonder why voluntary stuttering as it appears in <i>Easy Talker:
A Fluency Workbook for School-Age Children</i> <w:sdt citation="t" id="-1415700480"><!--[if supportFields]><span style='mso-element:field-begin'></span>CITATION
Bar97 \l 1033 <span style='mso-element:field-separator'></span><![endif]--><span style="mso-no-proof: yes;"><span style="mso-spacerun: yes;"> </span>(Guitar &
Reville, 1997)</span><!--[if supportFields]><span style='mso-element:field-end'></span><![endif]--></w:sdt> is vastly different from how it appears in <i>Easy Does It for Fluency:
Intermediate</i> <w:sdt citation="t" id="653958248"><!--[if supportFields]><span
style='mso-element:field-begin'></span><span
style='mso-spacerun:yes'> </span>CITATION Ros98 \l 1033 <span
style='mso-element:field-separator'></span><![endif]--><span style="mso-no-proof: yes;">(Roseman & Johnson, 1998)</span><!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt>. <span style="mso-spacerun: yes;"> </span>Let's reconsider voluntary stuttering,
especially in light of two recent research studies. <o:p></o:p></span></div>
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This definition of stuttering
appeared in "Stuttering as Defined by Adults Who Stutter:" “. . . <i style="mso-bidi-font-style: normal;">stuttering </i>indicates a sensation of
being stuck or losing control when speaking, a behavior a person might or might
not outwardly show, and various affective or cognitive reactions a person
experiences.”<w:sdt citation="t" id="1261187462"><!--[if supportFields]><span
style='mso-element:field-begin'></span>CITATION Tic19 \p 4363 \l 1033 <span
style='mso-element:field-separator'></span><![endif]--><span style="mso-spacerun: yes;"> </span>(Tichenor & Yaruss, 2019, p. 4363)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt> Given this
definition, fluency counts may be beside the point. A meaningful assessment of
stuttering may depend <u>primarily</u> upon a client's ability and willingness to
share their thoughts, feelings, and experiences associated with a loss of
control when speaking. <o:p></o:p></div>
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Since stuttering " . . . is
considered to be a complex, multifactorial disorder. . ." <w:sdt citation="t" id="797951015"><!--[if supportFields]><span style='mso-element:
field-begin'></span>CITATION Byr16 \p 290 \l 1033 <span style='mso-element:
field-separator'></span><![endif]-->(Byrd, Gkalitsiou, Donaher, &
Stergiou, 2016, p. 290)<!--[if supportFields]><span style='mso-element:field-end'></span><![endif]--></w:sdt>
the following advice found in <i>Easy Does It</i> is inappropriate: “Finally, reassure
the student that there's nothing wrong with him . . . He just needs to learn a
new habit and you’d like to help him.”<w:sdt citation="t" id="962078194"><!--[if supportFields]><span
style='mso-element:field-begin'></span>CITATION Ros98 \p 9 \l 1033 <span
style='mso-element:field-separator'></span><![endif]--><span style="mso-spacerun: yes;"> </span>(Roseman & Johnson, 1998, p. 9)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt><span style="mso-spacerun: yes;"> </span>It seems to me that describing more fluent
speech as a "habit" sets the client up for self-blame and failure. <o:p></o:p></div>
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Purportedly, there are at least
three reasons for stuttering on purpose:</div>
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<u>Reduce fear</u>: “Pseudo-stuttering
is an excellent desensitization tool and ‘turns stuttering on its head’ by
changing it from a behavior to which a child is seemingly defenseless to one
that the child can turn on and off at will."<w:sdt citation="t" id="2060965671"><!--[if supportFields]><span style='mso-element:field-begin'></span>CITATION
Ram15 \p 85 \l 1033 <span style='mso-element:field-separator'></span><![endif]--> (Ramig & Dodge, 2015, p. 85)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt><o:p></o:p></div>
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<u>Move through a stutter</u>:
“Sometimes, when children are experiencing a very tense block, they can
initiate their pull-out with a ‘bounce’ or an easy stutter.” <w:sdt citation="t" id="-38048815"><!--[if supportFields]><span style='mso-element:field-begin'></span>CITATION
Rea13 \p 101 \l 1033 <span style='mso-element:field-separator'></span><![endif]-->(Reardon-Reeves
& Yaruss, 2013, p. 101)<!--[if supportFields]><span style='mso-element:
field-end'></span><![endif]--></w:sdt><o:p></o:p></div>
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<u>Identify oral-motor tension</u>:
“First, Annie asked 3B to pretend to get stuck on a word. Then, Annie asked 3B
to stay in the stutter and feel what his body was doing ..." <w:sdt citation="t" id="747926172"><!--[if supportFields]><span style='mso-element:
field-begin'></span>CITATION Bar97 \p 113 \l 1033 <span style='mso-element:
field-separator'></span><![endif]-->(Guitar & Reville, 1997, p. 113)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt> (I do not find a
definition of voluntary stuttering in the <i>Easy Talker</i> workbook. Children
"pretend" to stutter and produce "cool fakes." Voluntary
stuttering is whatever the <u>speaker</u> feels it to be.)<br />
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The headline "Clients Who
Imitate Their Own Stuttering Patterns Claim Favorable Effects"<w:sdt citation="t" id="1471083435"><!--[if supportFields]><span style='mso-element:
field-begin'></span>CITATION ASH16 \l 1033 <span style='mso-element:field-separator'></span><![endif]--><span style="mso-spacerun: yes;"> </span>(ASHALeader, 2016)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt> caught my eye. I've
learned to look beyond headlines, so I read the AJSLP article. <span style="mso-spacerun: yes;"> </span>Let's look at the numbers.<o:p></o:p></div>
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"Seventy-five (42%) of the
177 respondents . . .reported that voluntary stuttering reduced their fear,
eight (5%) reported that voluntary stuttering eliminated their fear. . ." <w:sdt citation="t" id="1387061432"><!--[if supportFields]><span
style='mso-element:field-begin'></span>CITATION Byr16 \p 294 \l 1033 <span
style='mso-element:field-separator'></span><![endif]-->(Byrd, Gkalitsiou,
Donaher, & Stergiou, 2016, p. 294)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt> <o:p></o:p></div>
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". . .81 (45%) stated that
the use had no impact on their fear, eight (5%) stated that the use increased
their fear of stuttering, and five (3%) responded that voluntary stuttering
significantly increased their fear of stuttering." <w:sdt citation="t" id="-977836141"><!--[if supportFields]><span style='mso-element:field-begin'></span>CITATION
Byr16 \p 294 \l 1033 <span style='mso-element:field-separator'></span><![endif]-->(Byrd,
Gkalitsiou, Donaher, & Stergiou, 2016, p. 294)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt> <o:p></o:p></div>
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While the authors analyze the
data thoroughly, looking at the types of voluntary stuttering respondents used,
these percentages still give me pause. How do I decide which client is a member
of the 47% who felt less fear or of the 53% who found no benefit or an increase
in fear?<o:p></o:p></div>
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The <i>School-Age Stuttering Therapy
</i>workbook proposes that the clinician voluntarily stutter. “Thus, you need
to be willing to ‘put stuttering in your own mouth’ so you can enter real-life
situations and practice with your students. . .” <w:sdt citation="t" id="-1139256547"><!--[if supportFields]><span style='mso-element:field-begin'></span>CITATION
Rea13 \p 106 \l 1033 <span style='mso-element:field-separator'></span><![endif]-->(Reardon-Reeves
& Yaruss, 2013, p. 106)<!--[if supportFields]><span style='mso-element:
field-end'></span><![endif]--></w:sdt> I did this. I practiced voluntary
stuttering on my own at stores, restaurants, and other social situations. Then, I modeled easy repetitions,
prolongations, and blocks with my students. But, how could I be stuttering
voluntarily when the definition of stuttering is <i>a sensation of being stuck
or losing control when speaking</i>? Many years ago, I helped to organize a regional gathering on
behalf of the National Stuttering Association, and I used voluntary stuttering
in my closing remarks at the end of the day. As people leisurely left, an adult
person who stuttered charged up to me and said – quite angrily - that I had no idea what it was like to
stutter. My voluntary stuttering carried none of the affective and cognitive
baggage that was a part of his experience.<o:p></o:p></div>
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In episode 428 of the StutterTalk
podcast, “Caryn Herring, Roisin McManus and Joel Korte of The StutterTalk <span style="color: windowtext;"><a href="http://stuttertalk.com/meet-the-b-team/"><span style="color: windowtext;">B Team</span></a> discuss the different flavors
of voluntary stuttering and how this fits into stuttering management."<w:sdt citation="t" id="1793790751"><!--[if supportFields]><span style='mso-element:
field-begin'></span> CITATION Her13 \l 1033 <span style='mso-element:field-separator'></span><![endif]--> (Herring, McManus, & Korte, 2013)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt> These three adults
who stutter share their insights about voluntary stuttering – this is the real
deal, and it's fascinating. They did not convince me that I should have expected
my clients to use it. </span></div>
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My favorite book about stuttering
is <i>Stuttering is Cool: A Guide to Stuttering in a Fast-Talking World</i> by Daniele Rossi. I found this book at the
end of my career and it was the best book I ever read about stuttering. Rossi
joins in the chorus of praise for voluntary stuttering. “Yup, stuttering on
purpose! And yes, it is actually, totally, really, honest-to-goodness
advantage!" <w:sdt citation="t" id="1337736255"><!--[if supportFields]><span
style='mso-element:field-begin'></span>CITATION Ros14 \p 30 \l 1033 <span
style='mso-element:field-separator'></span><![endif]-->(Rossi, 2014, p. 30)<!--[if supportFields]><span
style='mso-element:field-end'></span><![endif]--></w:sdt> <o:p></o:p></div>
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<u>But wait</u> - Daniele also says, “I’ve never mastered this technique; however, I know many
people who use it.”<o:p></o:p></div>
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In my opinion, clinicians should
tread cautiously when offering voluntary stuttering as a fluency enhancing
strategy. Looking back over my long career as a speech language pathologist, I
see my earnest attempts to blend research with clinical work. Yet, I must
wonder how often my trust in research and commercially published materials may
have blinded me to the real needs of individual clients. I post this blog to
encourage speech language pathologists to take care in your work. Listen to
your clients, document your rationale, process, progress, and clients' responses
to speech therapy. Be clear about what you are doing and why. <o:p></o:p></div>
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<span style="color: windowtext;"><br /></span></div>
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<span style="color: windowtext;">Own your work,</span></div>
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<span style="color: windowtext;"> Judy<o:p></o:p></span></div>
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<span style="color: windowtext;"><br /></span></div>
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<span style="color: windowtext;"><br /></span></div>
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<!--[if supportFields]><b><span style='mso-element:field-begin'></span><span
style='mso-spacerun:yes'> </span>BIBLIOGRAPHY <span
style='mso-spacerun:yes'> </span>\l 1033 <span style='mso-element:field-separator'></span></b><![endif]-->ASHALeader. (2016, November 1). Clients Who Imitate
Their Own Stuttering Patterns Claim Favorable Effects. <i>The ASHA Leader</i>, <a href="https://doi.org/10.1044/leader.RIB2.21112016.13">https://doi.org/10.1044/leader.RIB2.21112016.13</a>.<o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Byrd, C., Gkalitsiou, Z., Donaher, J.,
& Stergiou, E. (2016). The Client’s Perspective on Voluntary Stuttering. <i>American
Journal of Speech-Language Pathology</i>, 291-305.<o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Guitar, B. P., & Reville, J. M.
(1997). <i>Easy Talker: A Fluency Workbook for School-age Children.</i> Austin,
Texas: PRO-ED, Inc.<o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Herring, C., McManus, R., & Korte,
J. (2013, November 9). <i>StutterTalk: Changing how you think about
stuttering...one podcast at a time.</i> Retrieved from The Flavors of Voluntary
Stuttering (Ep. 428): <a href="http://stuttertalk.com/?s=428">http://stuttertalk.com/?s=428</a><o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Ramig, P. R., & Dodge, D. M. (2015).
<i>The Child and Adolescent Stuttering Treatment and Activity Resource Guide,
Second Edition.</i> Clifton Park, NY: Delmar Cengage Learning.<o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Reardon-Reeves, N. M., & Yaruss, J.
S. (2013). <i>School-Age Stuttering Therapy: A Practical Guide.</i> Stuttering
Therapy Resources.<o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Roseman, B. A., & Johnson, K. L.
(1998). <i>Easy Does It for Fluency: Intermediate.</i> Austin, Texas, PRO-ED,
Inc.<o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Rossi, D. (2014). <i>Stuttering is Cool:
A Guide to Stuttering in a Fast-Talking World.</i> Canada: Mischief, Mayhem and
Mirth Publishing.<o:p></o:p></div>
<div class="MsoBibliography" style="line-height: normal; margin-left: .5in; text-indent: -.5in;">
Tichenor, S. E., & Yaruss, J. S.
(2019). Stuttering as Defined by Adults Who Stutter. <i>Journal of Speech
Language Hearing Research</i>, 4356-4369.<o:p></o:p></div>
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<br />Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-85815638980000100972015-07-08T08:20:00.002-04:002020-04-09T11:06:46.151-04:00Final Post - thank you for reading<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;">This
is the final post for this blog as I close my speech therapy business. It's
been interesting to watch the field of stuttering treatment change over the
decades. I appreciate that ASHA (1) has added a few new resources, and I
appreciate the hard work of researchers and clinicians. Thank goodness
treatment has emerged from the darkness of blaming the client for failure.
Fluency used to be the goal. Now the goal of therapy is a combination of
cognitive, affective and behavioral changes. It's been refreshing, though I'm disappointed there is no cure. </span></div>
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;"> In
the book <u>Show Your Work!</u>, Author
Austin Kleon quotes C.S. Lewis: "The fellow-pupil can help more than the
master because he knows less. The difficulty we want him to explain is one he
has recently met. The expert met it so long ago he has forgotten." All my
credentials are red flags that I've been doing this work long enough.</span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><o:p></o:p></span></div>
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;"> It's
time to become an amateur at something new. I’m going to develop my interest in
literacy. A summer course by The Grimes
Reading Institute (2) will soon complement my training in Reading with TLC (3) and
Orton-Gillingham (4). But, alas, I collect more credentials!</span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><o:p></o:p></span></div>
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;"> I'm
also gradually developing an online store at <a href="https://www.teacherspayteachers.com/Store/Books-Too">Teachers Pay Teachers
Books Too</a>. (5)</span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><o:p></o:p></span></div>
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;"> Thank
you for reading.</span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><o:p></o:p></span></div>
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;">Find
your voice,</span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><o:p></o:p></span></div>
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;">Judy<o:p></o:p></span></div>
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<span style="background: white; color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;"> (1)
<a href="http://www.asha.org/">www.asha.org</a> </span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><o:p></o:p></span></div>
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<span style="color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;">(2) (</span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><a href="http://www.grimesreadinginstitute.com/">b</a>roken link)<o:p></o:p></span></div>
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<span style="color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;">(3) </span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><a href="http://www.readingwithtlc.com/">http://www.readingwithtlc.com/</a><o:p></o:p></span></div>
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<span style="color: #141823; font-family: "times new roman" , serif; font-size: 12.0pt;">(4) </span><span style="font-family: "times new roman" , serif; font-size: 12pt;"><a href="https://orton-gillingham.com/">https://orton-gillingham.com/</a><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24.0pt; margin-bottom: .0001pt; margin-bottom: 0in; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; font-size: 12pt; line-height: 107%;">(5) </span><span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><a href="https://www.teacherspayteachers.com/Store/Books-Too">https://www.teacherspayteachers.com/Store/Books-Too</a></span></div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-44339617068893264322015-05-04T10:48:00.000-04:002015-05-07T10:41:13.620-04:00Coping Strategies<div class="MsoNormal">
In March, I watched a new DVD from the Stuttering
Foundation: <i>Williams’ Normal Talking
Approach to Help Children Make Speech Changes</i> <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[1]</span></span><!--[endif]--></span></a>
In this video, Dr. Zebrowski seemed to repackage some old concepts in new language.
One old concept retrieved from the past which seems to be trending now is Dean
William’s approach to treatment. I took a look at <i>The Genius of Dean Williams<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftn2" name="_ftnref2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><b><span style="font-family: "Calibri",sans-serif; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[2]</span></b></span><!--[endif]--></span></a></i>
to prepare for a student's session. <o:p></o:p></div>
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<br />
Dr. Dean Williams said that what a child believes will influence the choices he
makes. So it's helpful to ask children "what they <b>believe</b> is wrong and what they do that they believe helps them talk
better.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftn3" name="_ftnref3" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[3]</span></span><!--[endif]--></span></a>
Dr. Williams wrote that it was important to remember the difference between 1.)
the stuttered moment and 2.) the behavior
to cope with that moment. This is a concept we could take a look at again.<br />
<br />
I’ve observed a lot of disagreement over # 1, what the stuttered word is all
about. Since research of the past few decades indicates stuttering is a
neurological difference with genetic roots, I'm surprised to see Dr. Williams'
old ideas about this resurface in 2014. So I very respectfully disagree with Dr. Zebrowksi when
she says to tell children that stuttering is something they do and not
something that happens to them. Dr. Williams said to tell children that stuttering
is something they do, I believe, in order to empower them, to imply that they can do
something different. But, it seems to me that we risk blaming the child with this
philosophy.<br />
<br />
Nevertheless, there is little disagreement over #2, how children cope with the
stutter. They may push at the stutter in order to keep up with the pace of
conversation. This can become a physically difficult “fight” that results in
negative listener feedback. They may move on to strategies that increase
fluency, such as switching out words and talking less. I think that children
are not always aware of their coping behavior. I also think children deny
coping behaviors. Children who stutter are doing the best they can. Some more progressive
thinking is that children should be allowed to stutter. For more such ideas,
listen to Vivian Sisskin in StutterTalk podcast episodes 503-507, March 23-27, <a href="http://www.stuttertalk.com/">www.stuttertalk.com</a>. <br />
<br />
The take-home concept here is that there is a difference between the stutter
and the coping behavior. Dr. Williams said that we can help children discover
this distinction. We can talk with them about what they believe helps, their
motivation for choosing certain coping strategies. This conversation will
involve talking about feelings. The physical act of speaking becomes tangled up
with emotion for people who stutter. This is my understanding of chapter 1.<br />
<br />
If we can repeatedly help the child see the difference between the stutter and
his choices for coping, then we can be clear about the behaviors he may have
the power to change. We can help children "learn that attending to and
changing one's behavior is dependent on what the child does and is not
dependent on reducing or eliminating one's emotions." <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftn4" name="_ftnref4" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[4]</span></span><!--[endif]--></span></a>
Children say they want to stop stuttering; this may be a clue that the
distinction between the stutter and the coping strategy is blurred. In
response, we repeat the message that we don't have a cure for the stutter (#1).
We do have options for coping. (#2) We
want children to keep talking. We want them to develop good communication
skills all through childhood. And we want them to experiment with coping
strategies to make the speaking easier. <o:p></o:p></div>
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<br /></div>
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In <i>The Child and
Adolescent Stuttering Treatment and Activity Resource Guide</i> <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftn5" name="_ftnref5" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[5]</span></span><!--[endif]--></span></a>
there is a drawing of a coping strategy called a “pullout.” It has the moment
of the stutter as a jagged line that changes into a gently rolling line. It
illustrates a tense disfluency that becomes less tense. The stuttered moment is
the tense disfluency. The rolling hills represent a copy strategy, loosening
tension. I wasn’t skilled enough to
recreate it here using Word®. I thought we could take this drawing and turn it
into a way to brainstorm other coping
strategies. Remember, a brainstorm is not judgmental. All kinds of ideas are
acceptable. After brainstorming, we can talk about why a child might believe a
particular coping strategy is most effective.
(Note: Doing nothing is a coping strategy associated with acceptance. A speaker
may believe that stuttering is the best way to communicate quickly and
completely in some situations. ) <o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
In conversation, we can talk about the pros and cons of various coping strategies to help the child discover and own his communication skills. </div>
<br />
<div>
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<br />
<div id="ftn1">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[1]</span></span><!--[endif]--></span></a> Stuttering
Foundation 2014, No. 6325, <a href="http://www.stutteringhelp.org/">www.stutteringhelp.org</a>
<o:p></o:p></div>
</div>
<div id="ftn2">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftnref2" name="_ftn2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[2]</span></span><!--[endif]--></span></a>
Ibid, 2005, No. 0425<o:p></o:p></div>
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<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftnref3" name="_ftn3" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[3]</span></span><!--[endif]--></span></a> Ibid,
p. 9<o:p></o:p></div>
</div>
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<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftnref4" name="_ftn4" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 10.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[4]</span></span><!--[endif]--></span></a> The
Genius of Dean Williams, p. 16<o:p></o:p></div>
</div>
<div id="ftn5">
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/2015/Coping%20Strategies.docx#_ftnref5" name="_ftn5" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Calibri",sans-serif; font-size: 11.0pt; line-height: 150%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[5]</span></span><!--[endif]--></span></a>
Peter R. Ramig and Darrell M. Dodge (<span style="font-size: 12.0pt;">2010)
Delmar Cengage Learning, p. 335 <o:p></o:p></span></div>
<div class="MsoFootnoteText">
<br /></div>
</div>
</div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-14143302925783682892015-03-07T11:21:00.001-05:002015-03-07T11:21:18.438-05:00Common Factors<div class="Normal1CxSpFirst" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">When I attended
a master’s degree program decades ago, I was trained that thoughtful lesson
planning guided treatment. The speech-language pathologist (SLP) wrote specific
goals and designed activities to achieve them. The activities carefully blended
fun and reward to help children enjoy the hard work of therapy. The university I
attended required that graduate students create their own therapy materials
based on current research. I was the expert.<o:p></o:p></span></div>
<div class="Normal1CxSpMiddle" style="line-height: 150%;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> <o:p></o:p></span></div>
<div class="Normal1CxSpMiddle">
<span style="font-family: Calibri, sans-serif;"><span style="font-size: 12pt; line-height: 150%;"> After
graduation, I discovered beautifully made picture cards and thick ring-bound
workbooks were easy to buy, saving me hours of prep time. Glossy </span><span style="line-height: 24px;">catalogs</span><span style="font-size: 12pt; line-height: 150%;"> marketing expensive therapy materials arrived in my mail every fall. Children cooperated more easily with these commercial
products. I bought items on clearance. My colleagues encouraged me to purchase
formal tests, though quite expensive. Thus, my lesson plans were supported by
official diagnostic testing and my therapy activities super charged with
specialized teaching materials. Therapy was fun.<o:p></o:p></span></span></div>
<div class="Normal1CxSpMiddle" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
</div>
<div class="Normal1CxSpLast" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> Then
along came “Evidence Based Practice” (EBP). I attended conferences at which professors
challenged earlier research and proclaimed a new (and nearly impossible)
standard as the only valid treatment. Data was paramount. Suddenly, <i>the
most important</i> thing to do in speech therapy was collect data. I spent perhaps the last 10 years reacting
to this pronouncement. I audio recorded activities, filled data grids,
photographed children’s drawings, and filled out questionnaires during sessions. I documented diagnostics, individual lessons
and long term progress… it was downright distracting. Therapy was about the numbers.</span></div>
<div class="Normal1CxSpLast" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br /></span></div>
<div class="Normal1CxSpLast" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> <o:p></o:p></span><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">I
imagined a backlash to this kind of clinical process was at work when I read a
recent e-newsletter from </span><i style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">attachment
parenting international</i><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;"> (1). </span><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;"> </span><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">The
January 28th blog post was titled </span><i style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">Parents
need to be the compass point.</i><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;"> By example it
reported the following: “A mother recently told me that she met with her son’s teacher,
guidance counselor and school psychologist. She wanted to explain that it was
important that her son’s teachers develop a caring relationship with him. When
she explained to them what her son needed, their response was, ‘You’re only the
mother.’ In other words, ‘We are the professionals who know best what students
need.’” The blog article encouraged parents to defend themselves against this
attitude. Attachment parenting recognizes that parents are their “child’s
compass point, guide, comforter and safe home base.” How can therapy welcome
collaboration with families?</span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">This change
in clinical process has taken place in Early Invention services. </span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">In
2004, “the intervention focus moved from engaging children in planned
educational therapy activities to supporting caregivers to embed interventions
within their typical activities/routines.” (2) This was a “major shift in
service delivery.” SLPs put down their traditional lesson plans and materials.
They adapted knowledge and skill to the individual needs of a family’s living
situation. This <i>paradigm shift </i>meant
the SLP’s new job description included “...(a) seeking out and respecting
caregivers’ views; (b) ensuring equal participation of family members in the
decision-making process; (c) recognizing caregivers’ rights to make decisions
even when decisions are contrary to the professionals’ views; and (d) affirming
the role of culture, values, and family beliefs in their community.” (3) This
was not easy. A study in 2007 found
“...that 51% of home visit time was spent in direct instruction with the child,
and less than 1% of the time was used to coach the caregiver.” (4) Speech
therapy had to move forward by training SLPs to coach adult learners. The article has a detailed description of 11 strategies for coaching caregivers. Speech
therapy is now all about collaboration.</span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"><br /></span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"> <o:p></o:p></span><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;">A recent continuing education course invited
me to re-evaluate once again what goes on in therapy. (5) The title of the
course is </span><i style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;">Balancing Certainty and
Uncertainty in Clinical Practice.</i><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;"> Children are unique human beings who
can’t be defined by the certainty of data points. Every new day is a creative
process filled with uncertainty. Given this reality, how might we move forward
in speech therapy? The seven articles in this course debated </span><i style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;">rational thinking</i><b style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;"> </b><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;">as a guiding principal. “Rational, team-based thinking uses a
balance of certainty and uncertainty to arrive at decisions that are likely to
have a positive impact on student performance. Collective thinking helps to
frame problems as uncertainties for which appropriate solutions can be found."
(6) Rational thinking depends upon conversation. It’s not a solitary activity.
It’s not about an SLP sitting alone in an office carefully crafting lesson plans.
This conversation is referred to as </span><i style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;">generative
dialogue. </i><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%;">“In generative dialogue, student-centered problems (e.g.,
behavior, learning difficulties) are reframed as uncertainties that are
explored to reveal underlying principles of teaching that apply to all
learners.” (7) Decision making becomes a process involving teachers, students, and
parents defining mutual goals. (8)</span></div>
<div class="Normal1CxSpMiddle" style="line-height: 150%;">
<br /></div>
<div class="Normal1" style="line-height: 150%;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"> I required that a parent participate
in speech therapy with their child for several years now. This reduced my caseload but ensured that
caregivers were educated about stuttering. They learned about teaching methods
and the process of change. They tailored goals to suit their children’s lives. I was letting go of the lesson plan and beginning
to view each therapy session with greater uncertainty. My job description was evolving from lesson
planner to listener. Because I was in this transition, The StutterTalk
podcast <i>Serious Concerns about Speech Therapy for People Who Stutter in the Public Schools </i>(9) raised the hair on the back of my neck. Taro Alexander recounted a presentation by a self-described expert who felt he had
the perfect lesson plan. Mr. Alexander and Peter Reitzes wondered aloud about what
was going on in speech therapy and why.<o:p></o:p></span></div>
<div class="Normal1" style="line-height: 150%;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"><br /></span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">I
attended many conferences and workshops over the years searching for answers to
this question. Outside of formal
presentations, I heard experts comment that a specific treatment protocol
didn’t matter, it was the relationship between the client and the clinician
that determined success. I don’t recall seeing this point of view on a PowerPoint
slide. It simply floated in and out of conversations. This was confusing. I spent
much of my career writing lesson plans, buying specialized therapy materials,
collecting data, and accumulating continuing education credits. What’s all this
about how it doesn’t matter? <o:p></o:p></span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">At
every conference, I asked for references. At the 2014 National Stuttering
Conference, one speaker told me to buy the <i>Heart
and Soul of Change</i>. (10) I’d heard about the role of counseling in speech
therapy and listened Dr. Luterman (11) say to put down the lesson plan. This
book explained WHY. This book proposes that something beyond therapy technique
is more important to progress. There are four common factors that seem to
account for successful change. The authors write, <b>“In all, we found that the effectiveness of therapies resides not in
the many variables that ostensibly distinguish one approach from another.
Instead, it is principally found in the factors that all therapies share in
common.”</b> (12)<b><o:p></o:p></b></span></div>
<div class="Normal1" style="line-height: 150%;">
<br /></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">This
book is about counseling, not stuttering. Yet experience taught me that
stuttering is not like learning to play the piano or golf or baseball or math
or science or social studies or writing. Speech therapy for stuttering is not
only about learning a motor skill or a thought process. It’s about personal transformation.
It’s about becoming a different speaker, a new identity with a new voice. When
I heard an adult stutterer and her SLP describe this as a part of her increased
fluency, I felt they had it right. (13) To
paraphrase: <i>my speech language
pathologist and I decided what my new voice would be. </i> This is not fluency. This is a new voice, a
new speaker, a new identity. <o:p></o:p></span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="Normal1" style="line-height: 150%;">
</div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Back
to <i>the Heart and Soul of Change. </i>The
authors of this book were amazed by “the wide range of theories, therapies,
models, and approaches being promoted” at a Family Therapy Network
Symposium. So, they “decided to turn to
the clinical and research literature for answers on what matters for effective
treatment.” (14) <b>They discovered four “common factors.”</b> Only two – only two – of these factors
accounted for 70% of success. <o:p></o:p></span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"><br /></span></div>
<div class="Normal1CxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">1.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Client/extratherapeutic
factors</span></b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">: This
category consists “of the client’s strengths, supportive elements in the
environment, and even chance events. In short, they are what clients bring to
the therapy room and what influences their lives outside it…. This category
accounts for 40% of outcome variance.” (15)<o:p></o:p></span></div>
<div class="Normal1CxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto;">
<br /></div>
<div class="Normal1CxSpLast" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">2.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Relationship
factors</span></b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">: “These represent a wide range of
relationship-mediated variables found among therapies no matter the therapist’s
theoretical persuasion. Caring, empathy, warmth, acceptance, mutual
affirmation, and encouragement of risk taking and mastery are but a few.” This category accounts for “30% of the
successful outcome variance.” (16)<o:p></o:p></span></div>
<div class="MsoListParagraph">
<br /></div>
<div class="Normal1CxSpFirst" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">3.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Placebo,
hope, and expectancy</span></b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">: “These curative effects therefore are
not thought to derive specifically from a given treatment procedure; they come
from the positive and hopeful expectations that accompany the use and
implementation of the method.” p.
10 “...their contribution to
psychotherapy outcome at 15%.” (17)<o:p></o:p></span></div>
<div class="Normal1CxSpMiddle" style="line-height: 150%;">
<br /></div>
<div class="Normal1CxSpMiddle" style="line-height: 150%; margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">4.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Model/technique
factors</span></b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">: “They include a rationale, offer an explanation
for the client’s difficulties, and establish strategies or procedures to follow
for resolving them….most therapeutic methods or tactics share the common
quality of preparing clients to take some action to help themselves...they
account for 15% of improvement in therapy.” (18)<o:p></o:p></span></div>
<div class="Normal1" style="line-height: 150%;">
<br /></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">One
reason for gathering client input is to establish where he is in the process of
change. The book describes nine clinical processes that coincide with different
stages of change. I can talk about the <i>stages
of change</i> in another article. <o:p></o:p></span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">I’m learning to welcome more collaboration.
Family preference guides therapy. SLPs with little experience in stuttering </span><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">can read about what it’s like to live with in the archived
newsletters of the National Stuttering Association and the Stuttering
Foundation. There are personal stories posted in years of International
Stuttering Awareness Day online conferences. In StutterTalk podcast (19) What</span><i style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;"> I Wish My SLP Knew About Stuttering,</i><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">
Elana Kahan shares what it was like to attend years of stuttering therapy as a
child.</span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"><br /></span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"> <o:p></o:p></span><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">Therapy
is not about the SLP dictating a therapy program and manipulating client compliance. It’s about how the “</span><b style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">Clients’ own generative, self-healing capacities allow them to take
what different therapies have to offer and use them to self-heal.” </b><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">(20)</span><span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">
Therapy is about partnership balanced by certainty and uncertainty. It's about discovering the benefits of change.</span></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<o:p></o:p></div>
<div class="Normal1" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="Normal1" style="line-height: 150%;">
<b><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"> <o:p></o:p></span></b></div>
<div class="Normal1" style="line-height: 150%;">
<br /></div>
<div class="Normal1" style="line-height: 150%; margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]-->(1)<span style="font-size: 7pt; font-stretch: normal; line-height: normal;"> </span><!--[endif]--><a href="http://attachmentparenting.org/"><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">http://attachmentparenting.org</span></a><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">
</span><o:p></o:p></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]-->(2)<span style="font-size: 7pt; font-stretch: normal;"> </span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">J.
J. Woods et. al. (2011) Collaborative Consultation in Natural Environments:
Strategies to Enhance Family-Centered supports and Services</span>. <i><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Lang, Speech, Hear Serv Sch</span></i><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">,
42: p. 381</span><o:p></o:p></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]-->(3)<span style="font-size: 7pt; font-stretch: normal;"> </span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Ibid.</span><o:p></o:p></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]-->(4)<span style="font-size: 7pt; font-stretch: normal;"> </span><!--[endif]-->Ibid.<o:p></o:p></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]-->(5)<span style="font-size: 7pt; font-stretch: normal;"> </span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">ASHA
Professional Development Self Study 8726 © 2011</span><o:p></o:p></div>
<div class="Normal1CxSpMiddle" style="margin-left: .25in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(6)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">MK Clark and
P Flynn (2011) Rational Thinking in School -Based Practice, <i>Language Speech Hearing Services in Schools</i>,
42, p. 74.<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(7)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;"> </span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ibid<o:p></o:p></span></div>
<div class="Normal1CxSpMiddle" style="margin-left: 0.25in; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(8)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nickola Wolf
Nelson (2011) Questions About Certainty and Uncertainty in Clinical Practice, <i>Lang Speech, Hearing Services in Schools</i>,
42: see Figure 1, page 84<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]-->(9)<span style="font-size: 7pt; font-stretch: normal;"> </span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Serious
Concerns about Speech Therapy for People Who Stutter in the Public Schools,
episode 484, <a href="http://www.stuttertalk.com/">www.stuttertalk.com</a> </span><o:p></o:p></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]-->(10)<span style="font-size: 7pt; font-stretch: normal;">
</span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">Mark A. Hubble, Barry L. Duncan, Scott D. Miller</span>
<span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">(Eds.) </span>(1999) <span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">The Heart & Soul of Change: what
Works in Therapy, Washington, DC</span>: <span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;">the American
Psychological Association</span><o:p></o:p></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(11)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">David
Luterman, Ph. D., Sharpening Your Counseling Skills, July 3, 2014, </span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">National
Stuttering Association Annual Conference in Washington DC.<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(12)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ibid p.</span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;"> (xxii)</span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(13)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">K. Sabourin and E. Alpern, Why Stutter More? July 4, 2014 National
Stuttering Association Annual Conference in Washington DC.<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(14)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">M.A. Hubble et. al., (1999)</span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"> p. xxi</span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> <o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(15)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ibid. p. 9<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(16)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ibid. p. 9<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(17)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ibid. p. 9<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(18)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ibid. p. 10<o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(19)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"><a href="http://www.stuttertalk.com/">www.stuttertalk.com</a>
February 24, Episode 497,</span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
<div class="Normal1" style="margin-left: .25in; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">(20)<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal; line-height: normal;">
</span></span><!--[endif]--><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">M.A. Hubble et. al., (1999)</span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-bidi-font-family: Calibri; mso-bidi-font-size: 10.0pt; mso-fareast-font-family: Calibri;"> p. 14</span><span style="font-family: "Calibri",sans-serif; font-size: 12.0pt; line-height: 115%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-12182643732591388822014-12-28T23:14:00.001-05:002020-04-09T11:10:23.759-04:00Counting Stuttered Words<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">I’m watching a video of one of my students. I’m
typing what he says and marking each stuttered word, listening to some of his sentences over and
over again to accurately label blocks,
prolongations, repetitions and secondary behaviors. I can think about a
child’s speech more sensitively this way than if I try to take a frequency
count in real time. <o:p></o:p></span></div>
<div class="normal" style="text-indent: .5in;">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">It takes several hours to transcribe and
score a speech sample this way. I’ve been doing it for more than 20 years. In
1992, I learned a detailed protocol called Systematic Dysfluency Analysis (SDA)
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[1]</span></span><!--[endif]--></span></a>.
It introduced me to careful listening.
Eventually, I had to admit that SDA took too much time. In 2010, I bought the
<b><i>Test Of
Childhood Stuttering</i></b> (TOCS)<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn2" name="_ftnref2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[2]</span></span><!--[endif]--></span></a>
which provided a simpler method. I knew that most speech language pathologists
(SLPs) used the Stuttering Severity Instrument (SSI).<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn3" name="_ftnref3" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[3]</span></span><!--[endif]--></span></a> However, as a specialist, I felt obliged to
offer an alternative. The
Stuttering Foundation has a continuing
education video called <b><i>Scoring Disfluencies</i></b>,<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn4" name="_ftnref4" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[4]</span></span><!--[endif]--></span></a>
an excellent resource for anyone interested.<o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">In this blog post, I'd
like to reflect on what speech analysis means. For starters, certain types of
disfluency are considered stuttering and others are not. The distinction is
especially relevant when considering whether or not a young child might be at
risk for developing a chronic stuttering problem. Disfluency types can
differentiate between stuttering and cluttering. And, sometimes, I see children
show progress by gradually changing the type of disfluency they produce, even
if frequency stays the same. The American Speech Language Hearing Association (ASHA)
website has a thorough review of this information for SLPs in <b><i>Clinical
Topics: Childhood Fluency Disorders</i></b>. There is quite a lot of information for the
public at the ASHA site as well.<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn5" name="_ftnref5" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[5]</span></span><!--[endif]--></span></a> <o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">Any presence of physical tension is usually
labeled stuttering. One form of <u>tension</u>
is a laryngeal block. This is when the vocal cords (located in the larynx) stop
vibrating. Speech seems to be stuck in the throat. This may
take a fraction of a second or up to several seconds. Tension may also appear in the face and/or
neck. It can spread through the torso. A change in <u>timing</u>, a
prolongation, is another form of stuttering. It is a sound that lasts too long
and fails to transition quickly into the
sound that follows. These two types of stuttering are called “<b>disrupted phonation</b>.” <a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn6" name="_ftnref6" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[6]</span></span><!--[endif]--></span></a><sup>,
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn7" name="_ftnref7" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[7]</span></span><!--[endif]--></span></a></sup>
<o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">Parents may not realize disrupted phonation
in their child's speech could be stuttering. It's the repetitions that usually
trigger concern. Friends, family and even pediatricians say ‘ wait and see’,
maybe the toddler will pass through a common phase called developmental
disfluency. Most young children do “outgrow” this. But the mystery remains;
which children will develop normal speech and which children will stutter? <o:p></o:p></span></div>
<div class="normal" style="text-indent: .5in;">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">Research conducted in the 1990's identified
disrupted phonation (blocks and prolongations) as associated with chronic
stuttering. Disrupted phonation, whether it has a sudden or gradual onset is
probably not normal. It turns out that some kinds of repetition are probably not
normal either. Atypical repetitions
along with disrupted phonation are called <b>Stuttering</b>
<b>Like</b> <b>Dysfluency (SLD)</b>. A careful
speech analysis will determine precisely what kinds of disfluency is occurring.
<o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="normal">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">A special calculation called the "<b>weighted</b> <b>stuttering</b> <b>like</b> <b>disfluency</b>" has been found to discriminate between young children who do and do not stutter. It
combines repetitions and disrupted phonation in a mathematical formula .<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn8" name="_ftnref8" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[8]</span></span><!--[endif]--></span></a>
In fact, a weighted SLD measure of 4 identified 97% of children (35/36 children
ages 3 & 4 years) in one study.<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn9" name="_ftnref9" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[9]</span></span><!--[endif]--></span></a>
It is important for parents to know that blocks and prolongations could be
warning signs of chronic stuttering. <o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">A careful speech analysis will count three
types of <b>repetition</b>. Two types are associated
with stuttering in young children: repeating parts of words (I w-w-w-want; I
want pop-pop-popcorn.), and repeating single-syllable whole words (I
want-want-want popcorn.)<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn10" name="_ftnref10" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[10]</span></span><!--[endif]--></span></a>
In addition, the number of iterations is relevant. This is because the presence
of a single repetition (I w-want) versus multiple iterations (I w-w-w-want) also
distinguish between children who stutter (CWS) and children who do not stutter.<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn11" name="_ftnref11" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[11]</span></span><!--[endif]--></span></a>
These guidelines have been revered for decades due to extensive research support.
<o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">For some children, stuttering apparently worsens
with time.<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn12" name="_ftnref12" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[12]</span></span><!--[endif]--></span></a>
One research team proposed that these children “may be encouraged, by a more
positive listener reaction, to use increased physical tension to stabilize (or
make less obvious) part word repetitions."<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn13" name="_ftnref13" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[13]</span></span><!--[endif]--></span></a>
This didn't make sense to me. Rather, my intuition is that the older children's
speech contain more SLDs because it always
did. By this I mean, children arriving at a clinic for evaluation at age four
would be those who always had more disrupted phonation. But then I read <b><i>The
Genius of Dean Williams</i>.</b> <a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn14" name="_ftnref14" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[14]</span></span><!--[endif]--></span></a>
In chapter 9, he recalls the following: "One second grade boy reported
that when he was in kindergarten and first grade he had repeated sounds a great
deal. People called it 'stuttering.' Now, he tensed and 'pushed' to get the
words out so he wouldn't 'repeat,' or 'stutter,' as he understood the meaning
of the word." I was in awe that Dr. Williams could elicit such insights from
a youngster.<o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">Recording single-syllable whole word
repetitions as stuttering is not universally accepted. "There is
evidence...that children who recovered from stuttering showed a greater
proportion of WWR than those who did not [and] ..<b>.Riley (1994) as creator of
the SSI-3 asserts that WWRs should not be counted as moments of stuttering, as
long as they are not disrhythmic</b>."<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn15" name="_ftnref15" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[15]</span></span><!--[endif]--></span></a>
Why all the fuss over counting single
syllable whole words? Well, we’re talking
about accurately diagnosing children at risk for persistent stuttering
and recommending who should receive treatment. If we dismiss all childhood
disfluency as something children outgrow, parents may not seek appropriate help. Or maybe the opposite. Maybe parents will be unnecessarily concerned.<o:p></o:p></span></div>
<div class="normal">
<br /></div>
<div class="MsoNormal" style="mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">It turns out that "...as a group, bilingual children produce
higher levels of typical speech disfluency than their monolingual peers." <a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn16" name="_ftnref16" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[16]</span></span><!--[endif]--></span></a>
Repetitions ranged from 3-22% and number of iterations 4-8 in a recent study of
Spanish-English speaking children. It may be that the guidelines for diagnosis
revered for decades actually applies only to monolingual children. Here is a danger of incorrectly labeling children
at risk for stuttering. “</span><span style="color: #292526; font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">…at present, researchers do not have a sufficient understanding of
the disfluent speech of bilingual children who do not stutter. Thus, it is
difficult to determine whether a bilingual child is in fact at risk for
stuttering or if, perhaps, as a group, bilingual children produce higher levels
of typical </span><span style="color: #292526; font-family: "calibri" , sans-serif; font-size: 12pt; line-height: 115%;">speech
disfluency than their monolingual peers.”</span><a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn17" name="_ftnref17" style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 115%;" title=""><span class="MsoFootnoteReference"><span class="MsoFootnoteReference"><span style="color: #292526; font-size: 12pt; line-height: 115%;">[17]</span></span></span></a></div>
<div class="normal">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">I began
this blog because I was working with a middle schooler. I didn’t find anything
new in the ASHA journals for this age group. I did come across an article that validated
a common phenomenon. A group of children
who stuttered ages 6 years old to 10 years and 5 months old, stuttered more in
narrative than in conversation.<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn18" name="_ftnref18" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[18]</span></span><!--[endif]--></span></a>
What’s the difference between having a conversation with someone versus
recalling a story? <o:p></o:p></span></div>
<div class="normal" style="text-indent: .5in;">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;"> A
conversation is a shared experience. Speakers pay attention to one another.
They interpret facial expressions, body language, tone and loudness of voice and
changes in topic. There is time pressure to access language and speech/motor
skills in socially acceptable ways. It matters who’s talking and the speaking situation. Conversation can
be challenging! CWS in this study used shorter
utterances in conversation than in narrative. Any surprise here? I’ve certainly
seen this. <o:p></o:p></span></div>
<div class="normal" style="text-indent: .5in;">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">Okay, let's take a look at narrative. The
speaker is completely responsible for all of the information, language,
non-verbal messages, and listener reaction. It’s the speaker's job to keep a
listener’s interest and ensure that he understands the message. Here’s two
reasons a story telling activity would have been more difficult in this particular study. Reason number 1: "...children [need] to hold a series of
sequential intentions in memory while simultaneously planning and executing the
motor movements required...” Reason number 2: “…the utterances the CWS produced during
narration were longer than the utterances they produced during conversation,
thus creating the context for motor system instability…”<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn19" name="_ftnref19" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[19]</span></span><!--[endif]--></span></a> Narrative is also quite challenging! This
research suggests that <b>narrative may be an efficient tool for gathering a
speech sample. </b><o:p></o:p></span></div>
<div class="normal" style="text-indent: .5in;">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">The results of a speech analysis are combined
with other information to help in the accurate diagnosis and the selection of treatment for CWS. For the older
child, I refer to lessons found in <b>Easy Talker</b><a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn20" name="_ftnref20" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[20]</span></span><!--[endif]--></span></a>,
<b>my own workbook</b><a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn21" name="_ftnref21" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[21]</span></span><!--[endif]--></span></a>,
and the <b>Stuttering Treatment Guide</b>. <a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn22" name="_ftnref22" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[22]</span></span><!--[endif]--></span></a>
I’m also taking another look at the workshop booklet from<b> Dr. Dean Williams’</b>
presentation I attended in 1993.<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn23" name="_ftnref23" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;">[23]</span></span><!--[endif]--></span></a> <b>School-Age Stuttering Therapy</b> is another
superb resource.<span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 12pt; line-height: 115%;"><a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn24" name="_ftnref24" title="">[24]</a> The <b>Stuttering Foundation</b> has many videos about treatment taught by highly respected experts.</span></span></span><o:p></o:p></span></div>
<div class="normal" style="text-indent: .5in;">
<br /></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">This is just a personal reflection. I can only speak from my personal experience. I’ve had 20+ years to form opinions and a
clinician bias. I’m looking forward to retiring soon and hope to contribute to
the field in ways other than studying speech samples. I’m looking forward to
future generations of SLPs bravely taking on the challenge of stuttering
therapy.<o:p></o:p></span></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;"><br /></span></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">Thank you for reading,</span></div>
<div class="normal" style="text-indent: .5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">Judy</span></div>
<div class="MsoNormal">
<br /></div>
<br />
<div>
<!--[if !supportFootnotes]--><br clear="all" />
<hr align="left" size="1" width="33%" />
<!--[endif]-->
<br />
<div id="ftn1">
<div class="MsoNormal">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[1]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"> Systematic
Disfluency Analysis </span><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;">Campbell, J. H. & Hill, D.G.
(1987) Systematic Disfluency Analysis, Stuttering Therapy: A Workshop for Specialists,
IL: Northwestern University</span><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"><o:p></o:p></span></div>
</div>
<div id="ftn2">
<div class="MsoNormal">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref2" name="_ftn2" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[2]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"> R.B. Gillam, K.J.
Logan, N.A. Pearson (2009) Test of Childhood Stuttering<b> </b> Austin TX: pro-ed.<o:p></o:p></span></div>
</div>
<div id="ftn3">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref3" name="_ftn3" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[3]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif";"> G. D. Riley (2009) Stuttering Severity
Instrument, Austin TX: pro-ed, inc. <o:p></o:p></span></div>
</div>
<div id="ftn4">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref4" name="_ftn4" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[4]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif";"> Diane Parris, Scoring Disfluencies,
Stuttering Foundation DVD No. 6350. <a href="http://www.stutteringhelp.org/">www.stutteringhelp.org</a>
<o:p></o:p></span></div>
</div>
<div id="ftn5">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref5" name="_ftn5" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[5]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif";"> <a href="http://www.asha.org/public/speech/disorders/stuttering/">http://www.asha.org/public/speech/disorders/stuttering/</a>
<o:p></o:p></span></div>
</div>
<div id="ftn6">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref6" name="_ftn6" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[6]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif";"> E. Yairi and N. G. Ambrose (2005)
Early Childhood Stuttering: For Clinicians By Clinicians, Austin, TX: pro-ed,
p. 97.<o:p></o:p></span></div>
</div>
<div id="ftn7">
<div class="normal">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref7" name="_ftn7" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[7]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"> Let’s remember, too, that some
speakers say they stutter when no dysfluency is evident to the listener. This phenomenon is called covert stuttering.<o:p></o:p></span></div>
</div>
<div id="ftn8">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref8" name="_ftn8" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[8]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> The
weighted SLD is "calculated by multiplying the number of part word
(PW) and single syllable (SS) repetitions (PW + SS) per 100 words spoken by the
mean number of repetition units (RU) and adding the result to two times the
frequency of disrhythmic phonation (DP), thus yielding the following formula:
([PW + SS] x RU) + (2 x DP), as described by Ambrose & Yairi (1999, p.
899). 2002 p. 23." M. W. Pellowski
& E. G. Conture (2002) Characteristics of Speech Disfluency and Stuttering
Behaviors in 3- and 4- Year Old Children, Journal of Speech, Language, and
Hearing Research, vol. 45, 20-34.<o:p></o:p></span></div>
</div>
<div id="ftn9">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref9" name="_ftn9" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[9]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> Ibid p. 26<o:p></o:p></span></div>
</div>
<div id="ftn10">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref10" name="_ftn10" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[10]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> E. Yairi and N.G. Ambrose (2005) p. 96.<o:p></o:p></span></div>
</div>
<div id="ftn11">
<div class="MsoNormal">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref11" name="_ftn11" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[11]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;"> M. W. Pellowski & E. G.
Conture p. 26. </span><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt;">“In general, findings indicated that the percentage of total
disfluencies, percentage of stuttering-like disfluencies, weighted SLD measure,
and mean number of repetition units significantly differed between CWS and
CWNS, whereas the percentage of other disfluencies did not significantly differ
between the two talker groups.” <o:p></o:p></span></div>
</div>
<div id="ftn12">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref12" name="_ftn12" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[12]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> Ibid. p. 26 “…</span><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-hansi-theme-font: minor-latin;">that increases in time
since stuttering onset were associated with increases in the percentage of
stuttering-like disfluencies for all CWS.”</span><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
</div>
<div id="ftn13">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref13" name="_ftn13" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[13]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> Ibid, p. 31.<o:p></o:p></span></div>
</div>
<div id="ftn14">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref14" name="_ftn14" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[14]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">
Stuttering Foundation Publication No. 0425, p. 96. <o:p></o:p></span></div>
</div>
<div id="ftn15">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref15" name="_ftn15" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[15]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> David Ward (2013) Risk Factors and
stuttering: Evaluating the evidence for clinicians. <i>Journal of Fluency Disorders, </i>38, p. 138. <i><o:p></o:p></i></span></div>
</div>
<div id="ftn16">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref16" name="_ftn16" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[16]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> C.T. Byrd, L.M. Bedore & D.Ramos (2014)
The Disfluency Speech of Bilingual Spanish-English Children: Considerations for
Differential Diagnosis of Stuttering, <i>Language,
Speech, and Hearing Services in Schools, </i>Dec. 10, p. 10.<i> <o:p></o:p></i></span></div>
</div>
<div id="ftn17">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref17" name="_ftn17" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[17]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> Ibid. p. 10<o:p></o:p></span></div>
</div>
<div id="ftn18">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref18" name="_ftn18" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[18]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> C.T. Byrd, K.J. Logan, R.B. Gillam (2012)
Speech Disfluency in School-Age Children’s Conversational and Narrative
Discourse. <i>Language, Speech, and Hearing
Services in Schools</i>, 43, p. 160.<o:p></o:p></span></div>
</div>
<div id="ftn19">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref19" name="_ftn19" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[19]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> Ibid. p. 160</span>.</div>
</div>
<div id="ftn20">
<div class="MsoNormal">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref20" name="_ftn20" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-family: "arial" , "sans-serif"; line-height: 115%;">[20]</span></span><!--[endif]--></span></a> <span style="font-family: "calibri" , "sans-serif";">B. Guitar & J. Reville (1997)
<strong><span style="font-weight: normal;">Easy Talker: A Fluency Workbook
for School Age Children</span></strong><strong>,</strong> Austin, TX: pro-ed pro-ed, 1997</span><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 12.0pt;"><o:p></o:p></span></div>
</div>
<div id="ftn21">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref21" name="_ftn21" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[21]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif";"> J. Butler (2014) Respecting the
Communication Needs of Children Who Stutter, This has been removed.<o:p></o:p></span></div>
</div>
<div id="ftn22">
<div class="MsoNormal">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref22" name="_ftn22" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; line-height: 115%;">[22]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif";"> The Child and Adolescent Stuttering Treatment and Activity Resource
Guide, Second Edition, Delmar Cengage Learning, 2010<span style="font-size: 10pt;"><o:p></o:p></span></span></div>
</div>
<div id="ftn23">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref23" name="_ftn23" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-size: 10pt; line-height: 115%;">[23]</span></span><!--[endif]--></span></span></a><span style="font-family: "calibri" , "sans-serif";"> D. Williams (1993) Stuttering
Therapy for Children: Learning to Learn, University of Wisconsin-Milwaukee,
School of Allied Health Professions, Office of Continuing Education<o:p></o:p></span></div>
</div>
<div id="ftn24">
<div class="MsoFootnoteText">
<a href="https://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref24" name="_ftn24" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: black; font-family: "arial" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[24]</span></span><!--[endif]--></span></a> <span style="font-family: "calibri" , "sans-serif";">N. Reardon-Reeves & J. S. Yaruss
(2013) School-Age Stuttering Therapy: A Practical Guide. McKinney, TX: Stuttering
Therapy Resources, Inc. <a href="http://www.stutteringtherapyresources.com/">www.StutteringTherapyResources.com</a>
</span></div>
</div>
</div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-52536165878165650462014-10-31T18:00:00.003-04:002014-10-31T18:00:55.659-04:00POWERR: a treatment option<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Thank
you NSA! The National Stuttering Association sponsored another Family Fun Day
in Boston this fall. Such a uniquely empowering event! Children who stutter
meet one another, learn about stuttering and enjoy self-affirming activities.
Parents learn about stuttering and share experiences. It’s a morning that takes
hours and hours of volunteer planning. It was my privilege to help facilitate the teen group again this
year. It is so energizing to spend time with people who work at
self-improvement and mutual support.<o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="color: windowtext; font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The
National Stuttering Association (NSA) is a self-help group for people who
stutter. It has local chapters across the United States. There are videos,
podcasts, books, newsletters, brochures and merchandize on the NSA website.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="color: windowtext; font-size: 12pt; line-height: 115%;">[1]</span></span><!--[endif]--></span></a>
The annual conference features programs for adults, families and speech
language pathologists (slps). I’ve attended many of them, always returning home
enlightened and enthusiastic. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">The NSA annual
conference is a ‘reality check’ for me.
People of all ages fill the workshops and hallways with a variety of
viewpoints. The many voices at an NSA conference are like a cacophony of bird song
at dawn. Some are louder than others. Some sound nearly identical. Most are emotional
and sincere. Everyone has a story. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Wondering
what I mean by ‘reality check?’ Take a
look at the writings of Doreen Lenz Holte, parent of a child who stutters. <i>Voice Unearthed</i> <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn2" name="_ftnref2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[2]</span></span><!--[endif]--></span></a>
is her memoir. Someone handed me a copy
to read and then pass along. I was dismayed by the many pages of opinion presented
as fact. But, I respected Ms Holte’s passion. Her arguments were no surprise. I’m
familiar with the journey. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Let’s look
at two of her comments. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">One. Ms
Holte challenges “the powers that be…to establish resources and support around
indirect therapy, so parents have <i>real</i>
options. If, as you tell us, ‘what works for one doesn’t work for everybody,’
then give us real choices beyond changing the moment of the stutter and
minimizing speech errors.’”<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn3" name="_ftnref3" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[3]</span></span><!--[endif]--></span></a>
I’ve watched the profession search for these options. Perhaps this is why I learned way back in
1992<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn4" name="_ftnref4" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[4]</span></span><!--[endif]--></span></a>
that differential diagnosis may be one key to designing treatment. A workbook called <i>The School – Age Child Who Stutters: Working Effectively with Attitudes
and Emotions</i> came out in 2001. Research suggests that stuttering is often
accompanied by other issues such as differences in phonology, language and
temperament and there may be subtypes of stuttering.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn5" name="_ftnref5" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[5]</span></span><!--[endif]--></span></a>
I’ve witnessed experts battle heatedly over early intervention. The debate
rages on in a recent ASHASphere <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn6" name="_ftnref6" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[6]</span></span><!--[endif]--></span></a>
and, quite frankly, I grow tired of the bitterness. Ms Holte is not alone in
her confusion and frustration. <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn7" name="_ftnref7" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[7]</span></span><!--[endif]--></span></a><o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">May I
suggest The <i>POWERR</i> Game<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn8" name="_ftnref8" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[8]</span></span><!--[endif]--></span></a> as an eloquent option. It costs
$16.00 and has been around since 2003. It was created by Gordon W. Blood,
Ph.D., CCC-SLP, a well respected expert in the field. I presented this option to teens at the NSA
conference in Atlanta and both NSA Family Days in Boston. The longer I stay in
this profession, the more I appreciate this program. I really didn’t know how
to access the depth and breadth of this resource in my younger days. The
letters of <i>POWERR </i>represent <u>P</u>ermission,
<u>O</u>wnership, <u>W</u>ell-Being, <u>E</u>steem of Self, <u>R</u>esilience
and <u>R</u>esponsibility. What families need is this larger context in which
to place stuttering treatment. This year, I designed new playing cards with
many of the <i>POWERR</i> concepts
represented as single words. For example, <i>reaction,
change, myth, </i> and <i>outcome </i> fall under the category of <u>P</u>ermission.
The children in the NSA teen group selected from words like these and shared
stories from their own lives. This became the preface for discussing speech and
communication skills. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Two. Ms
Holte was dissatisfied with several “rounds” of therapy (few details provided).
Talk to many seasoned experts in the field of stuttering and you’ll hear this:
It’s not the program that matters. It’s the relationship between the slp and
the client. In the spirit of placing
treatment in a broader context, I digress with story of my own of how people
make a difference. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">It is a
bright, very warm, September afternoon at the soccer field. I sit with about 30
or so other parents in a single row of colorful folding chairs decorating a
sideline. We watch our unique children become team players in a league
sponsored by a local non-profit organization. I've watched for many years and it fascinates me how every
child, every coach, and every fan contributes to the experience. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">It's 2:30
and players age 12 to 18 (all shapes,
sizes, skill-levels, and personalities) take the field. The referee blows a
whistle, glances at his watch and the game begins. Red team players laugh as
they pass the ball around. Blue team players are more serious. A few strong
players touch the ball most of the time. Many blue team members look like
spectators embedded in the game. Like a flock of birds swirling through the
sky, players run around the field. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">To my left,
two women share some play by play. “She
scored that goal from midfield! " To my right, a husband and wife catch up
because he’s been on the road. The red
team players exchange friendly, supportive banter. "That's it!...way to
be!...man on, man on!" Then, a
whistle. The game stops. A blue team player is called out for tripping.<o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Each person
here adds to the joy of this moment. One angry parent could transform this
pleasant community gathering into an anxious two hours. But I’ve never seen
that happen. My only complaint is the aggressiveness of the blue team coach.
The rules of soccer are the same for both teams. Yet coaches interpret the game
differently and you can see it in how the children play. The blue team wins -
again. And the fans politely congratulate everyone as we walk to the parking
lot. But I know that some parents will
request their children be on the red team next year. Because soccer is fun,
except when it's not. It’s how you
choose to play it. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Back to
stuttering. This is not rocket science. Who do you choose as your friends? Who
do you hire for projects? What religious community, social organization, or
volunteer groups do you join? I bet you engage and employ people you feel good
about. So here’s a problem. Public education provides one-size-fits-all
programs. Students get “free” therapy with the only slp available. Health
insurance covers a very limited course of treatment – if you’re lucky. An slp
with additional training in stuttering may not be near you and tele-practice
regulations make it difficult to access their services. I don’t accept
insurance and I require parents participate in all treatment sessions.
Consequently, I’ve always had few clients. I was glad to read that Ms Holt
eventually found the “right” slp for her son. <o:p></o:p></span></div>
<div class="normal" style="line-height: 150%;">
<br /></div>
<div class="normal" style="line-height: 150%;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> I
believe frustration about treatment boils down to one simple concept. We cannot
change another person’s behavior. Parents want me to fix their child’s speech.
It can’t be done. A child is not a tablet needing the right app or an animal to
be trained. And no matter how I present therapy, I see parents continue to
blame children for stuttering. Ms Holte is right. There needs to be a
revolution in how we provide treatment for stuttering. The disconnect between
researcher, clinician, and family hasn't been bridged. I for one will stop providing treatment in all but a very select few
cases. Instead, I will offer family education and training as the only first option.<o:p></o:p></span></div>
<div class="normal" style="line-height: 200%;">
<br /></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">I wish you
well on your journey with stuttering. When you are ready to change (I'm talking to parents and children) the
National Stuttering Association and Stuttering Foundation are there to support
and inform you.<o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;"><br /></span></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;">p.s.</span></div>
<div class="normal" style="line-height: 150%; text-indent: .5in;">
<span style="font-family: Calibri, sans-serif; font-size: 12pt; line-height: 150%; text-indent: 0.5in;"><br /></span></div>
<div class="normal" style="line-height: 150%;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">And here’s a brand new gem: <i>Stuttering is Cool</i>: <i>A Guide to
Stuttering in a Fast-Talking World</i>.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn9" name="_ftnref9" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[9]</span></span><!--[endif]--></span></a>
This humble book filled with delightful drawings of Franky Banky & friends
will validate the children, teens and even adults who stutter, especially
someone far enough along on his personal journey to glimpse whole-picture
thinking. <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftn10" name="_ftnref10" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%;">[10]</span></span><!--[endif]--></span></a>
Mr Rossi gives us a modern version of the ‘reality check.’ <o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><br /></span></div>
<div class="normal" style="line-height: 150%;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Thanks for reading,</span></div>
<div class="normal" style="line-height: 150%;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12.0pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Judy</span></div>
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<br />
<div>
<!--[if !supportFootnotes]--><br clear="all" />
<hr align="left" size="1" width="33%" />
<!--[endif]-->
<div id="ftn1">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[1]</span></span><!--[endif]--></span></a> <a href="http://www.westutter.org/">www.westutter.org</a> </div>
</div>
<div id="ftn2">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref2" name="_ftn2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[2]</span></span><!--[endif]--></span></a> <span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Doreen Lenz Holte (2011) <i>Voice Unearthed: Hope, Help, and a Wake-Up-Call for the Parents of
Children Who Stutter. </i>no publisher
listed.</span></div>
</div>
<div id="ftn3">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref3" name="_ftn3" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[3]</span></span><!--[endif]--></span></a> <span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Ibid. p. 104</span></div>
</div>
<div id="ftn4">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref4" name="_ftn4" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[4]</span></span><!--[endif]--></span></a> <span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">A 2-week residential training program at
Northwestern University sponsored by the Stuttering Foundation</span></div>
</div>
<div id="ftn5">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref5" name="_ftn5" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[5]</span></span><!--[endif]--></span></a> <span style="background: white; color: windowtext; font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Nan
Bernstein Ratner, Ed.D. (2012) <i>Evidence
Based Practice and Practice-Based Evidence: Closing the Gap</i>, Nashville, TN:
Stuttering Foundation No. 6720.</span></div>
</div>
<div id="ftn6">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref6" name="_ftn6" title=""><span class="MsoFootnoteReference"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 10pt; line-height: 115%;">[6]</span></span><!--[endif]--></span></span></a><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> <strong><span style="font-weight: normal;">Roger
J. Ingham and Janis Costello Ingham<i> (Oct.28, 2014) </i></span></strong><a href="https://www.blogger.com/null" name="1"></a><a href="http://feedproxy.google.com/~r/ASHAsphere/~3/1XrqLA7lNkc/?utm_source=feedburner&utm_medium=email">A Misleading Account of Research on Stuttering Treatment
for Young Children</a><o:p></o:p></span></div>
</div>
<div id="ftn7">
<div class="MsoFootnoteText">
<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref7" name="_ftn7" title=""><span class="MsoFootnoteReference"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-size: 10pt; line-height: 115%;">[7]</span></span><!--[endif]--></span></span></a><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> I recently switched to <i>Practical Intervention for Early Childhood Stammering: Palin PCI
Approach</i> (2008) for children through age 7. Written by Elaine Kelman &
Alison Nicholas. Published by United Kingdom: Speechmark Publishing Ltd. This
program requires and respects parent participation.<o:p></o:p></span></div>
</div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref8" name="_ftn8" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[8]</span></span><!--[endif]--></span></a> <span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Gordon W. Blood (2003) <i>The PowerR Game: Managing Stuttering</i>, Memphis, TN: The Stuttering
Foundation publication no. 0250, </span><a href="http://www.stutteringhelp.org/"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">www.stutteringhelp.org</span></a><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">. </span></div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref9" name="_ftn9" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[9]</span></span><!--[endif]--></span></a><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Daniele Rossi (2014) Canada: Mischief, Mayhem
and Mirth Publishing, </span><a href="http://www.stutteringiscool.com/"><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">www.stutteringiscool.com</span></a><span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> </span></div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/POWERR%20Oct%202014.docx#_ftnref10" name="_ftn10" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">[10]</span></span><!--[endif]--></span></a> <span style="font-family: "Calibri","sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">PowerR, p. 36</span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-32890657510240368722014-09-14T12:39:00.000-04:002020-04-09T11:14:09.915-04:00Classroom Presentation<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0in;">
<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> One of my courageous students
presented a slide show about stuttering
to his 5th grade class. I admit that
I was slow to assist him in this ambitious project. I expected his good intentions would languish on
a wish list. Then he showed me a YouTube video he wrote and directed. Here was proof that he was a persistent
and competent young man, very likely to pursue any project to
completion.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Wondering
what my role would be, I recalled seeing an interview with Bill Belichick,
coach of the New England Patriots football team. He said quarterback Tom Brady knew it all and studied
hard. He asked Coach Belichick so many tough questions that coaching him was
very challenging. How was I going to coach my talented 5<sup>th</sup> grader? <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">I already
had a few links to accounts of other children who had spoken to their classes. <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[1]</span></span><!--[endif]--></span></a>
But I surfed the "just for kids" section of the Stuttering Home Page looking
for inspiration.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn2" name="_ftnref2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[2]</span></span><!--[endif]--></span></a> I chose only two articles in order to prepare a thoughtful lesson within a week.
This kept me occupied during a long, snowy evening. <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">I happened
to be learning about Google tools and writing a talk for speech language
pathologists at a nearby school.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn3" name="_ftnref3" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[3]</span></span><!--[endif]--></span></a>
I was multi-tasking in researching for my student' s assignment and for my own.
I found two YouTube videos to learn the
basics of Google Slides. One featured a
teacher apparently in his home office. He spoke in a soft voice with the sweet
sounds of a happy toddler in the background. Another YouTube video, this one intended
for small business owners, gave me a few
more helpful tips. I</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">m grateful to these two people who were so
generous in sharing their knowledge on the internet. <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">The two articles I chose from the Stuttering Home
Page were written in very different styles. I read one written by Dr Bill
Murphy called </span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">“</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Class Presentations for Children Who Stutter. <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn4" name="_ftnref4" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[4]</span></span><!--[endif]--></span></a>
It had an academic attitude and tight structure. It opened with a premise followed by a lengthy list of serious content. I took my time reflecting
upon the parts of the article consistent with my clinical experience. How could
this academic content translate into a message
my young student could quickly absorb? <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">The
other article was </span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">“</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">FRIENDS Presentation Guide</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">”</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> by John Ahlbach.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn5" name="_ftnref5" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[5]</span></span><!--[endif]--></span></a>
It had emotion, intuition and humor. It
affected me more now than when I read it many years ago. It suited my situation
perfectly. John knew a child's perception of the world. His article addressed a
question hugely relevant to the child
who stutters: Is it a good idea to hide ones' stuttering? The article grabbed the reader</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">s attention immediately by proposing the issue this way: What if our
hair turned green periodically? I read John's article with gratitude and a
smile. It had the down-to-earth, friendly attitude I needed. It buoyed my
spirits and gave me the energy to return to Dr. Murphy's article for more
content. <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> Brave children have taught others about stuttering in
very public ways. Nate has a recent podcast </span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">“</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Stuttering advice for parents, siblings and teachers</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">”</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> at <i>Stuttering is Cool<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn6" name="_ftnref6" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><b><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[6]</span></b></span><!--[endif]--></span></a>.</i>
He has a video of a recent class presentation<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn7" name="_ftnref7" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[7]</span></span><!--[endif]--></span></a>
and one from four years ago<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn8" name="_ftnref8" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[8]</span></span><!--[endif]--></span></a>. (Also, take a look at Parker Mantell</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">s 2014 Commencement Speech.<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn9" name="_ftnref9" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[9]</span></span><!--[endif]--></span></a>)
My student, his mother and I watched Nate</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">s videos during a speech therapy session. Nate</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">s model was absolutely priceless.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">The
final product was a true collaboration. Per his request, I emailed my template home
for him to review and edit. <a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn10" name="_ftnref10" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[10]</span></span><!--[endif]--></span></a>
He deleted several of my slides and added his own. This entire process, which busied
us for several sessions, fulfilled the requirements of a comprehensive
treatment approach. We reviewed cognitive and affective components as we talked
about what to put on each slide. The
behavioral goal (practicing speech change)
was satisfied as we rehearsed the
presentation. I</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">m sure this project could meet requirements within
the Common Core as well.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> Rehearsal was more difficult than I expected.
My student began by denying any need to practice. Consequently, I needed a way to transition
from Nate</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">s videos to the present moment. So, I stood up
and pretended we were in a classroom and that my student and his mom were students.
I made eye contact, resisted time
pressure, reduced speaking rate slightly, paused at phrase boundaries, and
talked. Yes , it was pretty humbling to stumble my way through this exercise.
But perfection was never the goal. It was more important to have some fun with
public speaking. <o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> We
made videos with my phone. I reviewed only three slides for </span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">‘</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Take 1.</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> I
smiled alot and played around with impromptu
commentary. After giggling over the results, our attitudes brightened. We used mom</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">s phone to video </span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">‘</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Takes 2</span><span style="font-family: "times new roman" , "serif"; font-size: 12.0pt; line-height: 150%;">’</span><span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">. This time, I added loose, easy voluntary
stuttering and modification techniques. I
held up a brochure about famous people who stutter and announced that everyone
would take one home. I had a laminated a
poster of the movie The King's Speech<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftn11" name="_ftnref11" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12.0pt; line-height: 115%;">[11]</span></span><!--[endif]--></span></a>
to hold up high for the entire class to see that I was in excellent company! My
easy repetitions and mild blocks did not accompany any negative affect nor
interrupt the flow of information. At this point in the session, my student was
experimenting with the slow-motion feature and which made my videos became
downright hilarious. I thought this was
a terrific because the project was no longer terrifying. It was great fun.<o:p></o:p></span></div>
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<span style="font-size: 12.0pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> Nate's YouTube video showed classmates asking questions.
We brainstormed around this possibility.
Mother typed all of this into her laptop for future reference. I was delighted
to watch mother and son work together. What success! <o:p></o:p></span></div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[1]</span></span><!--[endif]--></span></a> J.
Butler (8/26/13) Back To School Preparations for Children Who Stutter <a href="http://butlerspeechtherapy.blogspot.com/2013/08/back-to-school-preparations-for.html">http://butlerspeechtherapy.blogspot.com/2013/08/back-to-school-preparations-for.html</a>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref2" name="_ftn2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[2]</span></span><!--[endif]--></span></a> <a href="http://www.stutteringhomepage.com/">www.stutteringhomepage.com</a> </div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref3" name="_ftn3" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[3]</span></span><!--[endif]--></span></a> J. Butler (3/8/14) Workshop Slides pdf (This has been removed.)</div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref4" name="_ftn4" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[4]</span></span><!--[endif]--></span></a> As
I edit this blog post on 9/14/14, I find that the link to Bill Murphy<span style="font-family: "times new roman" , "serif"; mso-ascii-font-family: Calibri;">’</span>s
article is broken. The same content appears on the Stuttering Foundation site
in the article <span style="font-family: "times new roman" , "serif"; mso-ascii-font-family: Calibri;">“</span>Teaching
Others<span style="font-family: "times new roman" , "serif"; mso-ascii-font-family: Calibri;">”</span> <a href="http://www.stutteringhelp.org/teaching-others">http://www.stutteringhelp.org/teaching-others</a>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref5" name="_ftn5" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[5]</span></span><!--[endif]--></span></a> <a href="http://www.mnsu.edu/comdis/kuster/kids/ahlbachguide.html">http://www.mnsu.edu/comdis/kuster/kids/ahlbachguide.html</a>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref6" name="_ftn6" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[6]</span></span><!--[endif]--></span></a> <a href="https://soundcloud.com/stuttering-is-cool">https://soundcloud.com/stuttering-is-cool</a>
Episode #174</div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref7" name="_ftn7" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[7]</span></span><!--[endif]--></span></a> Nate<span style="font-family: "times new roman" , "serif"; mso-ascii-font-family: Calibri;">’</span>s
Stuttering Presentation with Questions (Nov. 30, 2013) <a href="https://www.youtube.com/watch?v=-0kxyzOxY3o">https://www.youtube.com/watch?v=-0kxyzOxY3o</a>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref8" name="_ftn8" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[8]</span></span><!--[endif]--></span></a> Stuttering
Presentation (May 8, 2010) <a href="https://www.youtube.com/watch?v=KKG2UM_5F_Y">https://www.youtube.com/watch?v=KKG2UM_5F_Y</a>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref9" name="_ftn9" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[9]</span></span><!--[endif]--></span></a> 2014
IU Commencement Speaker: Parker Mantell <a href="https://www.youtube.com/watch?v=sTRAripodJY#t=154">https://www.youtube.com/watch?v=sTRAripodJY#t=154</a>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref10" name="_ftn10" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[10]</span></span><!--[endif]--></span></a> Classroom
Presentation pdf (2/19/14) <a href="https://sites.google.com/site/judithvbutlermaccc/home/free">(</a>Removed)</div>
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<a href="file:///C:/Users/judy/Documents/Speech%20Therapy%20Stuff/Blogs/Class%20Presentation%20Feb%202014.docx#_ftnref11" name="_ftn11" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10.0pt; line-height: 115%;">[11]</span></span><!--[endif]--></span></a> Stuttering
Foundation , code 0074 <a href="http://www.stutteringhelp.org/">www.stutteringhelp.org</a>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-16130502365346865502014-07-18T14:51:00.001-04:002014-11-21T15:47:40.786-05:00Thinking Aloud with a Listener<div>
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Mistakes. Revisions. Self-reflections. I calculated a set of numbers incorrectly the other day. I realized my error after explaining my computations aloud to a friend. Actually, it wasn't just at that moment. It was several days later, when I happened to recall the conversation. Maybe I was driving here and there and my mind wandered a bit. I "heard" myself explain my calculation to this friend and suddenly realized I had been wrong. The numbers were wrong. Talking aloud to a listener had made me aware of my error.</div>
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Talking aloud is important to me. I talk aloud to memorize information, for example. I talk aloud to solve problems, make plans and ask for opinions and information. I reflect on my conversations with others and sometimes wonder about comments I made or even thoughts I left unspoken. Have you ever wished you could take back something you've blurted out in an emotional moment? I sure have. Yet, this process is necessary. This trial and error teaches me how to choose my words differently in the future. I learn about what I think and feel by listening to what I say to others.</div>
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Here's a new perspective (or an old one I only recently realized): stuttering affects the value of talking aloud to listeners <b>in order to understand oneself. </b></div>
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I'm currently reading <i>Early Chilhood Stuttering by Clinicians for Clincians </i>by Ehud Yairi and Nicoline Grinager Ambrose. It is a comprehensive text, yet somewhere states that stuttering is first a disorder of speech.<br />
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Yes. However, as soon as the disorder manifests itself, a variety of consequences ensue - attempts to resolve the problem and cope with the consequences . Attempts to resolve the stuttered speech include a variety of compensatory strategies for talking. The consequences of stuttered speech can include talking less, talking <u>aloud</u> less. I've thought about this in terms of developing social communication skills. Now, I am intrigued by the idea that less talking aloud with listeners may reduce opportunities for self-reflection.<br />
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This process of talking aloud was mentioned on the Diane Rehm radio show recently. Ms Rehm was talking with counselors from addiction treatment programs. One woman referenced "motivational interviewing" as a method of guiding addicts through stages of change. This method engaged addicts who were not in the <i>action stage</i> yet, but nevertheless wanted help.<br />
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Dr. Nan Ratner introduced motivational interviewing in her presentation at the National Stuttering Association in Washington, D.C.. She advised speech language pathologists to be aware of the stages of change <u>and</u> to learn about motivational interviewing. As a person who has been in therapy, I know first hand the effect of unconditional positive regard and supportive interviewing. It is very different from the judgemental, logical, and downright confrontational discussions one might have with family and peers. I know what it is like to reflect upon my spoken word, reconsider it and then talk aloud about options.<br />
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How can the child who stutters benefit from this process if he/she doesn't talk freely with friends and family? How can this process occur if a child who stutters is fretting over being fluent, dodging sounds and words by all kinds of avoidance tricks? Here is another reason it is ok to stutter: it may permit the self-expression with which speakers come to know themselves.<br />
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Judy</div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-43007952859016700122014-03-21T11:33:00.001-04:002014-03-21T11:37:24.061-04:00Some thoughts about "um"<br />
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri;">Once in a while,
I write a letter to a student and his/her family.<span style="mso-spacerun: yes;"> </span>It is a way to present my thoughts in a
manner I hope will be easy to understand. Here’s my attempt to clarify what I
consider to be a case of a child with a mixed language/speech-motor based dysfluency
who has been trying to manage it on his own. <span style="mso-spacerun: yes;"> </span>Please take a listen to the interview with
Joe Donaher on StutterTalk, Episode 436, for some thoughts about different
types of stuttering. <a href="http://stuttertalk.com/"><span style="color: blue;">http://stuttertalk.com/</span></a>
<span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 2;"> </span></span><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
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<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">Dear Student,</span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
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<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none; text-indent: 0.5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">This notebook has many language
activities in it. You don’t need to do all of the activities in 1 week!<span style="mso-spacerun: yes;"> </span>Please try to do at least 2 activities before
your next speech therapy visit. Don’t worry about your stuttering when you do
these. I want to know how difficult the <u>language</u> tasks were. </span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
<br />
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none; text-indent: 0.5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">I’m giving you <b style="mso-bidi-font-weight: normal;">Kids’ Big Book of Games</b> (Games Magazine Junior) to take home and
keep. I bought it at a library books sale for maybe $1.00, so you might see a
little bit of writing in it already. Please keep it in a special place so you
can remember to bring it back to speech therapy with you. I want to know which
pages you liked, which pages you found easy, and which pages you thought were
hard to do.<span style="mso-spacerun: yes;"> </span>Don’t worry about your
stuttering when you do this book.</span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></div>
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<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none; text-indent: 0.5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">Here’s what I think:<span style="mso-tab-count: 4;"> </span></span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></div>
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<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none; text-indent: 0.5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">1. <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Maybe</i></b> you use alot of
“um” to help you say words easily. For example, if you think you might get
stuck on the word “dog” in the sentence, “My dog and I played in the snow.”, <b style="mso-bidi-font-weight: normal;">maybe </b>you would find yourself saying,
“My <u>um</u> dog and I played in the snow.” The “um” might give your mouth
just enough extra time to day the word dog easily. Maybe you would pause to
stop and think and take your time too. Some kids who stutter do this.</span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></div>
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<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none; text-indent: 0.5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">2. <b style="mso-bidi-font-weight: normal;">Or maybe</b> you use alot of “um” to help you remember the word you
know you want to say but you can’t think of fast enough. You can picture you
and your dog in your head, and you know you want to talk about playing in the
snow with your dog, but when you say the sentence, the word “dog” got lost in
your head somewhere and you can’t find it. This happens to all of us sometimes,
but maybe it’s happening to you alot. Some kids who stutter do this too.</span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
<br />
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></div>
<br />
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none; text-indent: 0.5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">3. <b style="mso-bidi-font-weight: normal;">Or maybe </b>you want to talk about lots of things at once. If this is
true, then maybe “um” is helping your brain sort through all your ideas and get
them organized. <b style="mso-bidi-font-weight: normal;">Maybe </b>you have your
thoughts organized, and the “um” helps your brain put all those ideas into
grammatically correct sentences. </span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></div>
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<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none; text-indent: 0.5in;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">4. It seems to me that you are trying
very hard to talk more smoothly. I wonder if you are changing your words or
sentences when you feel a stuttered sound. For example, some kids who stutter
will do this:<span style="mso-spacerun: yes;"> </span>if they want to say, “I’m
going to my friend’s house for a while” and they discover the word “to” is hard
to<span style="mso-spacerun: yes;"> </span>say, they will revise the sentence
right in the middle of saying it and hear themselves say something like, “I’m
going t-outside for a while.” Kids who use this strategy sometimes find that
starts happening automatically. They don’t plan to change what they were
saying; revising their sentences just becomes an automatic behavior that
happens really fast before they even know they are doing it. </span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></div>
<br />
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">5.<span style="mso-spacerun: yes;">
</span>Soooooo…..</span><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span></div>
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<div class="normalCxSpMiddle" style="line-height: 150%; margin: 1em 0px 1em 0.5in; mso-add-space: auto; mso-list: l0 level1 lfo1; mso-pagination: none; text-indent: -17.95pt;">
<!--[if !supportLists]--><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><span style="mso-list: Ignore;">★<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">If<span style="mso-spacerun: yes;"> </span>your “ums” and<span style="mso-spacerun: yes;"> </span>pauses are because of stuttering, then, we
want to spend most of our time on speech practice.<o:p></o:p></span></div>
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<div class="normalCxSpMiddle" style="line-height: 150%; margin: 1em 0px 1em 0.5in; mso-add-space: auto; mso-list: l0 level1 lfo1; mso-pagination: none; text-indent: -17.95pt;">
<!--[if !supportLists]--><a href="https://www.blogger.com/" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><span style="mso-list: Ignore;">★<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-theme-font: minor-latin;">If your
“ums” and<span style="mso-spacerun: yes;"> </span>pauses are because some<span style="mso-spacerun: yes;"> </span>language activities are difficult, then, we
want to be sure to help you turn your thoughts into words more easily while we
practice easier speech.<o:p></o:p></span></div>
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p></o:p></span><br />
<br />
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; mso-pagination: none;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Let’s talk
about this more at each visit. I want to be I understand what you are doing,
thinking and feeling about your speech. <o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Thanks,<o:p></o:p></span></div>
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<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt 4in; mso-pagination: none;">
<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Judy<o:p></o:p></span></div>
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<span style="font-family: "Calibri","sans-serif"; font-size: 12pt; line-height: 150%; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><o:p> </o:p></span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.comtag:blogger.com,1999:blog-3698866522577265651.post-91498970100391970252014-03-08T08:59:00.000-05:002020-04-09T11:15:15.581-04:00Free Workshop for Schools<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"> This is the text for a 3-hour workshop for Speech Language Pathologists in the schools. The slides are "Workshop Slides" at (this has been removed.) </span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"> Thank you very much for inviting me
to your school to talk about stuttering. Let’s begin by watching<i style="mso-bidi-font-style: normal;">Stuttering for Kids by Kids. </i>There is a
link to this video later in the side presentation.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-spacerun: yes;"> </span>In 1997 my family and I moved and it was then
that I decided to limit my private practice to stuttering. I was trying to
continue in speech language pathology while learning to live in a new location
and parent a toddler. I<span style="mso-spacerun: yes;"> </span>became
an ASHA Board Recognized Specialist in 2000. This new specialty was renewed every
three years with continuing education credits and at least 100 hours/year of
clinical work in stuttering. ASHA changed the name, requirements and renewal
process in 2014. I am now called a <i style="mso-bidi-font-style: normal;">Board
Certified Specialist in Fluency</i> and must renew every 5 years.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">I am not
a professor. They know much, much more about stuttering than I do.
What I hope to do in this brief, introductory workshop is to share a clinical
perspective based on years of experience working with children who stutter. I
have attended several National Stuttering Association conferences, published in
the International Stuttering Awareness Day online conferences, read our ASHA
journals and written a blog. This is my present understanding of
stuttering. I feel like the messenger. I'm hoping to<span style="mso-spacerun: yes;"> </span>inspire you to learn more about stuttering
and become more comfortable treating and advocating for the children who
stutter who attend<span style="mso-spacerun: yes;"> </span>your school. <o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Each student presents a new
challenge. I revisit familiar material and look for research to support <span style="mso-spacerun: yes;"> </span>all of my treatment recommendations. It almost
never feels like I can use<span style="mso-spacerun: yes;"> </span>a ‘one size
fits all’ approach. Because there were many days when I felt as if<span style="mso-spacerun: yes;"> </span>I was reinventing the wheel, I started writing
my thoughts down. In the beginning, these were published in <i style="mso-bidi-font-style: normal;">Reaching Out</i>, the newsletter of Friends:
The Association for Young People Who Stutter. <span style="mso-spacerun: yes;"> </span>I later compiled many of these articles in a
self-published book called <i style="mso-bidi-font-style: normal;">Becoming a
Friend </i>in 2002 and donated it to Friends. At that time, I was inspired by
my friend Nancy Cohen and one of my students. <span style="mso-spacerun: yes;"> </span>I felt the need to write again in 2008 and
began a blog, <i style="mso-bidi-font-style: normal;">Comments on Speech Therapy</i>
as a personal reference. It helped me to keep track of issues I wrestled with
respect to different cases. <i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span></i><o:p></o:p></span></span></div>
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 3</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">This may
be the most important concept in stuttering treatment. <i style="mso-bidi-font-style: normal;">Stuttering is no one's fault</i>. Stuttering appears to be a
neurologically based disorder. Until a child develops anticipation anxiety, it can
be fairly unpredictable. And so we need to be cautious about expectations for
fluency. The moment of stuttering is something that we don’t understand. We do
not know what causes the repetition, prolongation or block.</span></span><span style="font-size: 12pt; line-height: 150%;"><o:p><span style="font-family: "calibri";"> </span></o:p></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">There is research linking
stuttering with length and complexity of spoken language, emotional reactivity,
stability of the speech motor system and attention. Researchers think there may
be subgroups of the disorder. Since I’m not the best person to talk about
research studies, I’ll stop there and encourage you to choose a reference
article that interests you from my blog <span style="mso-spacerun: yes;"> </span>or from the references section of my therapy
training manual.<o:p></o:p></span></span></div>
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 5</span></b><span style="font-size: 12pt; line-height: 150%;"> <o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">There
are many valuable resources on the market. These are just the ones that I
happened to use and are referenced in my own therapy manual. I just bought a
brand-new therapy text by Yaruss & Reeves. It isn’t<span style="mso-spacerun: yes;"> </span>listed here because I just haven't had a
chance to read it yet.<b style="mso-bidi-font-weight: normal;"> </b><o:p></o:p></span></span></div>
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 6 </span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Here are some additional excellent
resources. The<i style="mso-bidi-font-style: normal;"> Stuttering Foundation </i>produces
a variety high-quality materials in multiple languages. Some are even available
as free downloads. The <i style="mso-bidi-font-style: normal;">National
Stuttering Association</i> is a support organization with chapters
throughout the United States. <i style="mso-bidi-font-style: normal;">StutterTalk</i><span style="mso-spacerun: yes;"> </span>is a podcast hosted by a speech language
pathologist. The <i style="mso-bidi-font-style: normal;">Stuttering
Homepage</i> is a website with lots of materials and a link to the archived <i style="mso-bidi-font-style: normal;">International Stuttering Awareness Day</i>
Online Conferences. Several years ago, I started a Google site as a personal
resource. This is a link to one of the pages of that site. And finally, I write
a blog called <i style="mso-bidi-font-style: normal;">Comments on Speech Therapy</i>
.<o:p></o:p></span></span></div>
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 7 </span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">I have
been working on a speech therapy manual so that I can easily locate materials I
find most helpful. Eventually, I hope to sell the workbook as a companion text
for therapy and for school workshops. It needs alot more work before I can
do that, so I’ve provided draft copies by email and on CD for free. There are
many good books about stuttering on the market that stand alone as wonderfully
thorough resources and I definitely defer to those texts.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">I’ll be
adding<span style="mso-spacerun: yes;"> </span>a section about self advocacy to
my manual soon because I recently created a classroom presentation. You can
find it in the <i style="mso-bidi-font-style: normal;">lesson ideas </i>page of
my website.<span style="mso-spacerun: yes;"> </span>Students occasionally write
a report about stuttering for school, but<span style="mso-spacerun: yes;">
</span>never has one of my students been willing to make a presentation – until
this year. One gifted and courageous student asked how to put one together
for<span style="mso-spacerun: yes;"> </span>a 5<sup>th</sup> grade class. We
spent many sessions talking about it. He blended his own thoughts and style
with some of my input to create a truly collaborative project. <o:p></o:p></span></span></div>
<br />
<br />
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 8<span style="mso-spacerun: yes;"> </span></span></b><span style="font-size: 12pt; line-height: 150%;">- 10 minute group activity<o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 9</span></b><span style="font-size: 12pt; line-height: 150%;"> (therapy manual page 40)</span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">This slide reminds us that typically
fluent speech is complex. 1.) When a person has an idea, the brain has so much
to do!<span style="mso-spacerun: yes;"> </span>2.) It selects words using the
phonology (including the local accent) of a language. The words are organized
in sentences using the grammatical rules of the his language and
situation. And let’s not forget intonation, loudness and
turn-taking choices. All of this is presented in a socially appropriate manner.
Nonverbal behavior such personal space, gesture and eye contact will accompany
the verbal message.<span style="mso-spacerun: yes;"> </span>3.) A motor plan
will<span style="mso-spacerun: yes;"> </span>program the body to produce
pitch, loudness, co-articulation and breath groups for phrasing, syllable-
and word- emphasis ...all at a very fast speeds! 4.) The idea, the language and
the motor plan will coordinate into an action sequence that can even withstand
environmental interruptions!<span style="mso-spacerun: yes;"> </span>5.) All of
this is monitored within and without our awareness. </span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Of course many other important
systems need <span style="mso-spacerun: yes;"> </span>separate diagrams. <span style="mso-spacerun: yes;"> </span>For example, listening skills<span style="mso-spacerun: yes;"> </span>are important because some researchers feel
auditory processing maybe implicated in stuttering. <o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 10</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Here are
a few handy links for a review of speech production<o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 11</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">This slide reminds us that stuttering
is also complicated. On page 46, we see one theoretical basis for treatment.
The point here is that stuttering is now considered a disorder influenced by
many possible factors. As we think about the child sitting with us, we wonder
how various parts of this model may apply to that child. Immediately, we begin
to question if asking a child to reduce percentage of stuttering is realistic
given that so many other variables influence the presence of stuttering.<o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 12</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-spacerun: yes;"> </span>Let's think about how we can update therapy.
Back when I was in college, we learned to count stuttered words and<span style="mso-spacerun: yes;"> </span>praise children for reducing frequency of
stuttering.<span style="mso-spacerun: yes;"> </span>Now we must consider how
this approach could foster guilt, fear and shame. Stuttering is a neurological
in nature and potentially affected<span style="mso-spacerun: yes;"> </span>by
many other issues, some of which are clearly beyond our control. How often are
we ourselves aware of co-articulation when we talk! <o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Yet, we
ask children to change how they talk and thereby reduce stuttering. In
response, some children discover that<span style="mso-spacerun: yes;">
</span>avoidance is an effective way to stop stuttering. You can’t stutter if
you don’t talk. Children can also avoid sounds and<span style="mso-spacerun: yes;"> </span>words, by using synonyms or otherwise
revising their message. Other children discover secondary behaviors that seem
to make talking easier. The child with negative feelings about stuttering can
find ways to hide it or fight it.<o:p></o:p></span></span></div>
<br />
<span style="font-size: 12pt; line-height: 150%;"><o:p><span style="font-family: "calibri";"></span></o:p></span><br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%;"> On the other hand, if we encourage
children to examine their speech and how it affects them, I believe we have the
opportunity to prevent the development of a larger communication problem. We
can teach children about speech and language, about stuttering in a non
judgmental way, options for change and owning the process of improved
communication.<span style="mso-spacerun: yes;"> </span>What does this all mean?<o:p></o:p></span></span></span></div>
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">
</span></span>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="font-family: "times new roman";">
</span></span></span></div>
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 13</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
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<span style="font-family: "times new roman";">
</span></div>
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<span style="font-size: 12pt; line-height: 150%;">Some people describe stuttering as an
ice berg. Above the surface of the water we see a very small portion of the
iceberg. This portion is the bumpy speech. Below the surface of the water is a
much larger portion of the iceberg and represents the feelings and thoughts
that are hidden from view but has the potential to become a significant portion
of the stuttering problem. For the child who stutters, these feelings translate
into behaviors such as avoiding class participation, avoiding the telephone and
enduring teasing and bullying that an adult may or may not witness. Also below
the surface are feelings of failure when parents ask why children will not use speech
strategies in daily life. There is a parent who writes a blog called <i style="mso-bidi-font-style: normal;">Voice Unearthed</i> who addresses these
kinds of problems.<o:p></o:p></span></div>
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<span style="font-family: "times new roman";">
</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 14</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt;">
<span style="font-family: "times new roman";">
</span></div>
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<span style="font-size: 12pt; line-height: 150%;">I'm not
too sure why I placed this slide here. Perhaps it is because now that we have
upgraded our understanding of stuttering, we can think about how we treat it
from the very earliest years. We begin with genetics because research presumes
there is a predisposition to stutter. Furthermore, as with other
conditions, environment plays a role. The child with speech language planning
and production weaknesses, the child with greater emotional reactivity and
difficulty with self regulation, the child who experiences difficulty with
communication, and the child who reacts negatively to the stuttering may have a
more difficult experience with stuttering. Of course I am simplifying. Exactly
how one or more of these factors influence one another is a mystery. We do not
know the cause of stuttering but we have some ideas about how it might become a
persistent and disabling condition for some children.</span></div>
<span style="font-size: 12pt; line-height: 150%;"><o:p><div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; text-indent: 0.5in;">
</div>
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<o:p><strong>Slide 15</strong></o:p></div>
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<span style="font-family: "times new roman";">
</span></div>
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<span style="font-size: 12pt; line-height: 150%;">For additional information about
treatment of developmental stuttering in preschoolers, please refer to
the pages listed on the slide. Please note that I have not included the Lidcomb
Program. I am not trained in that protocol and feel I should not comment it.<o:p></o:p></span></div>
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<span style="font-family: "times new roman";">
</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 16</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; text-indent: 0.5in;">
<span style="font-family: "times new roman";">
</span></div>
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<span style="font-size: 12pt; line-height: 150%;">If we
are<u> not</u> going to ask children to reduce stuttering what are we going to
do? Well, teach them strategies to help reduce oral-motor tension, help them to
understand their own communication needs and the process of change, and help
them feel confident about saying what they need to say when they need to say
it. By the way, this does not mean speech-language pathologists stop counting
stuttered words. But it is no longer our sole or even our top priority. We
pursue easier speech, positive affect and productive thinking regarding the
child's communication needs. This means that we measure and treat
speech-motor, cognitive and affective issues in our therapy
activities. <o:p></o:p></span></div>
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<span style="font-family: "times new roman";">
</span></div>
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 17 </span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; text-indent: 0.5in;">
<span style="font-family: "times new roman";">
</span></div>
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; text-indent: 0.5in;">
<span style="font-size: 12pt; line-height: 150%;">demonstration
of reduced rate, phrasing, easy onset, gentle voluntary stuttering, freezing,
pullout, cancellation, natural prosody, non-verbal communication, confidence;
comment that these strategies can feel more awkward than stuttered speech<o:p></o:p></span></div>
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<span style="font-family: "times new roman";">
</span></div>
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<b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 18</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></div>
<div class="normal" style="line-height: 150%; margin: 0in 0in 0pt; text-indent: 0.5in;">
<span style="font-family: "times new roman";">
</span></div>
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<span style="font-size: 12pt; line-height: 150%;">Children 8 and older can talk about
typical speech, stuttering, acceptance, avoidance and concomitant disorders in
a more explicit way. You already do this in treatment for other communication
problems. You take care to consider the unique needs of each individual student
and you can do the same for children who stutter. Please refer to the many
inexpensive and wonderful training DVDs produced by the Stuttering Foundation
for more information. Also there are brand new books about teasing and bullying
at the National Stuttering Association website.</span></div>
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</div>
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 19 </span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">You
already know how to use a hierarchy for learning other speech language
behaviors. I don't know of any skill that can be learned overnight and yet
parents and teachers expect immediate carryover of new speech skills. Why is
this? I once had a conversation with a parent who worked as a school aide
and who did not know I was a speech language pathologist. She said she thought
speech therapy was a fraud because the children she saw were not improving
speech skills in the classroom!! We need to remind others that any skill takes
time to learn and it is no different for children in speech therapy.<o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Speech
strategies and counseling are explained on Stuttering Foundation DVDs.
Participation in social and academic settings can reference the literature on
pragmatic language. If you read the stories children tell in (FREE) newsletters
published by the Stuttering Foundation and the National Stuttering Association,
you will learn about the recurring issues specific to children who stutter. If
you are an ASHA Certified SLP, you can join Special Interest Division 4 for
more information about stuttering. Please tell others about the free workshop
you are attending right now. The slides and this text are post on my website. <o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">You
simply don't need to be a rocket scientist to understand and empathize with the
child with a speech problem for which he/she has experienced teasing, bullying
and communication breakdown.<o:p></o:p></span></span></div>
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 20</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Here are
resources for addressing attitudes and emotions of children who stutter.<o:p></o:p></span></span></div>
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%;">Slide 21</span></b><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">In
conclusion I think we have a choice: we can continue to focus on counting
stuttered words and blame children for a neurological difference OR we can
focus on the larger picture. <o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Thank you.<span style="mso-spacerun: yes;"> </span>Judy</span></span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.comtag:blogger.com,1999:blog-3698866522577265651.post-75375334156240176432013-12-30T08:40:00.000-05:002013-12-30T08:41:09.720-05:00Thank You<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> I hope that 2014 is a year in which your children
are safe, healthy, and talking with self-confidence. You have supported
your children in a world that values speed and efficiency over patience
and attention. Thank you for being the change.<o:p></o:p></span></div>
<br />
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<span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> Five wonderful challenges took my time this fall:<o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;">1.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> I spoke to a class of
graduate students at the University of Connecticut. The topic was treatment for
stuttering in preschool children. <o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;">2.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> I was a guest on the
National Stuttering Association Family Radio show. We discussed the
relationship between the speech-language pathologist and family. <o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;">3.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> I facilitated a
workshop for teens at the National Stuttering Association Family Day at Boston
University. <o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;">4.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> I presented a
two-hour workshop for a local school district. <o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: Verdana; mso-fareast-font-family: Verdana;"><span style="mso-list: Ignore;">5.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Nina Reeves, MS, CCC-SLP,
BRS-FD of Stuttering Therapy Services/Seminars, PLLC, spoke to the Maine Speech
Language and Hearing Association and I was there. Local workshops about
stuttering are rare and Nina is one of the best therapists in the country. <o:p></o:p></span></div>
<br />
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<span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">All of this prompted me to reflect on my 30+ years as a
speech-language pathologist. It's been hard work and wonderfully
rewarding. I've watched changes in education and health care
reduce access to stuttering therapy and live continuing education workshops. My
response in 2014 will be to assemble a workbook for free regional, small-group workshops.</span></div>
<br />
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<span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> Thank goodness the <a href="http://r20.rs6.net/tn.jsp?f=0012vVTlRit9hOwP0kFFTT0gtqaEhnkGIX8U21l7vYTkiL0y_F7C5H2KQTCWxFv8MR4T1t-rybt1kmrgHIZ2I9fejelw3TaIn0lvIDufzdS3tLm6wFwf4oALga7Gz2lHMSvchBL9I77BF0a8fO_YQnt5q8G6Ly8pSdoruOI6OR6LbgqoTHGKbgLtA==&c=X3CvC5VOGLbOJZWOV6zSK1PoajgGJYm-ohPH9afYDQEq1oWzYlqiOQ==&ch=XBFhRuQNMb9NKVhKDWMxllOTffDQAVmC_70p871EKYCtsPjtqqx8xw==" target="_blank"><span style="color: black; line-height: 150%; mso-bidi-font-size: 11.0pt;"><strong>Stuttering Foundation</strong></span></a> and the <a href="http://r20.rs6.net/tn.jsp?f=0012vVTlRit9hOwP0kFFTT0gtqaEhnkGIX8U21l7vYTkiL0y_F7C5H2KQTCWxFv8MR4j_KoaV1SDBbkPSyHzJJPJva--kF75PO7ndglcR-brzy_aWb3RYpTzOaJ87pRhMaaWYgPzFqptwtKlawJfo5EJs2zCSP4yfHLW6C3W4bjt38=&c=X3CvC5VOGLbOJZWOV6zSK1PoajgGJYm-ohPH9afYDQEq1oWzYlqiOQ==&ch=XBFhRuQNMb9NKVhKDWMxllOTffDQAVmC_70p871EKYCtsPjtqqx8xw==" target="_blank"><span style="color: black; line-height: 150%; mso-bidi-font-size: 11.0pt;"><strong>National Stuttering Association</strong></span></a> continue
to inform and support us. I recommend you take a listen to <a href="http://r20.rs6.net/tn.jsp?f=0012vVTlRit9hOwP0kFFTT0gtqaEhnkGIX8U21l7vYTkiL0y_F7C5H2KYOs8kn1pIrsuVmo9m_aDjS62KpxZna4mczE5qE1wF74TEBX6avshXJNPY3R03jMHXfRcNlrXxyjUaLHF_plrHsvhviuWzb4ld4enJ_wQ3KhFMWm-mswJqY=&c=X3CvC5VOGLbOJZWOV6zSK1PoajgGJYm-ohPH9afYDQEq1oWzYlqiOQ==&ch=XBFhRuQNMb9NKVhKDWMxllOTffDQAVmC_70p871EKYCtsPjtqqx8xw==" target="_blank"><span style="color: black; line-height: 150%; mso-bidi-font-size: 11.0pt;"><strong>StutterTalk</strong></span></a> as well, where you will
find podcasts representing a variety of opinions about stuttering with
Peter Reitzes as a polite and unbiased host. These outstanding
organizations deserve our gratitude. Let us support them in 2014 and beyond.<o:p></o:p></span></div>
<br />
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<span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Happy New Year!<o:p></o:p></span></div>
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<span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";"> <o:p></o:p></span></div>
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<span style="color: black; font-family: "Verdana","sans-serif"; font-size: 10pt; line-height: 150%; mso-bidi-font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">Judy<o:p></o:p></span></div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-13241202972228274402013-09-03T17:58:00.000-04:002015-02-02T11:57:48.501-05:00The Arm Bump - Revised<br />
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<span style="font-family: Calibri;">This is a revised version of the blog post from 3/18/09.<span style="mso-spacerun: yes;"> </span></span></div>
<br />
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<span style="color: #222222; font-family: "Comic Sans MS"; font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">Here is a popular activity that helps
fluent speakers understand a little bit about what stuttering is like. I led a
group of about 20 teachers in this exercise. <span style="mso-spacerun: yes;"> </span>I expected it would be the most effective way
to engage them at the end of a school day. And we only had 30 minutes.<o:p></o:p></span></div>
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<span style="color: #222222; font-family: "Comic Sans MS"; font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">I began by asking them all to take
out their #2 pencils. Seriously. <br />
<br />
<span style="mso-spacerun: yes;"> </span>Each teacher chose a partner
sitting beside them. One partner wrote her name several times on a piece of
paper. The other partner bumped the writer's arm several times as she was
writing. The bumping needed to vary in pressure and timing so that the writer
could not predict when it would happen or how it would feel. Teachers were
laughing, talking, <span style="mso-spacerun: yes;"> </span>and grumbling about
messy writing....the first objective of the afternoon had been accomplished -
they were engaged.<o:p></o:p></span></div>
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<span style="mso-spacerun: yes;"> </span>Facilitated discussion
followed: how did they like the writing? How did their fingers, hands, wrists,
arms, shoulders or any other parts of their body react to being bumped? How did
they respond emotionally... any anticipation anxiety? Did they try prepare for the
bumping? <br />
<br />
<span style="mso-spacerun: yes;"> </span>This activity elicits physical
tension in the fingers and hands of the writer. People tend to grip their
pencils more tightly in anticipation of and in reaction to being bumped. They
feel a range of emotions: annoyance, frustration, loss of control. One writer
spontaneously grumbled, "I give up." I wondered – give up what?
Trying to write smoothly or to write at all? <o:p></o:p></span></div>
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<span style="color: #222222; font-family: "Comic Sans MS"; font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";">People who stutter tend to stutter
when saying their own names, which can be very embarrassing. This is why the
writers were asked to write their own names. They write for several minutes so
as to experience the relentless nature of the bumping. Yet, after 5 minutes,
they have the luxury of returning to their original state of fluent writing.
Facilitated discussion guides the conversation to how a person responds to
stuttering. <o:p></o:p></span></div>
<br />
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<span style="color: #222222; font-family: "Comic Sans MS"; font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";"><br />
<span style="mso-spacerun: yes;"> </span>In the 10 minutes reserved for
questions, someone asked, "What can teachers do to help a child who
stutters?" and I knew I had missed an important objective. The next
presentation must include copies of Straight Talk for Teachers from the
Stuttering Foundation of America for every teacher. We all still want a "How
to..." list of directions. Please visit <a href="http://www.stutteringhelp.org/"><span style="color: #2288bb; text-decoration: none; text-underline: none;">http://www.stutteringhelp.org/</span></a> for
specific tips for the classroom.<o:p></o:p></span></div>
<br />
<br />
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<span style="color: #222222; font-family: "Comic Sans MS"; font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman";"><span style="mso-tab-count: 1;"> </span>Update: 1.) Tell
the bumpers to offer advice to writers during the activity, like “Take your
time.” 2. ) After one partner writes and one partner bumps, ask the bumper what
she observed in the writer. What did she think the writer was thinking and
feeling. How did she think the writer was coping with having her arm bumped.
Then, do a reality check. Ask the writer what she was actually thinking,
feeling, and doing.<o:p></o:p></span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-34125248135736385962013-08-26T18:03:00.002-04:002020-04-09T11:19:47.765-04:00Back to School Preparations for Children Who Stutter<br />
<br />
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">When
I walked to a nearby shopping center this week, the parking lot outside the
office supply store was extraordinarily busy. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Inside,
children strolled up and down the aisles chattering about new classrooms and selecting
school supplies. It was back-to-school shopping time.<o:p></o:p></span></div>
<br />
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">The
beginning of a new school year brings with it an abrupt lifestyle change. We
can help children transition from the casual summer months to the more rigorous
academic calendar by making small changes several days before school begins. The
<b style="mso-bidi-font-weight: normal;">National Center for Learning Disabilities
</b>suggests<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span><!--[endif]--></span></span></a>
<o:p></o:p></span></div>
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<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">1.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">re-establishing bedtime routines before the
start of school,<o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">2.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">preparing a location and schedule for doing
homework,<o:p></o:p></span></div>
<br />
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<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">3.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">collecting and organizing needed supplies,<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">4.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">reviewing basic academic material,<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">5.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">building excitement for school, and,<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 1in; mso-add-space: auto; mso-list: l1 level1 lfo1; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">6.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">reading books together about going back to
school. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>The child who stutters has an even longer
to-do list. <span style="mso-spacerun: yes;"> </span>She has the added
responsibility of<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 0in 0in 0pt 75.2pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">1.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">educating her new teacher(s) and peers
about stuttering,<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 75.2pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">2.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>planning new communication goals, and,<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 75.2pt; mso-add-space: auto; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<!--[if !supportLists]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">3.<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><!--[endif]--><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>role-playing
options for how to cope with teasing. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">I
read through print copies of newsletters I’d saved over the years in search of
tips for going back-to-school. These newsletters from Friends<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span><!--[endif]--></span></span></a>,
The National Stuttering Association<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span><!--[endif]--></span></span></a> and
The Stuttering Foundation<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span><!--[endif]--></span></span></a> are
priceless resources for family-friendly information. They are filled with brief,
understandable articles by children, parents, and professionals. <span style="mso-spacerun: yes;"> </span>I was thrilled to find that back issues were available
on the organizations’ websites. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>A few back-to-school activities showed up
repeatedly: writing a letter to the new teacher(s), planning a class presentation,
and dealing with teasing. The National Stuttering Association had a brochure
about <i style="mso-bidi-font-style: normal;">Stuttering and Reading Fluency </i>also.
<span style="mso-spacerun: yes;"> </span>I was grateful this information was so
easy for families to locate and download. In this article, I’d like us to think
about skills and attitudes that may be preconditions to accomplishing any of
these self-advocacy activities.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>The child feels respected.<span style="mso-spacerun: yes;"> </span></span></b><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">I have listened to some children,
with and without speech/language differences, talk about school as an
intimidating institution in which expectations feel overwhelming and
dehumanizing. When school personnel view students in terms of performance data,
I understand why children hide their stuttering. A former student of public
school speech therapy writes,</span><span style="font-family: "trebuchet ms";"> “</span><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">By counting each stuttered word or
reporting specific moments of dysfluency in the classroom, I would argue that
this places an unnecessary burden on the young stutterer. I have been lucky to
witness the extraordinary work of numerous special educators who resist this
pressure. Take it from my firsthand experience, educators are able to make a lasting
impact by working closely with their student without quantifying his or her
communicative performance.”<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span><!--[endif]--></span></span></a> I
think a child will need to feel the warmth of personal concern from a teacher
before starting a conversation about stuttering.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">The child can discuss thoughts,
feelings and behaviors. </span></b><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Most moms of older children tell me
they seldom talk about stuttering. Parents of preschoolers worry that saying
something will make the stuttering worse.<span style="mso-spacerun: yes;">
</span>I sympathize. Inviting children to talk about stuttering is a delicate
process and I’ve had many mishaps trying to talk about ‘the elephant in the
room.’ I’ve had students cry, change the topic, act silly or aggressive, or
stare at me silently when I ask them specifics about their speech and
experiences with communication. <span style="mso-spacerun: yes;"> </span>Stuttering
is an intimately personal topic and should be approached carefully. Peter
Reitzes experimented with humor by asking children to write funny laws such as ”Anyone
who tells a child who stutters to ‘slow down’ will have to walk around all day
with his or her shoelaces tied together.” This humor helped move children into
discussions of how to educate and advocate. “Creating new laws for people who
stutter proved to be a valuable tool for discussing stuttering in an open, fun,
and productive manner.” <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span><!--[endif]--></span></span></a> <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">I
don’t anticipate much progress in fluency therapy until a child and family can take
a step back and observe stuttering with a cool head and forgiving heart.
Desensitization to the moment of stuttering is, in my opinion, essential. It’s
an issue that resonates across sessions and communication goals. It impacts
multiple components of a comprehensive speech therapy program. Negative emotional
reactions to stuttering create a fog, clouding our senses, preventing a clear
perception of reality and blinding us to creative solutions.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">So…<o:p></o:p></span></b></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">If
a child is developing sense of empowerment and can talk about his communication
needs, then speech therapy can confront the issues children who stutter encounter
at school. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Quick, verbal self-defense is
especially difficult for children who stutter. </span></b><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>Even the cleverest come-back can be too
difficult to say right when it’s needed the most. So alternate ways of coping
with teasing are important.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Listeners don’t know stuttering.</span></b><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"> Teachers
and peers will need some information. If a child would like to <u>write a
letter to her teacher</u>, there are examples on the Friends website.<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span><!--[endif]--></span></span></a>
The August 2010 issue has Approaching<i style="mso-bidi-font-style: normal;">
Your Teacher About Stuttering</i> by Elizabeth Mendez<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span><!--[endif]--></span></span></a> who
writes, “Think about a fresh start and consider being open about something
about you that has made you become the amazing and strong person you are today.
Consider sharing with your teachers your stuttering and for those who can do
the extra mile, educate them with resources.” Resources are free at the
National Stuttering Association website including the comprehensive brochure
“What Teachers Need to Know to Help Children Who Stutter.” The Stuttering Foundation
has a booklet, DVD, brochure, and new storybook about teachers. I recommend
that a parent be proactive as well, arranging frequent parent-teacher check-ins.
<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Some
children may want to give a <u>class presentation</u> about stuttering with the
help of their speech language pathologist.</span><span style="font-family: "trebuchet ms";"> </span><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">The National Stuttering
Association and the Stuttering Foundation furnish guidelines for putting such a
presentation together. <span style="mso-spacerun: yes;"> </span>The following issues
of <i style="mso-bidi-font-style: normal;">Reaching Out</i> have examples: <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt;">A
Proud Mom’s Story by Sue Parisi (Sept-Oct 2008)<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt;">Does
Anyone Have Any Questions? By Ellie Hooey (Jan-Feb 2009)<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt;">Telling
the Class by Francine J Bliss (March-April 2010)<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt; text-indent: 0.5in;">
</div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Children who stutter are teased. </span></b><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>Constance Dugan has a very thoughtful article to
accompany her “Teasing Inventory for School-Age Kids Who Stutter” in the 2006
International Stuttering Awareness Day Online Conference<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span><!--[endif]--></span></span></a>.
She spends a few minutes of every speech therapy session filling out the
teasing inventory. Repetition helps children get comfortable with the process. She
finds that the scale format helps children to respond and teaches them about intensity.
“It is important to recognize not only different feelings but different
intensities. For example, ‘annoyed’ reflects less distress than
‘furious’.”<span style="mso-spacerun: yes;"> </span>The few, carefully crafted,
short-answer questions “communicate the old advice: Honor your feelings but
monitor your actions. Following these up by “How did you feel then?” can help
kids become aware that they have some power to reduce their own suffering.” <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Gail
Wilson Lew’s article “Stuttering and Teasing” in the Nov-Dec 2009 <i style="mso-bidi-font-style: normal;">Reaching Out</i> reminds us why children may
not seek help for teasing. She writes, “One day, in 9<sup>th</sup> grade
Spanish class, the boy behind me started to pull on my pony tail. I did not
want to turn around because I was afraid I would get in trouble with the
teacher. I was also reluctant to tell the teacher, because I would then have to
speak up and explain: thus, the possibility of stuttering and
embarrassment.”<span style="mso-spacerun: yes;"> </span>Later in the article she
explains, “A child who stutters does not want others to know that he stutters,
because he does not want to be ‘different.’ He wants to be accepted. A lot of
pressure may be lifted if a child lets people know that he stutters and does
not try to hide it.” <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Reading aloud and reading assessments can
be demoralizing. </span></b><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">I appeal to everyone who reads this article
to download the brochure <u>“Stuttering and Reading Fluency: Information for
Teachers.</u>” The national initiative to promote reading is admirable.
However, it is placing excessive pressure on children who stutter. “Reading
aloud can be quite stressful for those who stutter, mostly because they are
worried about how others might react to their stuttering.” Also, “a child
should not be penalized for moments of stuttering when assessing reading
fluency. Fluency of speech is not the same as fluency of decoding.”<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftnref11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>I agree that children, in partnership with
parents and educators, can advocate for their communication needs. <span style="mso-spacerun: yes;"> </span>I also think that advocacy is predicated on healthy
communication attitudes and sensitive support from others. If teasing crosses
the line and becomes bullying, my blog of 9/6/12 “Bullying Prevention and
Intervention Laws Could Help Children Who Stutter” may prove useful. <b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>I wish you lots of fun friendships, fond memories and academic
success as you embark upon another school year!<o:p></o:p></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Judy<o:p></o:p></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span><!--[endif]--></span></span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
</span><span style="font-family: "calibri" , "sans-serif";">The National Center for
Learning Disabilities, 8/17/13, “Six Ways to Get Your Child Back into the
Learning Groove,” e-mail newsletter, the six items are paraphrased, <a href="http://www.ncld.org/"><span style="color: blue;">www.ncld.org</span></a> </span><o:p></o:p></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span><!--[endif]--></span></span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
</span><span style="font-family: "calibri" , "sans-serif";">According the Bill of Rights
and Responsibilities of People Who Stutter, “A person who stutters has the
responsibility to... 1.understand that listeners or conversation partners may
be uninformed about stuttering and its ramifications…” <span style="mso-spacerun: yes;"> </span>International Stuttering Association <a href="http://www.isastutter.org/what-we-do/bill-of-rights-and-responsibilities"><span style="color: blue;">http://www.isastutter.org/what-we-do/bill-of-rights-and-responsibilities</span></a>
<o:p></o:p></span></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span><!--[endif]--></span></span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
</span><i style="mso-bidi-font-style: normal;"><span style="font-family: "calibri" , "sans-serif";">Reaching
Out,</span></i><span style="font-family: "calibri" , "sans-serif";"> Friends: The
Association of Young People Who Stutter <a href="http://www.friendswhostutter.org/"><span style="color: blue;">www.friendswhostutter.org</span></a> </span><o:p></o:p></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span><!--[endif]--></span></span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
</span><i style="mso-bidi-font-style: normal;"><span style="font-family: "calibri" , "sans-serif";">Family
Voices</span></i><span style="font-family: "trebuchet ms";">, </span><span style="font-family: "calibri" , "sans-serif";">The
National Stuttering Association, <a href="http://www.westutter.org/"><span style="color: blue;">www.westutter.org</span></a>
</span><o:p></o:p></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span><!--[endif]--></span></span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
</span><span style="font-family: "calibri" , "sans-serif";">The Stuttering Foundation <a href="http://www.stutteringhelp.org/"><span style="color: blue;">www.stutteringhelp.org</span></a> <o:p></o:p></span></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "calibri" , "sans-serif";"><span style="font-size: x-small;"> Jack McDermott. “Speech Therapy in
Public Education Settings: A Former Student’s Perspectives”,<span style="color: blue;"> </span></span><span style="font-size: x-small;">Family Voices Third Quarter 2012 p. 7 (broken link)<o:p></o:p></span></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span><!--[endif]--></span></span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
</span><span style="font-family: "calibri" , "sans-serif";">Peter Reitzes, “It Outghta Be
a Law!” <i style="mso-bidi-font-style: normal;">Reaching Out</i>, October-November-December
2005.</span><o:p></o:p></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "calibri" , "sans-serif";"><span style="font-size: x-small;"> Friends: Teacher Letters </span><a href="http://www.friendswhostutter.org/teacher-letters/"><span style="color: blue; font-size: x-small;">http://www.friendswhostutter.org/teacher-letters/</span></a><span style="font-size: x-small;">
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "calibri" , "sans-serif";"><span style="font-size: x-small;"> Reaching Out July /Aug 2010 </span><span style="color: blue; font-size: x-small;">(broken link)</span><span style="font-size: x-small;"><o:p></o:p></span></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span><!--[endif]--></span></span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
</span><span style="font-family: "calibri" , "sans-serif";">Constance Dugan (2006) “Teasing
Inventory for School Age Kids Who Stutter” International Stuttering Awareness
Day Online Conference <a href="http://www.mnsu.edu/comdis/isad9/papers/therapy9/dugan9.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad9/papers/therapy9/dugan9.html</span></a>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/BAck%20to%20School%20Aug%2013%20third%20attempt.docx" name="_ftn11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "calibri" , "sans-serif";"><span style="font-size: x-small;"> broken link</span></span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-22724679963298469162013-08-17T00:30:00.000-04:002020-04-09T11:21:44.317-04:00National Stuttering Association Family Fun Day<br />
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"> The
National Stuttering Association (NSA) is finally returning to the Boston area
by hosting a Family Fun Day and adult workshop on <strong>November 2<sup>nd</sup> at
Boston University</strong>. This is a rare opportunity to learn about stuttering in a uniquely
welcoming and empowering environment. <o:p></o:p></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"> I
recall when the Boston Chapter of the NSA hosted a Family Day in the summer of
2002 at Newton Wellesley Hospital. I helped organize it alongside NSA member,
John Carter. <span style="mso-spacerun: yes;"> </span>After opening words by
Boston chapter members, the mother of one of my students said a few words about
parenting a child who stutters. Her kind smile and open heart set everyone at
ease. <span style="mso-spacerun: yes;"> </span>I still have a copy of what she
said. “I truly believe that everything that I can do to find inner peace and
balance within myself will affect the way I interact and parent my children.
Taking care of ourselves is probably the most important thing we can do for
them.” One of my adult clients came up with a theme for the day: <i style="mso-bidi-font-style: normal;">Be an advocate for yourself and a role model
for others</i>. Local speech-language pathologists volunteered to facilitate workshops.
A magician entertained us after lunch. We finished the day with open-mic,
certificates of attendance and balloons. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"> Fast forward to 2013! <o:p></o:p></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"> I’m told the Family Fun Day
this year will run from 9-12<b style="mso-bidi-font-weight: normal;">.</b> There
will be a program for adults in the afternoon and continuing education for
speech language pathologists as well. This is a golden opportunity to glimpse
the magic that happens every year at an NSA national conference. I’ve attended
several: Cleveland, Chicago, Boston, Knoxville, Atlanta, Parsippany and St.
Petersburg. Attending an NSA event is truly a game changer. I hope some families
from the area will join me in Washington, DC for <b style="mso-bidi-font-weight: normal;">NSA 2014: Red, White, Blue, and You! <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/NSA%20Family%20Day%20Aug%202013%20graphic.doc.docx" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></b></span><!--[endif]--></span></span></a>
</b>The NSA vision to bring “hope and empowerment to children and adults who
stutter, their families, and professionals through support, education,
advocacy, and research” is reflected in four days of education, sharing, and
fun. The Boston Family Day will only whet your appetite!<o:p></o:p></span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;"> If you’re wondering what
will happen at the Family Fun Day this fall, I encourage you to browse the <strong>Family Voices</strong>
newsletter archives.<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/NSA%20Family%20Day%20Aug%202013%20graphic.doc.docx" name="_ftnref2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span><!--[endif]--></span></span></a> <span style="mso-spacerun: yes;"> </span>Every issue represents a community scattered
across the country yet close in heart and mind. You’ll <i style="mso-bidi-font-style: normal;">see</i> articles written by parents, “experts,” and children of all
ages. Poems, drawings, photos and event listings fill up any remaining space. <span style="mso-spacerun: yes;"> </span>Themes of friendship, self-respect,
empowerment, understanding and raising public awareness show up again and
again. You’ll <i style="mso-bidi-font-style: normal;">hear</i> the passion behind
the words, if you listen to a radio show<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/NSA%20Family%20Day%20Aug%202013%20graphic.doc.docx" name="_ftnref3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span><!--[endif]--></span></span></a>. And
you <i style="mso-bidi-font-style: normal;">feel</i> the magic if you attend a
Family Fun Day or Annual Conference. </span><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Hope to see you there!
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Visit <a href="http://www.westutter.org/"><span style="color: blue;">www.westutter.org</span></a> for updates.</span></div>
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<span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 150%;">Judy</span></div>
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</span><a href="http://www.westutter.org/annual-conference/"><span style="color: blue; font-family: "trebuchet ms"; font-size: x-small;">http://www.westutter.org/annual-conference/</span></a><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></span></div>
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<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/BLOG/NSA%20Family%20Day%20Aug%202013%20graphic.doc.docx" name="_ftn3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span><!--[endif]--></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="color: blue; font-family: "trebuchet ms"; font-size: x-small;">broken link</span><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";"><o:p></o:p></span></span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-35470342463321210842013-06-25T18:41:00.002-04:002020-04-09T11:22:59.977-04:00Delayed Auditory Feedback<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"> Delayed
Auditory Feedback, nicknamed DAF, is sometimes helpful for older children,
teens and adults who stutter. DAF is easily accessible now as a mobile app. So,
I think it’s important to talk about it. DAF is when a speaker does not hear
her own voice in real time, but instead, hears it after a teeny tiny delay.
Here’s a more scientific description:<o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>“Briefly, when speech is fed back to
a speaker via earphones at 75 to 100 milliseconds delay (one tenth of a
second), the speaker will automatically (passively) slow their rate of utterance,
flatten their intonation, prolong their words and/or raise their speech volume
to cope with the competing signal…<o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>“The alteration in speech prosody
will often inhibit the stuttering response. Unfortunately this does not
carry-over very well because the DAF is not paired to the stuttering
specifically but to the speech signal in general. It is therefore difficult to
maintain this new speech pattern without the DAF/echo-present… <o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>“The effects of speaking in the
presence of your own delayed speech signal remains the single most efficient,
immediate and initially passive fluency evoking stimuli available.”<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>A therapy
program may include DAF to help establish greater fluency, then arrange for it
to “be gradually reduced so that the individual is speaking with his own
internal controls.” <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>Many of
my clients have tried DAF. <span style="mso-spacerun: yes;"> </span>In the late 1990s,
I helped several of them obtain free DAF for phone use. In 2001, I discovered
the Casa Futura School DAF in a catalogue and bought one. It cost almost $300 (and
another $27.00 when a student stepped on the headset). <span style="mso-spacerun: yes;"> </span>In 2008, I bought two more devices. It was the
most affordable DAF at the time. Then, in 2011, SPEECH4GOOD <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span><!--[endif]--></span></span></a> put
DAF into a mobile application. One of my clients purchased it this spring for
under $10! Version 3.0 launched this month. These dramatic changes in price and
availability prompted me to re-examine the role of DAF for speech language
pathologists who treat stuttering.<o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span><span style="mso-tab-count: 1;"> </span>My
own use of DAF has to do with the nature of my business. <span style="mso-spacerun: yes;"> </span>My clients tend not to follow through with the
rigorous expectations of speech therapy, so, I find myself writing fewer lesson
plans and more educational/problem-solving memos.<span style="mso-spacerun: yes;"> </span>That means spending a lot of time learning
about issues associated with fluency: concomitant disorders, therapy options,
parenting, child development, social communication, literacy, and the ever changing
landscape of public education. So, when new student responded particularly well
to DAF, I had another reason to re-examine this option.<o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Let’s begin with a study published this
year. <span style="mso-spacerun: yes;"> </span>It found that fluent adults
responded to DAF with an increase in stutter-like dysfluencies and sound errors,
and, the adults fell roughly into two groups. Adults who experienced the least
amount speech disruption with DAF were given the label “low responders.” The authors
of the study hypothesized that these low responders “have better developed
speech motor skills…[which enabled] fluent speech under the DAF perturbation by
using more accurate <i style="mso-bidi-font-style: normal;">feedfoward control</i>
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span><!--[endif]--></span></span></a>…[and
also] that low responders could be less dependent on auditory feedback…” The
other group of adults were greatly affected by DAF. <span style="mso-spacerun: yes;"> </span>This second group of adults experienced much
more speech disruption and so they were labeled “high responders”. “In
contrast, high responders have a high dependency on auditory feedback to
maintain fluency under typical speaking conditions…” In the larger scheme of
things, these results add “…to the accumulating findings that motor-phonetic
encoding involves auditory-to-motor integration.”<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span><!--[endif]--></span></span></a> Perhaps
we can hypothesize that our clients respond differently to DAF because of
differences in auditory-to-motor integration. I propose that research such as
this justifies the inclusion of DAF as an option in speech therapy.<o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>In truth, the use of DAF for persons
who stutter is a topic of contentious debate. I kind of enjoy heated arguments
in professional journals. I’m curious to read how deeply held disagreements are
thinly disguised as polite discussions. Also, controversy reveals fascinating
details. As I understand it, one side of this controversy over DAF declares that
decades of evidence prove DAF has a powerful effect on stuttering.<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span><!--[endif]--></span></span></a> The
opposing view challenges this research.<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span><!--[endif]--></span></span></a> <span style="mso-spacerun: yes;"> </span>The challenge is not trivial. <o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span><span style="mso-spacerun: yes;"> </span>The issue of legitimacy appears in a
fascinating article about Lionel Logue, the speech therapist portrayed in The
King’s Speech.<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span><!--[endif]--></span></span></a>
<span style="mso-spacerun: yes;"> </span>Highly respected clinicians of the early
20<sup>th</sup> century were unsuccessful in helping Prince Albert, Duke of
York, manage his stuttering. On the other hand, Lionel Logue, with less formal education,
was portrayed as experienced, persistent, and successful. <o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>“Logue’s therapy methods were
typical of those used by other clinicians of his time…emphasizing diaphragmatic
breathing…muscle relaxation…methods that provided King Albert with a sense of
his own fluency [including] masking the feedback the king received from his own
voice, …singing through blocks…counseling…[and nurturing] the confidence that
he could, with hard work, within the proper therapeutic regimen, stutter less.”
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>“To achieve legitimacy, today’s
practitioners are encouraged to select methods that have been shown to be
efficacious when studied using evidence-based methods (ASHA 2011). For
therapies that have not been scrutinized by evidence-based systematic reviews,
today’s clinicians are sometimes asked to provide their own documentation of
therapy progress, using carefully controlled, objective methods…” <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>By now, I’ve left DAF <span style="mso-spacerun: yes;"> </span>by the wayside and turned my attention to
Evidence Based Practice, commonly known as EBP. For any reader still with me, this
will be a short and productive digression. I cracked open a textbook to a
chapter about the role of evidence in stuttering treatment. <span style="mso-spacerun: yes;"> </span>Let’s begin with a definition. In EBP, “
evidence refers to research findings, and the goal of clinical practice is to
find and implement the treatment that represents the best combination of
information from three sources : (1) research (i.e., evidence), (2) physician
or clinician expertise, and (3) patient or client preferences.” <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>I learned about four levels of
evidence quality and how, apparently, the only legitimate evidence in the field
of stuttering was provided by a few literature summaries, prepared by a few
authors, and justified only a few therapeutic approaches. I read about clinician
bias and insufficient client input. There appeared to be wholesale disregard
for whole lot of research. <span style="mso-spacerun: yes;"> </span>I like
reading my ASHA journals yet the article discredited such an approach,
stating<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>“reading individual research reports should
actually be a last resort for practitioners.” <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span><!--[endif]--></span></span></a> <span style="mso-spacerun: yes;"> </span>So, I respectfully disagree. Journal
publications provide more than experimental data. They include brief historical
reviews, theoretical hypotheses, and intriguing discussion. They illustrate ways
to think about complex issues.<o:p></o:p></span></div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Thankfully, this book chapter ended
with some suggestions. “For current stuttering treatments in particular,
because the highest levels of evidence hierarchy (systems, synopses, and even
multiple meta-analyses and systematic reviews) are not yet widely available, it
becomes the responsibility of the clinician to carefully assess the
effectiveness of the selected treatment with each client.” <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span><!--[endif]--></span></span></a> EBP
can focus on “one clinician-client pair at a time” . Treatment should be
“directed toward relieving the client’s ‘source of complaint’” and <span style="mso-spacerun: yes;"> </span>“…the ‘most critical components of stuttering
treatment outcome evaluation…might be the self-judgments or self-measurements
made by the speakers themselves.’” <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>We can apply this guidance to the use of DAF. <a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Now that DAF is widely available as
an app, I feel that SLP’s should educate the public about how it might be
helpful. <span style="mso-spacerun: yes;"> </span>It could be a way for clients
to generalize communication goals outside the speech clinic. Apps may be a way
for clients to make the self-judgments and self-measurements necessary in a EBP
approach to communication change. I hope SLPs will take advantage of this
technology, even though it will require some creativity within the ideals of
EBP .<o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span><o:p></o:p></span></div>
<br />
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<u><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Epilogue</span></u><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">:<o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>I finished this article feeling
somewhat incompetent. Has my profession failed to keep up with recent changes in
health care standards? <span style="mso-spacerun: yes;"> </span>My mind cleared after
reading an article in the newspaper about the humanities in <span style="mso-spacerun: yes;"> </span>modern day higher education. College is becoming
a narrowly focused job training program rather than an opportunity for high
level, broad based education. “The tragedy of the humanities is that it has
become cordoned off: viewed as separate, arcane, and indulgent, instead of
something that undergirds the other parts of life. Maybe instead of trying to
steer students back to humanities degrees, we should be rethinking the way we
teach humanities in general. We could be foisting those thinking skills on
everyone, a bit.”<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftnref14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span><!--[endif]--></span></span></a><span style="mso-spacerun: yes;"> </span>I could definitely relate! An SLP draws from a
wide range of knowledge and skills. </span></div>
<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><br />
<span style="mso-tab-count: 1;"><span style="color: black; font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"> While I commend the
profession of speech language pathology for staying grounded in science,
speech/language therapy requires a generous amount of "humanness".
Think about the personal manner of your child's pediatrician., or even
the customer service you received while dining out? I feel the best of
these relationships are based on something almost invisible yet
tangible. The therapeutic alliance is similar for me - invisible
yet essential. Which leads me to my next topic:
mindfulness. But first, I'll visit an art museum and remind myself
that life is more than big data.</span></span><br />
</span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;"><o:p>Judy</o:p></span><br />
<div style="mso-element: footnote-list;">
<!--[if !supportFootnotes]--><br />
<hr align="left" size="1" width="33%" />
<!--[endif]-->
<br />
<div id="ftn1" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Richard M. Merson (2003)
“Auditory Sidetone and the Management of Stuttering: From Wollensak to
SpeechEasy” </span><a href="http://www.mnsu.edu/comdis/isad6/papers/merson6.html"><span style="color: blue; font-size: x-small;">http://www.mnsu.edu/comdis/isad6/papers/merson6.html</span></a><span style="font-size: x-small;">
<o:p></o:p></span></span></div>
</div>
<div id="ftn2" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Speech4Good<span style="mso-spacerun: yes;"> (broken link)</span></span></span></div>
</div>
<div id="ftn3" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Judith V. Butler (11/7/10) DIVA </span><a href="http://butlerspeechtherapy.blogspot.com/2010/11/diva.html"><span style="color: blue; font-size: x-small;">http://butlerspeechtherapy.blogspot.com/2010/11/diva.html</span></a><span style="font-size: x-small;">,
italics mine <o:p></o:p></span></span></div>
</div>
<div id="ftn4" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> H.C. Chon, et. al. (2013)
Individual Variability in Delayed Auditory Feedback Effects on Speech Fluency
and Rate in Normally Fluent Adults. Journal of Speech, Language, and Hearing
Research, Vol. 56, p. 500 for all quotes<o:p></o:p></span></span></div>
</div>
<div id="ftn5" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> J. Kalinowski & V.K.
Guntupalli (2007) On the Importance of Scientific Rhetoric in Stuttering: A
Reply to Finn, Bothe, and Bramlett (2005), American Journal of Speech-Language
Pathology, Vol. 16, 69-76.<o:p></o:p></span></span></div>
</div>
<div id="ftn6" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> P. Finn, et. al. (2005) Science
and Pseudoscience in Communication Disorders: Criteria and Applications,
American Journal of Speech-Language Pathology, Vol. 14, 172-186.<o:p></o:p></span></span></div>
</div>
<div id="ftn7" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Judith Felson Duchan (2012)
Historical and Cultural Influences on Establishing Professional Legitimacy: A Case
Example from Lionel Logue. American Journal of Speech Language Pathology, Vol.
21, 387-396.<o:p></o:p></span></span></div>
</div>
<div id="ftn8" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Ibid. p. 391<o:p></o:p></span></span></div>
</div>
<div id="ftn9" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Ibid. p. 393<o:p></o:p></span></span></div>
</div>
<div id="ftn10" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> A.K. Bothe, et. al. (2010) The
Roles of Evidence and Other Information in Stuttering Treatment, in B. Guitar
& R.. MCCauley (eds.) Treatment of Stuttering: Established and Emerging
Interventions, (pp. 343-354).Baltimore, MD: Lippincott Williams & Wilkins. p.
344<o:p></o:p></span></span></div>
</div>
<div id="ftn11" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Ibid. p. 349<o:p></o:p></span></span></div>
</div>
<div id="ftn12" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Ibid. p. 352<o:p></o:p></span></span></div>
</div>
<div id="ftn13" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Ibid. remaining quotes from p.
351<o:p></o:p></span></span></div>
</div>
<div id="ftn14" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="file:///C:/Users/Judy/Documents/Speech%20Stuff/Paperwork%20website%20blog/Website%20and%20Blog/Blog/DAF%20final%20final.docx" name="_ftn14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif";"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span><!--[endif]--></span></span></span></a><span style="font-family: "times new roman" , "serif";"><span style="font-size: x-small;"> Joanna Weiss (June 16, 2013)
Humanities at Risk: Let’s rethink the way we teach college students. <i style="mso-bidi-font-style: normal;">The Boston Sunday Globe,</i> p.K8<o:p></o:p></span></span></div>
</div>
</div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-87398004345737414722013-04-25T13:02:00.001-04:002020-04-09T11:29:24.272-04:00Looking for a Language Hierarchy<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">How
can we help students use fluency enhancing strategies beyond the speech therapy
room? Transferring greater fluency to a variety of settings can be a big
challenge. If family and friends are reminded of this, they can partner with children,
not blame them, when carryover of new speech skills requires problem-solving
and patience.<o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">A
common tool for carryover is called the “hierarchy”.<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn1" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span></span></span></a> A
hierarchy is simply a sequence of activities that become gradually more
difficult. For example, a hierarchy may include first the use of <i style="mso-bidi-font-style: normal;">choral speech</i>, then <i style="mso-bidi-font-style: normal;">immediate imitation</i>, then <i style="mso-bidi-font-style: normal;">delayed
imitation</i>, then <i style="mso-bidi-font-style: normal;">elicited speech </i>and
finally, <i style="mso-bidi-font-style: normal;">spontaneous speech. </i><span style="mso-spacerun: yes;"> </span>Factors that contribute to fluency breakdown
can be similar across students, but I doubt there is a one-size-fits-all
hierarchy. <span style="mso-spacerun: yes;"> </span>So, I view a hierarchy as a
process, a sequence of talking tasks that changes week to week depending upon a
student’s goal, attempts to change and lessons learned from each attempt.<span style="mso-spacerun: yes;"> </span>The process considers: <span style="mso-spacerun: yes;"> </span>When and with whom is the child courageous
enough to attempt a small speech change? <span style="mso-spacerun: yes;"> </span>How can the experience help to design a
subsequent attempt at change?<span style="mso-spacerun: yes;"> </span>In what
ways can listeners be educated about and appreciated for supporting the child’s
hard work? <o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Research
on fluency offers some guidance. We know that “many variables – such as
language, motor, cognitive, emotional, and genetic factors – interact in
complex ways” in the development and appearance of disfluency.<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn2" name="_ftnref2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span></span></span></a><sup>,
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn3" name="_ftnref3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span></span></span></a></sup>
Gosh, this feels overwhelming. So let’s focus on language for now, because we
also know that “The importance of the interactions of… language and speech
motor processes, is supported by a wealth of data including behavioral findings
that increases in utterance length and/or syntactic complexity are associated
with the increased occurrence of disfluency.” <a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn4" name="_ftnref4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span></span></span></a> <span style="mso-spacerun: yes;"> </span>We know that language demand affects fluency.
Where can family and friends find activities to do with children that control
for language difficulty?<o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">I
should let you know that there are many commercially packaged therapy programs
for stuttering therapy. <a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn5" name="_ftnref5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span></span></span></a> Most
of them probably include a step-by-step program that includes a hierarchy of speech/language
activities. One exception is <u>Easy Talker</u><a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn6" name="_ftnref6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span></span></span></a> ,
which does such an excellent job of presenting an overview of fluency therapy that
I give it to my middle school students for free. I’ve spent a small fortune on
products published specifically for speech therapy. However, the most fun and
cost effective activities were those I created using books, games, and videos found
in the clearance sections of book stores and discount outlets.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">One
day I found some simple story books called “Reading Rod Readers” for only one dollar
each. They were orphans of a packaged, patented reading program published by
ETA Cuisenaire. <a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn7" name="_ftnref7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span></span></span></a>
The illustrations were colorful, the literacy goals explicit and the price was
right so I scooped up about 15 of them. They became part of take-home lessons for
my younger students.<span style="mso-spacerun: yes;"> </span>I mention this as
one example of children’s literature that controls for linguistic difficulty
and therefore offers families an opportunity for carryover practice. Such books
provide language content at prescribed levels of difficulty. <span style="mso-spacerun: yes;"> </span>The Reading Rod Readers that I discovered have
short language exercises at the end of each story to review vocabulary,
grammar, comprehension, and writing skills. Such graduated reading programs<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn8" name="_ftnref8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span></span></span></a>,
including the English Language Arts workbooks children are already using in
school, may provide opportunities for fluency practice.<o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Some
resources for language arts standards across age levels include:<o:p></o:p></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">The American Speech Language Hearing
Association <a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn9" name="_ftnref9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Resources for Understanding the Common
Core State Standards<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn10" name="_ftnref10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Massachusetts Early Learning Guidelines
for Infants and Toddlers<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn11" name="_ftnref11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Massachusetts Curriculum Frameworks for
English Language Arts and Literacy<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn12" name="_ftnref12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">World Class Instructional Design and
Assessment WIDA<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn13" name="_ftnref13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l2 level1 lfo3; text-indent: -0.25in;">
<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Partnership for Assessment of Readiness
for College and Careers<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn14" name="_ftnref14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
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</div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Let’s
look at some research on language and fluency.<o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">A
recent study examined the oral motor coordination of children who stutter while
saying sentences of different length and complexity. Here are some of the
study’s conclusions. Note that the abbreviation CWS means ‘<u>c</u>hildren <u>w</u>ho
<u>s</u>tutter’ and CTD refers to <u>c</u>hildren who are developing in a
typical way.<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn15" name="_ftnref15" style="mso-footnote-id: ftn15;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[15]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“For syntactically simple sentences, CWS
had significantly more variable articulatory coordination than CTD <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“…reduced coordinative stability within
the speech motor system is likely a significant component of developmental
stuttering… <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“…even during perceptually fluent speech
production, the speech motor systems of some CWS are functioning with a reduced
level of coordinative stability <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 10pt 1in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“Perhaps responses to sentence length
and syntactic complexity differ between children who will persist in stuttering
and children who will recover.” <o:p></o:p></span></div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Another
recent study reviewed 170 different reports on the language skills of children
who stutter. Through a rigorous selection process, 22 studies were chosen that adhered
to specific research standards. <span style="mso-spacerun: yes;"> </span>Note
that these findings are described by the abbreviation CWS for ‘children who
stutter’ and CWNS for ‘children who do not stutter.’<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn16" name="_ftnref16" style="mso-footnote-id: ftn16;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[16]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-indent: -0.25in;">
<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“…findings suggest that CWNS differ from
CWS on several language abilities…CWNS outperformed CWS on seven of the 10
comparisons of language abilities <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-indent: -0.25in;">
<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“…findings, however, do not necessarily
mean that, on average, the language development of CWS is ‘disordered’…but
rather…CWS exhibit relatively consistent but subtle differences in language
abilities when compared to their normally fluent peers <o:p></o:p></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“There is some question whether the
aforementioned between-group differences in language abilities contribute to
actual instances of stuttering…Be that as it may, one could speculate that when
planning/formulating sentences, CWS may experience subtle but important
difficulties in quickly and efficiently encoding and retrieving lexical items<o:p></o:p></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">“…comprehensive speech-language
assessment…may uncover concomitant speech-language concerns that need to be
considered in the development of a comprehensive treatment plan for the
child…assessment may indicate that CWS’s language abilities are subtly below
those of CWNS even though they fall within the broad range of normal
limits…coupled with environmental factors that can impede fluency…may constitute
a ‘tipping point’ (Gladwell, 2000) where normally fluent speech becomes
stuttered speech…” <o:p></o:p></span></div>
<br />
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</div>
<br />
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">The
relationship between language and fluency is not straightforward. I am not
recommending the purchase the Reading Rod Readers or any other specific program.
E very student has unique needs.<span style="mso-spacerun: yes;">
</span>My idea to adapt language arts programs and children’s literature is
because of ease of access, portability, affordability, a global interest in
literacy, and the findings of recent research that link language demand with
speech fluency. Books can be shared with siblings, care givers,
extended family and friends as a consistent homework resource. Books transport
easily to anywhere the child visits socially or needs to spend time waiting at
siblings’ activities, restaurants or stores. Favorite books become family memorabilia
shared across generations. <a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn17" name="_ftnref17" style="mso-footnote-id: ftn17;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[17]</span></span></span></span></span></a> <span style="mso-spacerun: yes;"> </span>Digital natives may like to browse for apps<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftn18" name="_ftnref18" style="mso-footnote-id: ftn18;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[18]</span></span></span></span></span></a>
to supplement the book experience. Families with special interests may enjoy
finding books on favorite topics. Those lucky enough to live near a library can
ask librarians for age- and grade-level literature. Ask your speech language
pathologist what specific goal you and your child could generalize through the
use of children’s literature. </span></div>
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</div>
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<span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 150%;">Happy reading!<o:p></o:p></span></div>
<br />
<div style="mso-element: footnote-list;">
<br clear="all" />
<hr align="left" size="1" width="33%" />
<div id="ftn1" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref1" name="_ftn1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> For example,
Carrie Clark explains a traditional, hierarchical approach to articulation
therapy in her excellent blog series at Podcast 5: Step by Step Guide for Teaching
Your Child a New Sound,<span style="mso-spacerun: yes;"> </span>Speech and
Language Kids, <a href="http://www.speechandlanguagekids.com/slk5-teach-a-new-sound/"><span style="color: blue;">http://www.speechandlanguagekids.com/slk5-teach-a-new-sound/</span></a>
<o:p></o:p></span></div>
</div>
<div id="ftn2" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref2" name="_ftn2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> An example of
multiple goals relevant to fluency therapy, including a brief linguistic
hierarchy can be found in “Using the CALMS Model as a Thematic Approach to
Fluency Therapy” by Elise Kaufman (2005) <a href="http://www.mnsu.edu/comdis/isad8/papers/kaufman8.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad8/papers/kaufman8.html</span></a>
<o:p></o:p></span></div>
</div>
<div id="ftn3" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref3" name="_ftn3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> My own graphic
of therapy is at <span style="color: blue;">(broken link)</span><o:p></o:p></span></div>
</div>
<div id="ftn4" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref4" name="_ftn4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> Megan K.
MacPherson and Anne Smith (2013) Influences of Sentence Length and Syntactic
Complexity on the Speech Motor Control of Children Who Stutter, Journal of
Speech, Language, and Hearing Research, Vol. 56, 89-102, p. 89.<o:p></o:p></span></div>
</div>
<div id="ftn5" style="mso-element: footnote;">
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref5" name="_ftn5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> <span style="mso-spacerun: yes;"> </span>pro-ed (broken link) ; Super Duper Publications <a href="http://www.superduperinc.com/search/search.aspx"><span style="color: blue;">http://www.superduperinc.com/search/search.aspx</span></a>
<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
</div>
<div id="ftn6" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref6" name="_ftn6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> Easy Talker: A
Fluency Workbook for School-Age Children (13554) ISBN: 9781416404729<o:p></o:p></span></div>
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<span style="font-family: "times new roman" , "serif"; font-size: 8pt;">Barr
guitar, PhD, Julie Reville, c 1997 now distributed by pro-ed <o:p></o:p></span></div>
</div>
<div id="ftn7" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref7" name="_ftn7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> This company now
has a new name and new products: <span style="color: blue;">broken link</span><o:p></o:p></span></div>
</div>
<div id="ftn8" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref8" name="_ftn8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> For example, <i style="mso-bidi-font-style: normal;">Flash Kids</i>, A Division of Barnes & Noble,
NY, NY; and, <i style="mso-bidi-font-style: normal;">Spectrum Reading</i>,
Greensboro, NC. ; and, the Scholastic Store <a href="http://store.scholastic.com/webapp/wcs/stores/servlet/HomeView?storeId=10052&catalogId=10051"><span style="color: blue;">http://store.scholastic.com/webapp/wcs/stores/servlet/HomeView?storeId=10052&catalogId=10051</span></a>
<o:p></o:p></span></div>
</div>
<div id="ftn9" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref9" name="_ftn9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> <a href="http://www.asha.org/public/speech/development/"><span style="color: blue;">http://www.asha.org/public/speech/development/</span></a>
<o:p></o:p></span></div>
</div>
<div id="ftn10" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref10" name="_ftn10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> <a href="http://www.edutopia.org/common-core-state-standards-resources"><span style="color: blue;">http://www.edutopia.org/common-core-state-standards-resources</span></a>
<o:p></o:p></span></div>
</div>
<div id="ftn11" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref11" name="_ftn11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> <span style="color: blue;">broken link</span></span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
</div>
<div id="ftn12" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref12" name="_ftn12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"><span style="color: blue;"><a href="http://www.doe.mass.edu/frameworks/ela/0311.pdf">b</a>roken link</span></span><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";"><o:p></o:p></span></span></div>
</div>
<div id="ftn13" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref13" name="_ftn13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> <span style="color: blue;"><a href="http://wida.us/downloadLibrary.aspx">b</a>roken link</span><o:p></o:p></span></div>
</div>
<div id="ftn14" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref14" name="_ftn14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> <a href="http://parcconline.org/"><span style="color: blue;">http://parcconline.org/</span></a> <o:p></o:p></span></div>
</div>
<div id="ftn15" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref15" name="_ftn15" style="mso-footnote-id: ftn15;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[15]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> Megan K.
MacPherson and Anne Smith (2013), pp. 98-99.<o:p></o:p></span></div>
</div>
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<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref16" name="_ftn16" style="mso-footnote-id: ftn16;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[16]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> Ntourou, K.,
Conture, E.G., Lipsey, M.W (2011) Language Abilities of Children Who Stutter: A
Meta-Analytical Review, American Journal of Speech-Language Pathology, Vol. 20,
163-179, quotes are taken from pp. 173-175.</span><o:p></o:p></div>
</div>
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<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref17" name="_ftn17" style="mso-footnote-id: ftn17;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[17]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> “Memories of a
Bedtime Book Club: personal reflection on reading aloud and some book
recommendations, by Dwight Garner, NY Times, April 24, 2013,<o:p></o:p></span></div>
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><a href="http://www.nytimes.com/2013/04/25/books/a-splendid-little-book-club-has-ended-its-run.html?pagewanted=2&_r=0&nl=todaysheadlines&emc=edit_th_20130425"><span style="color: blue;">http://www.nytimes.com/2013/04/25/books/a-splendid-little-book-club-has-ended-its-run.html?pagewanted=2&_r=0&nl=todaysheadlines&emc=edit_th_20130425</span></a>
<o:p></o:p></span></div>
</div>
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<a href="http://www.blogger.com/blogger.g?blogID=3698866522577265651#_ftnref18" name="_ftn18" style="mso-footnote-id: ftn18;" title=""><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , "serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[18]</span></span></span></span></span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> APPS for
Children with Special Needs <span style="color: blue;">broken link</span>;Speech
Techie <a href="http://www.speechtechie.com/"><span style="color: blue;">http://www.speechtechie.com/</span></a> <o:p></o:p></span></div>
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
</div>
</div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-42504112834848166272013-02-06T12:16:00.003-05:002020-04-11T14:06:00.339-04:00ADHD, Stuttering, and Executive Functioning<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"> ADHD
“significantly impacts the ‘efficiency and fluency’ of speech” </span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn1" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span></span></span></a><span style="font-family: "calibri";">
Some of the dysfluency may be stuttering. Some may be “excessive typical” or
“atypical” <span style="mso-spacerun: yes;"> </span>dysfluency. <span style="mso-spacerun: yes;"> </span>A detailed description of ADHD is beyond the
scope of this article. </span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn2" name="_ftnref2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span></span></span></a><span style="font-family: "calibri";">
However, beginning with a few basics is essential to testing and treating
dysfluency in the presence of ADHD. <o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-tab-count: 1;"> </span>Joseph Donaher, Ph. D.,
describes ADHD as a condition in which a child focuses on too many things simultaneously.
<span style="mso-spacerun: yes;"> </span>A 13 year old student of his described
ADHD like this: “I have a billion ideas bouncing in my head and I have trouble
trying to figure out which one is most important.” Much of the information
about ADHD in this article is taken from Dr. Donaher’s presentation in the
Stuttering Foundation DVD No. 6700, <i style="mso-bidi-font-style: normal;">ADHD
& Children Who Stutter</i>.<span style="mso-spacerun: yes;"> </span>I highly
recommend it for parents and professionals.<o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-tab-count: 1;"> </span>The Huffington Post recently
reported that “Children with ADHD produce more vocal repetitions or word
fillers as they try to organize their thoughts, somewhat similar to a stammer…A
response in the classroom may be along the lines of, ‘It’s a story abou…um…a
story…um…um…it’s about…akidwhofliesakite...um.” In addition, these children
“frequently struggle to find the right words and put thoughts together quickly
and linearly in conversation. Errors in grammar as they compose sentences also may
occur, because of planning difficulties present even when underlying skills in
this area are intact.” The social use of language, called pragmatics, is also
affected. Children with ADHD may blurt out responses to questions, interrupt,
talk excessively, and speak too loudly. Distractibility, impulsiveness and poor
executive function skills may make basic conversational rules too difficult for
them to use. </span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn3" name="_ftnref3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span></span></span></a><span style="font-family: "calibri";"> <o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-tab-count: 1;"> </span>Dr. Donaher reports that ADHD
“can result in dysfluencies” for children who do not stutter and “exacerbates
dysfluencies “ in children who do stutter. He lists the characteristics of ADHD
Hyperactive/Impulsive and ADHD Inattentive types and, because both lists
include difficulties with language, the dysfluency of ADHD resembles
cluttering. Stuttering is characterized by part-word repetitions (p-p-p-play),
prolongations (sssssoccer), and blocks (d-og). Cluttering, on the other hand,
is characterized by whole-word and phrase repetitions, revisions ( I want to_ I
think that…), and fillers (um, ah, mmm). <o:p></o:p></span></span></div>
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<span style="font-size: 12pt;"><span style="font-family: "calibri";">“Like stuttering, cluttering is a fluency disorder,
but the two disorders are not the same. Cluttering involves excessive breaks in
the normal flow of speech that seem to result from disorganized speech
planning, talking too fast or in spurts, or simply being unsure of what one
wants to say. By contrast, the person who stutters typically knows exactly what
he or she wants to say but is temporarily unable to say it. To make matters
even more confusing, since cluttering is not well known, many who clutter are
described by themselves or others as "stuttering." Also, and equally
confusing, cluttering often occurs along with stuttering.”</span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn4" name="_ftnref4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span></span></span></a><span style="font-family: "calibri";">
<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-tab-count: 1;"> </span>ADHD must be addressed prior
to speech therapy for best results. Stimulant medications seem to have a
greater impact on ADHD behaviors than non stimulant medications. Unfortunately,
stimulants are also linked to “the onset and exacerbation of disfluencies and
stuttering.” Behavior management of ADHD symptoms requires a lot of work collaborating
professionals across settings and is most effective in combination with
medication. <span style="mso-spacerun: yes;"> </span>It looks to me like concepts
of behavior management for ADHD may help almost any child working on speech
change.<o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-tab-count: 1;"> </span>“ADHD represents a deficit in
executive function, a skill set that includes attention, impulse control…and
far more. Seen as a disorder of self-regulation, ADHD potentially impacts
anything that requires planning and coordination, from sleep and eating habits
to laying out a long-term science project all the way to how someone speaks and
listens in conversation.”</span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn5" name="_ftnref5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span></span></span></a><span style="font-family: "calibri";">
<o:p></o:p></span></span></div>
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">That
said, we can understand Dr. Donaher’s conclusion: children with ADHD are unable
to do something <u>without appropriate support.</u> <o:p></o:p></span></span><br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-tab-count: 1;"> </span>This concept of providing
support, or “scaffolding,” is critical. A recent book dedicated to moving
beyond “the absurdity of public school IEPs and their bizarre, fuzzy-wuzzy
language,”</span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn6" name="_ftnref6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span></span></span></a><span style="font-family: "calibri";">
describes many ways for adults to support children so they may achieve
short-and long-term goals. For children with ADHD, this is support for
executive functioning skills. I will refer to concepts presented in the workbook
<u>Executive Skills in Children and Adolescents</u> </span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn7" name="_ftnref7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span></span></span></a><span style="font-family: "calibri";">
now as I write about speech therapy goals.<span style="mso-tab-count: 1;"> </span>
<o:p></o:p></span></span></div>
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<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Dawson
and Guare report that the first executive functioning skill to emerge in
childhood is called </span><b style="mso-bidi-font-weight: normal;"><i><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">behavioral inhibition</span></i></b><i><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">.</span></i><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> This skill begins to appear at 5-12 months of age and lays the
groundwork for subsequent skills. Behavioral inhibition has 3 properties: </span><span style="font-size: 12pt; line-height: 150%;">1. the ability to delay or prevent a
response, 2. the ability to stop ongoing behaviors, and 3. the ability to manage
distractions. Behavioral inhibition reminds me of a fluency enhancing strategy
called pausing. <a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn8" name="_ftnref8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span></span></span></a><o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="font-family: "calibri";">Pausing
appears in speech therapy for clients of all ages. Sheryl Gottwald lists pause
time as a conversational strategy adults can use with young children who
stutter.</span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn9" name="_ftnref9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span></span></span></a><span style="font-family: "calibri";">
Linda Cochran illustrates the value of wait time with a simple concise drawing
anyone will understand. </span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn10" name="_ftnref10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span></span></span></a><span style="font-family: "calibri";">
Coleman and Weidner encourage adults to divide long complex sentences with<span style="mso-spacerun: yes;"> </span>pauses when reading aloud to young children. </span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn11" name="_ftnref11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span></span></span></a><sup><span style="font-family: "calibri";">,</span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn12" name="_ftnref12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span></span></span></a></sup><span style="font-family: "calibri";">
I've also read about 'the power of the pause' in reference to public speaking. A
short pause gives a speaker extra time to organize ideas, retrieve vocabulary,
formulate grammatically correct sentences, create a speech motor program, and articulate
intelligibly. It also provides time for listeners to process information.<o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="font-family: "calibri";">In direct speech therapy, the student enlists
behavioral inhibition to <span style="mso-spacerun: yes;"> </span>find a new kinesthetic
(sensory) feeling of easier speech. He or she pauses long enough to find this
feeling while saying single sounds, syllables and then isolated words at first.
Gradually, the student uses this new feeling of speech production on tasks of
increasing difficulty, called a hierarchy. There is absolutely no expectation
that a student can enlist behavioral inhibition in everyday conversation until much
later in therapy. Everyday conversation is very demanding and will not provide enough
support to ensure success. However, speech homework is different. Homework <span style="mso-spacerun: yes;"> </span>games will have supportive rules, such as requiring
pause time from every player. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="font-family: "calibri";">Wise
adults know that children learn through imitation. Without launching into a
discussion of nature vs. nurture, let's agree that modeling is one way we
nurture our children. How fortunate that the speech language pathologist (SLP) demonstrates
the behaviors she is training! When the SLP says, "Let me think…;"
and, "I feel confident because...;" and, "First I'll make a plan…;"
and "What if...;"</span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn13" name="_ftnref13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span></span></span></a><span style="font-family: "calibri";">
followed by a brief pause, <span style="mso-spacerun: yes;"> </span>that SLP is
modeling </span></span><span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><i><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">verbal mediation</span></i></b><i><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">. </span></i><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Verbal mediation is about putting thoughts, feelings and choices
into words – prior to, during, and after a behavior. Verbal mediation is
essential to any kind of speech homework. To transfer a new skill, the parent
and the child will need verbal mediation to decide when, where, and how to
follow through with an agreed upon plan. Evidence based practice requires the
family actively participate in this way. <a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn14" name="_ftnref14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span></span></span></a>
<i><o:p></o:p></i></span></span></div>
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<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman";">If<i> </i></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">you ask a child what he does in speech therapy,
I can almost guarantee he will say something like 'I don't really know. We play
games.' This anecdote represents what happens when children practice new speech
skills. A child has to remember the new speech behavior as he is multi-tasking other
communication demands. It seems to me that adult support frees up a child’s </span><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">working memory</span></i></b><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> so that he can be successful. This support can
take the form of a linguistic hierarchy because one way to make a task easier
is to simplify language. Also, controlling for pragmatic language leads to
first practicing in choral speech, then immediate imitation, and delayed
imitation before moving on to very simple elicited and spontaneous language tasks.
Simple, repetitive homework games require minimal language processing and
interruption so that a child can remember to use his new speech skill. Children
find it easier to use a new skill when working memory is not overwhelmed. <o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Many small successes culminate in large achievements.
Remember, the small successes take place in <i style="mso-bidi-font-style: normal;">supportive</i>
situations. This is where the executive skill called </span><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">planning</span></i></b><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> comes in. Math curriculums plan addition and subtraction before
multiplication and division. Similarly, SLPs plan speech work along a continuum
of difficulty. To take this analogy further, we provide maximum instruction
when introducing a new math concept and expect children to solve real-life
mathematical problems only gradually. Similarly, we plan short- and long- term
speech goals that respect the student's ability to inhibit behavior and juggle
communication demands in working memory. <o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Once a lesson is presented, the student must <u>do</u>
it. I find a child must pay careful attention to a specific activity for about 10-20
minutes at the very least. This is called </span><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">sustained attention.</span></i></b><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> During sustained attention, the student chooses the new behavior
and remembers to use it repeatedly while relying upon the conditions set up for
his success. The child cannot interrupt the planned activity by leaving his
seat, talking about his favorite TV show, or giving up. He needs to engage his
brain in feeling, hearing, experiencing and comprehending the consequences of a
new behavior. Neurons in the brain need to record and retain the multi-sensory
experience of a new way of speaking. “Concept cells link perception to memory…their
elegant coding scheme allows our minds to leave aside countless unimportant
details and extract meaning that can be used to make new associations and
memories.” <a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn15" name="_ftnref15" style="mso-footnote-id: ftn15;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[15]</span></span></span></span></span></a>
Sustained attention is required at each step of a linguistic and transfer
hierarchies.<o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Metacognition </span></i></b><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">is the ability to observe one's own behavior. I
find this an especially tricky concept in speech change because sounds are
fleeting. Now you hear it - now you don't. Furthermore, the SLP does not see
nor experience production of the new speech goal. She is unlikely to hear
subtle moments of stuttering or appreciate the student’s <span style="mso-spacerun: yes;"> </span>internal thoughts and feelings. This is
problematic because the speaker needs feedback to know when she has made an
appropriate change. Listening to an audio recording or observing digital
analysis of her speech may help. This requires a sense of separateness, an
ability to look at speech as something distinct from her inherent identity. Speech
becomes something to study and manipulate.<o:p></o:p></span></span></div>
<br />
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<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">Perhaps this next executive functioning skill should
have come earlier : </span><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">regulation
of affect</span></i></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">.</span></b><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"> A child needs to feel comfortable talking about stuttering before
he can examine and experiment with speech change. Fear and embarrassment assume
many disguises. For example, when a second grader crawled under the table as
soon as I moved beyond introductory pleasantries and began talking about
stuttering, I knew affect would be an important therapy issue. In the
children's story <u>Hooray for Aiden</u> a young girl avoids school activities so
that her peers will not hear her stutter. Her sadness and anxiety are
overwhelming until a classroom visitor models self-respect and acceptance. A
policeman visits her classroom to explain his job and as he talks, he stutters.
Policeman Dave tells the class, “There’s n-n-nothing wrong with speaking the
way that Aiden and I speak. When we get stuck on a word, it’s call stuttering.
People who stutter are just r-r-regular people.” <a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn16" name="_ftnref16" style="mso-footnote-id: ftn16;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[16]</span></span></span></span></span></a>
</span><span style="font-size: 12pt; line-height: 150%;">The National Stuttering
Association brings hope and empowerment to children and adults who stutter, their
families, and professionals. Visit <a href="http://www.westutter.org/"><span style="color: blue;">www.westutter.org</span></a>
for more information.</span></span><span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"></span></span></span><br />
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"></span></span></span><br /></div>
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"></span></span></span><br />
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"></span></span></span><br />
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"></span></span></span><br />
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 17.15pt 17.15pt 17.15pt 0in; mso-add-space: auto; text-indent: 15.45pt;">
<div class="MsoListParagraph" style="line-height: 150%; margin: 17.15pt 17.15pt 17.15pt 0in; mso-add-space: auto; text-indent: 15.45pt;">
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="mso-spacerun: yes;"><span style="mso-spacerun: yes;"><em> </em></span>To shorten the length if this article, I will group together the
executive skills called <span style="mso-spacerun: yes;"> </span><b style="mso-bidi-font-weight: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><em>organization, time management & task initiation</em></span></b><b style="mso-bidi-font-weight: normal;"><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">.
</span></b><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">All three apply to speech
homework. I admit that I have never, in my 30 years as an SLP, been able to
convince anyone to consistently complete homework . Finally I realized the
obvious; this was not my job. I can talk with parents about playing speech
games in the car, combining speech work with school work, arranging teacher
conferences, requesting teacher feedback, completing take-home exercises, and
on and on. Ultimately, it is the parent or child who organizes the family
schedule to include speech homework - <u>according to a lesson plan that
respects<b> </b>the child's abilities and provides adequate scaffolding to
ensure success</u>. This is not easy given the pressures of our busy culture. But
speech change does not happen without a commitment to work outside the SLP's
office.</span></span></span></span></div>
</div>
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</span></span></span>
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<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><br /></span></span></div>
</div>
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<br /></div>
</div>
</span><br />
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<div class="MsoListParagraph" style="line-height: 150%; margin: 17.15pt 17.15pt 17.15pt 0in; mso-add-space: auto; text-indent: 15.45pt;">
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman";">The
final executive skills I’ll mention are<i> </i></span><b style="mso-bidi-font-weight: normal;"><i><span style="font-size: 14pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">goal-directed persistence
& flexibility</span></i></b><i><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">.
</span></i><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";">I wish I could find another
copy of a decorative wall hanging I've given as holiday gifts to two students.
It was a simple painted sign that read "never, never, never give up."
Stuttering is a peculiar condition. It is somewhat similar but always different
from person to person. It seems to be affected by so many different factors and
universally responsive to no single therapy method. "Progress" takes
many forms <a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn1" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 12pt; line-height: 115%;">[17]</span></span></span></span></a><sup>
</sup>and therapy week-to-week is dependent upon the client's experience with
previous lessons and homework. As quality of life improves, clients feel their
communication skills are 'good enough' and they leave therapy. Or, they drop
out for a variety of other reasons. So, I never really know how my students
fare over the long haul. I can only hope to have given them something of what
they needed at the time we worked together. Persistence and flexibility over
many weeks, months, or years is one key to success.<o:p></o:p></span></span></span></div>
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman";"></span></span><br /></div>
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-bidi-font-style: italic; mso-fareast-font-family: "Times New Roman";"><span style="font-family: "times new roman";">
<span style="font-family: "calibri";">It seems to me that concepts of executive functioning apply to speech therapy for children with and without ADHD. The latest catalogue from LinguiSystems arrived in my mail yesterday. I see there are four products for executive functioning and the Executive Functions Training workbooks are “Bestsellers”. </span><a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn18" name="_ftnref18" style="mso-footnote-id: ftn18;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-size: 12pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: Helvetica; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US; mso-hansi-theme-font: minor-latin;"><span style="color: blue; font-family: "calibri";">[18]</span></span></span></span></span></a></span><span style="font-family: "calibri";">I’ll add them to my wish list! In the mean time, I see it’s a beautiful sunny though chilly February day. Time to stop typing and soak up some sun. As usual, I’ll need to rearrange my to-do list , and tap my executive functioning skills, to make this change in my plan for the day! Wishing you plans with flexibility!</span><br />
</span></span><br />
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<div style="mso-element: footnote-list;">
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</span><br />
<div style="mso-element: footnote-list;">
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Helvetica; mso-fareast-font-family: "Times New Roman";"><span style="font-family: "calibri";">Judy </span></span></div>
<div style="mso-element: footnote-list;">
<br />
<hr align="left" size="1" width="33%" />
<div id="ftn1" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref1" name="_ftn1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span></span></span></span></a><span style="font-family: "calibri" , "sans-serif"; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"><span style="font-size: x-small;"> </span></span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;">J. Donaher (2012) ADHD and Fluency Disorders in School-Aged
Children, <i style="mso-bidi-font-style: normal;">Case Studies in Fluency
Disorders, </i>Rockville, MD: American Speech Language Hearing Association
Online Conference, May 9-12, slide 11.<o:p></o:p></span></div>
</div>
<div id="ftn2" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref2" name="_ftn2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span></span></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"> I recommend visiting websites
such as <i style="mso-bidi-font-style: normal;">Children and Adults with
Attention Deficit / Hyperactivity Disorder </i>(</span><a href="http://www.chadd.org/"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"><span style="color: blue;">http://www.chadd.org/</span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;">) for more information.<o:p></o:p></span></div>
</div>
<div id="ftn3" style="mso-element: footnote;">
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<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref3" name="_ftn3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span></span></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"> M. Bertin,
M.D. (January 16, 2013) That’s ADHD again? You Don’t Say! Listen Closely and
Hear the Effects of ADHD on Communication, HUFFLIVE, HUFF POST PARENTS.<o:p></o:p></span></div>
</div>
<div id="ftn4" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref4" name="_ftn4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "times new roman" , "serif"; font-size: 8pt;">The
Stuttering Foundation: </span><a href="http://www.stutteringhelp.org/cluttering"><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"><span style="color: blue;">http://www.stutteringhelp.org/cluttering</span></span></a><span style="font-family: "times new roman" , "serif"; font-size: 8pt;"> <o:p></o:p></span></div>
</div>
<div id="ftn5" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref5" name="_ftn5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span></span></span></a><span style="mso-ansi-language: NL;"><span style="font-family: "trebuchet ms"; font-size: x-small;"> </span></span><span lang="NL" style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;">M. Bertin, (1/16/13)</span><span lang="NL" style="mso-ansi-language: NL;"><o:p></o:p></span></div>
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<div id="ftn6" style="mso-element: footnote;">
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<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref6" name="_ftn6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span></span></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"> D.
Twachtman-Cullen & J. Twachtman-Bassett (2011) The IEP from A to Z: How
to Create Meaningful and Measurable Goals and Objectives, San Francisco,
CA: Jossey-Bass, p. XV<o:p></o:p></span></div>
</div>
<div id="ftn7" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 10pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref7" name="_ftn7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;">P. Dawson
& R. Guare (2010) Executive Skills in Children and Adolescents: A Practical
Guide to Assessment and Intervention, 2<sup>nd</sup> Edition, NY, NY: The
Gilford Press.<o:p></o:p></span></div>
</div>
<div id="ftn8" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref8" name="_ftn8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span></span></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"> D. Daley (2010) The Power of the
Pause, <a href="http://www.mnsu.edu/comdis/ica1/papers/nuggets/dalyc.html"><span style="color: blue;">http://www.mnsu.edu/comdis/ica1/papers/nuggets/dalyc.html</span></a><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
</div>
<div id="ftn9" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref9" name="_ftn9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span></span></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;"> S. Gottwald (2010) Moving from
Assessment to Intervention Planning , DVD No. 6300, <a href="http://www.stutteringhelp.org/"><span style="color: blue;">www.stutteringhelp.org</span></a>.<o:p></o:p></span></div>
</div>
<div id="ftn10" style="mso-element: footnote;">
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<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref10" name="_ftn10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span></span></span></span></a><span style="font-family: "calibri";"><span style="font-size: 8pt;"> </span><span style="font-size: 8pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">S. Cochrane ( 2011 ) "Brain Time" - A clinical technique for
children to aid in reducing impulsivity to speak and for a "preparation
time" prior to speaking </span><span style="font-size: 8pt;"><a href="http://www.mnsu.edu/comdis/isad15/papers/therapy15/cochrane15.html"><span style="mso-bidi-font-family: "Times New Roman"; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";"><span style="color: blue;">http://www.mnsu.edu/comdis/isad15/papers/therapy15/cochrane15.html</span></span></a></span><span style="font-size: 8pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";"> <o:p></o:p></span></span></div>
</div>
<div id="ftn11" style="mso-element: footnote;">
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref11" name="_ftn11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span></span></span></span></a><span style="font-size: 8pt;"><span style="font-family: "calibri";"> C. Coleman (Nov 21, 2012) <span style="mso-bidi-font-weight: bold;"><a href="http://stuttertalk.com/working-with-children-who-stutter-and-the-clinicians-acceptance-of-stuttering-375/"><span style="color: windowtext; text-decoration: none; text-underline: none;">Working with
Children Who Stutter and the Clinician’s Acceptance of Stuttering </span></a>, StutterTalk,
<a href="http://stuttertalk.com/working-with-children-who-stutter-and-the-clinicians-acceptance-of-stuttering-375/"><span style="color: blue;">http://stuttertalk.com/working-with-children-who-stutter-and-the-clinicians-acceptance-of-stuttering-375/</span></a>
</span><o:p></o:p></span></span></div>
</div>
<div id="ftn12" style="mso-element: footnote;">
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<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref12" name="_ftn12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span></span></span></span></a><span style="font-family: "calibri";"><span style="font-size: 8pt;"> </span><span style="font-size: 8pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">C. Coleman & M. Weidner (2009) Using Stories to Teach Fluency
Strategies to Young Children, <a href="http://www.mnsu.edu/comdis/isad12/papers/therapy12/coleman12.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad12/papers/therapy12/coleman12.html</span></a>
<o:p></o:p></span></span></div>
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</div>
</div>
<div id="ftn13" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref13" name="_ftn13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;">K. Chmela (2004 ) Working with
Preschoolers Who Stutter: Successful Intervention Strategies, DVD No. 0162, <a href="http://www.stutteringhelp.org/"><span style="color: blue;">www.stutteringhelp.org</span></a></span></div>
</div>
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<div class="MsoFootnoteText" style="line-height: normal; margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref14" name="_ftn14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;">Evidence Based Practice http://www.asha.org/members/ebp/</span></div>
</div>
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<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref15" name="_ftn15" style="mso-footnote-id: ftn15;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[15]</span></span></span></span></span></a><span style="mso-ansi-language: ES;"><span style="font-family: "trebuchet ms"; font-size: x-small;"> </span></span><span lang="ES" style="font-family: "calibri" , "sans-serif"; font-size: 8pt;">R. Q. Quiroga et al. </span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt;">(February, 2013) Brain Cells for
Grandmother: Each concept – each person or thing in our everyday experience –
may have a set of corresponding neurons assigned to it, NY, NY: Scientific
American, pp. 31-35.</span></div>
</div>
<div id="ftn16" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 10pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref16" name="_ftn16" style="mso-footnote-id: ftn16;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[16]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;">Karen
Hollett (2010) Hooray for Aiden, Yellowknife, NT, Canada: Hooray Publishing, broken link p.20</span></div>
</div>
<div id="ftn17" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 10pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref17" name="_ftn17" style="mso-footnote-id: ftn17;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[17]</span></span></span></span></span></span></a><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;"> <span lang="FR">J. S. Yaruss et. al. </span></span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;">(2012) Stuttering in School-Age
Children : A Comprehensive Approach to Treatment, <i style="mso-bidi-font-style: normal;">Language, Speech, and Hearing Services in Schools, </i>(43) pp.
536-548.</span></div>
</div>
<div id="ftn18" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 10pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref18" name="_ftn18" style="mso-footnote-id: ftn18;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[18]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri" , "sans-serif"; font-size: 8pt; line-height: 115%;">LinguiSystems <span style="color: blue;">broken link</span></span></div>
</div>
</div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-55434663566073508302012-12-14T14:00:00.000-05:002020-04-11T14:10:13.045-04:00Human Voice: It's Beautiful<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">I
can play an electric piano with the setting on <i style="mso-bidi-font-style: normal;">choir</i> and hear the digital sound of synthesized voices. It’s a
pretty fun way to liven up tedious practice exercises. But it’s not nearly as
beautiful as the sound of a real human voice. <span style="mso-spacerun: yes;"> </span>The real human voice depends upon airflow
instead of electronics.<span style="mso-spacerun: yes;"> </span>Two tiny vocal
cords tucked safely within the larynx vibrate to create the human voice.<span style="mso-spacerun: yes;"> </span></span></div>
<br />
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<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">I
brushed up on the basics of voicing when a young lady e-mailed me seeking voice
therapy. She was experiencing vocal fatigue and hoarseness. I recommended that an
otolaryngologist examine her vocal cords and that she follow through with any
referral to a speech language pathologist (SLP) specializing in voice therapy.
However, I also suggested we meet for a voice screening and a consultation
regarding normal voice production and good vocal hygiene. At our first meeting,
we talked about her concerns and completed both the <i style="mso-bidi-font-style: normal;">Voice Activity and Participation Profile<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn1" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></b></span></span></span></a></i>
and the <i style="mso-bidi-font-style: normal;">Consensus Auditory-Perceptual
Evaluation</i> <i style="mso-bidi-font-style: normal;">of Voice<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn2" name="_ftnref2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></b></span></span></span></a></i>.
In subsequent sessions, we talked over her vocal history, demands currently
placed on her voice, and some thoughts on change. I enjoyed these
conversations.<o:p></o:p></span></div>
<br />
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<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">Updating
my knowledge of voice and voice therapy was a welcome change of pace. The American
Speech Language Hearing Association studies that caught my eye questioned the
usefulness of vocal warm-up<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn3" name="_ftnref3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span></span></span></a>,
studied the significance of speaker temperament<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn4" name="_ftnref4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span></span></span></a>,
and recommended ‘motivational interviewing’ as a method to support change<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn5" name="_ftnref5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span></span></span></a>. <span style="mso-spacerun: yes;"> </span>YouTube had several relevant videos.<span style="mso-spacerun: yes;"> </span>There were animations of laryngeal and
related anatomy and physiology<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn6" name="_ftnref6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span></span></span></a>.
There was a 4-part power point presentation narrated in detail by Stephen M.
Tasko, Ph.D., CCC-SLP.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn7" name="_ftnref7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span></span></span></a>
Miriam van Mersbergen, Ph.D., CCC-SLP talked about the “Basics of Voice
Training” in a video produced by LinguaHealth.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn8" name="_ftnref8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span></span></span></a> <span style="mso-spacerun: yes;"> </span>The National Center for Voice and Speech had a
tutorial explaining how researchers have come to understand vocal fold function.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn9" name="_ftnref9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span></span></span></a>
And, there were lots of videos of the vocal cords recorded using
videostoboscopy. It was all so fascinating that I also purchased a 6-hour
continuing education course!<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn10" name="_ftnref10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">Here’s
a very short synopsis. <span style="mso-spacerun: yes;"> </span>Air from the
lungs pushes the vocal cords apart, increasing the space between them. A
combination of aerodynamics and vocal cord elasticity causes them to move back
toward one another, closing the airway. It is a continuous stream of air from
the lungs that separates the vocal cords again and again and again, resulting
in a “non-linear mucosal wave.”<span style="mso-spacerun: yes;"> </span>Puffs of
air explode through the opening between the vocal cords and breeze through the
throat, mouth and nose before leaving the body.<span style="mso-spacerun: yes;">
</span>This air is shaped into speech sounds along the way. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">I
was happy enough with that review. <span style="mso-spacerun: yes;"> </span>Except the continuing education course placed
such emphasis on diaphragmatic breathing, that I researched this too. <span style="mso-spacerun: yes;"> </span>A careful search of YouTube uncovered videos
about breathing that seemed useful for a wide range of clients. <i style="mso-bidi-font-style: normal;">How the body works: breathing</i> was a
delightfully simple animation with the sound muted. The narration is a bit
technical and bland for children.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn11" name="_ftnref11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span></span></span></a><span style="mso-spacerun: yes;"> </span>A white board presentation by a young woman
offered more complex information with friendly enthusiasm.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn12" name="_ftnref12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span></span></span></a> An
authoritative and quite professional looking animation was available for studious
teens and adults.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn13" name="_ftnref13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span></span></span></a><span style="mso-spacerun: yes;"> </span>Finally, that priceless podcast series, <i style="mso-bidi-font-style: normal;">Stutter Talk, </i>had at least two episodes
devoted to breathing and speech.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn14" name="_ftnref14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span></span></span></a><sup>,<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn15" name="_ftnref15" style="mso-footnote-id: ftn15;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[15]</span></span></span></span></span></a></sup>
I assembled a new webpage for voice almost instantly!<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn16" name="_ftnref16" style="mso-footnote-id: ftn16;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[16]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">Some
occupations demand a clear, professional sounding voice. People who depend on their
voice to earn a living include singers, politicians, broadcasters, actors,
salespersons, customer service workers and teachers. <span style="mso-spacerun: yes;"> </span>For these workers, vocal pathology is an
occupational hazard. <span style="mso-spacerun: yes;"> </span>They need to take excellent
care of their voices and actually, many of them do even more. They study
articulation (including accent reduction), intonation, loudness,
pausing/phrasing, vocabulary, and the difference between explicit and implied
meaning. SLPs treat a variety of voice disorders due to
medical conditions. However, they also train use and care of the professional
voice. <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">I
have a renewed appreciation for the role of breath support in communication. I
almost never talk about breathing with my students because they usually respond
with effortful thorasic or clavicular breathing.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn17" name="_ftnref17" style="mso-footnote-id: ftn17;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[17]</span></span></span></span></span></a><span style="mso-spacerun: yes;"> </span>Observe yourself taking “a deep breath.” What
do you do? Do your shoulders rise up and your chest expand? They shouldn’t, at
least not by much. It’s your abdomen that should expand as your diaphragm presses
downward to make extra space for the lungs. How many of us ever learned this? A
newspaper advertisement for a local performing arts school shows a little girl being
taught diaphragmatic breathing as she sings. <span style="mso-spacerun: yes;"> </span>This seemed exceptional. My curiosity got the
best of me and I purchased a <i style="mso-bidi-font-style: normal;">how to sing </i>DVD
by an internationally known singer. It instructed me in a series of fast-paced
vocal exercises with slight reference to diaphragmatic breathing. I had to
wonder how many viewers of this DVD damaged their voices by trying to sing using
the laryngeal muscles instead of adequate breath support.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">The
concept is simple. Physical work requires effort and that effort can be
misplaced. For example, I am learning to play the piano. My fingers are
uncomfortable at the piano keys. With every missed note, my arms and shoulders
stiffen and I hold my breath. Why?! I’m not entirely sure, but it happens. With
the wisdom of an adult, I pay close attention to gentle breathing and upper
body relaxation as I struggle to match music notes and piano keys and finger
movements. I stop. I slow down. I attend to the feeling of my muscles. I have
the time to do that. When voicing is difficult, speakers may compensate with
extra effort in the neck, mouth, and face. It happens.<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn18" name="_ftnref18" style="mso-footnote-id: ftn18;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[18]</span></span></span></span></span></a>
Conversation is fast paced and demanding so there is no time to stop, slow
down, attend to the feeling of muscle movement and prevent inappropriate motor
memories. (It can also be that differences in motor abilities affect this
process.) Finding the feeling of relaxation under a variety of circumstances
comes in handy. <a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftn19" name="_ftnref19" style="mso-footnote-id: ftn19;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 115%;"><span style="color: blue;">[19]</span></span></span></span></span></a><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "calibri light" , "sans-serif"; font-size: 12pt; line-height: 150%;">There
it is: a brief description of voicing, which necessarily includes a review of
breathing. I am looking forward to learning alot more about the voice and voice therapies in the future.</span></div>
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
</div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
</div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
</div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-indent: 0.5in;">
</div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
</div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
</div>
<br />
<div style="mso-element: footnote-list;">
<br />
<hr align="left" size="1" width="33%" />
<div id="ftn1" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref1" name="_ftn1" style="mso-footnote-id: ftn1;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[1]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">This can
be found in the Appendix of Estella P-M.Ma and Edwin M-L. Yiu (2001) Voice
Activity and Participation Profile: Assessing the Impact of Voice Disorders on
Daily Activities. Journal of Speech Language Hearing Research, 44, 511-524.</span><o:p></o:p></div>
</div>
<div id="ftn2" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref2" name="_ftn2" style="mso-footnote-id: ftn2;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[2]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">This can
be found as Appendix C in G.B. Kempster et. al. (2008) Consensus
Auditory-Perceptual Evaluation of Voice: Development of a Standardized Clinical
Protocol. American Journal of Speech Language Pathology, 18, 124-132. The
authors give permission to photocopy it for clinical purposes. When I
downloaded it, the lines used for severity ratings were only 95mm long, so I
retyped the entire document and drew 100 mm lines as required.Appendix A and B
describe the tool, administration, and scoring.</span><span style="font-size: 8pt;"><o:p></o:p></span></div>
</div>
<div id="ftn3" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref3" name="_ftn3" style="mso-footnote-id: ftn3;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[3]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Rochelle
L. Milbrath and Nancy Pearl Solomon (2003) Do Vocal Warm-Up Exercises Alleviate
Vocal Fatigue? Journal of Speech, Language, Hearing Research, 46, 422-436.</span><o:p></o:p></div>
</div>
<div id="ftn4" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref4" name="_ftn4" style="mso-footnote-id: ftn4;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[4]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">M. Dietrich
and K. Verdolini Abbott (2012) Vocal Function in Introverts and Extroverts
during a Psychological Stress Reactivity Protocol. Journal of Speech, Language,
and Hearing Research, 55, 973-987.</span><o:p></o:p></div>
</div>
<div id="ftn5" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref5" name="_ftn5" style="mso-footnote-id: ftn5;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[5]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Alison
Behrman (2006) Facilitating Behavioral Change in Voice Therapy: the Relevance
of Motivational Interviewing. American Journal of Speech Language Pathology,
15, 215-225</span><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">.<o:p></o:p></span></span></div>
</div>
<div id="ftn6" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref6" name="_ftn6" style="mso-footnote-id: ftn6;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[6]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Cricoarytenoid
Function AngleOne 4sec <a href="http://www.youtube.com/watch?v=nhVXgDEPu1E&feature=relmfu"><span style="color: blue;">http://www.youtube.com/watch?v=nhVXgDEPu1E&feature=relmfu</span></a></span><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">(this is
one of them)</span><o:p></o:p></div>
</div>
<div id="ftn7" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref7" name="_ftn7" style="mso-footnote-id: ftn7;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[7]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Part 1 <a href="http://www.youtube.com/watch?v=A5uW4LcAemw"><span style="color: blue;">http://www.youtube.com/watch?v=A5uW4LcAemw</span></a></span><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">(this is
one of them)</span><o:p></o:p></div>
</div>
<div id="ftn8" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref8" name="_ftn8" style="mso-footnote-id: ftn8;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[8]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Speech
Language Pathology: The Basics of Voice Training<span style="mso-spacerun: yes;"> </span><a href="http://www.youtube.com/watch?v=mC2b5PxGavM&feature=youtube_gdata_player"><span style="color: blue;">http://www.youtube.com/watch?v=mC2b5PxGavM&feature=youtube_gdata_player</span></a>
</span><o:p></o:p></div>
</div>
<div id="ftn9" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref9" name="_ftn9" style="mso-footnote-id: ftn9;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[9]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">National
Center for Voice and Speech <a href="http://www.ncvs.org/ncvs/tutorials/voiceprod/tutorial/model.html"><span style="color: blue;">http://www.ncvs.org/ncvs/tutorials/voiceprod/tutorial/model.html</span></a>
</span><o:p></o:p></div>
</div>
<div id="ftn10" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref10" name="_ftn10" style="mso-footnote-id: ftn10;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[10]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Ellen N.
Friedman (2012) Short - Term Voice Therapy. 6 hour CEU course, </span><o:p></o:p></div>
</div>
<div id="ftn11" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref11" name="_ftn11" style="mso-footnote-id: ftn11;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[11]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">How the
Body Works: Breathing <a href="http://www.youtube.com/watch?v=gYSIWceGMxY&feature=related"><span style="color: blue;">http://www.youtube.com/watch?v=gYSIWceGMxY&feature=related</span></a></span><span style="font-family: "trebuchet ms";"><span style="font-size: 8pt;"> </span><o:p></o:p></span></div>
</div>
<div id="ftn12" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref12" name="_ftn12" style="mso-footnote-id: ftn12;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[12]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">8.6
Respiratory System Structure and Function <a href="http://www.youtube.com/watch?v=12ddbrqpZiQ&feature=related"><span style="color: blue;">http://www.youtube.com/watch?v=12ddbrqpZiQ&feature=related</span></a>
</span><o:p></o:p></div>
</div>
<div id="ftn13" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref13" name="_ftn13" style="mso-footnote-id: ftn13;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[13]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Respiratory
System 3D <span style="color: blue;">broken link</span></span></div>
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
</div>
</div>
<div id="ftn14" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref14" name="_ftn14" style="mso-footnote-id: ftn14;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[14]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Stutter
Talk:<span style="mso-spacerun: yes;"> </span>Episode 263 The Anatomy and
Physiology of Normal Speech Breathing as It Relates to Costal Breathing and
Stuttering, 2/27/11,<span style="mso-spacerun: yes;"> </span><a href="http://stuttertalk.com/?s=breathing"><span style="color: blue;">http://stuttertalk.com/?s=breathing</span></a>
<o:p></o:p></span></div>
</div>
<div id="ftn15" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref15" name="_ftn15" style="mso-footnote-id: ftn15;" title=""><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt; line-height: 115%;"><span style="color: blue;">[15]</span></span></span></span></span></span></a><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;"> Stutter Talk:
Stuttering and Breathing with Doctor Phillip Shneider,<span style="mso-spacerun: yes;"> </span>Nov 8, 2008<span style="mso-spacerun: yes;">
</span><a href="http://stuttertalk.com/tag/breathing/"><span style="color: blue;">http://stuttertalk.com/tag/breathing/</span></a>
</span><o:p></o:p></div>
</div>
<div id="ftn16" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref16" name="_ftn16" style="mso-footnote-id: ftn16;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[16]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;"> </span><span style="color: blue; font-family: calibri, sans-serif; font-size: 10.6667px;">na</span><o:p></o:p></div>
</div>
<div id="ftn17" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref17" name="_ftn17" style="mso-footnote-id: ftn17;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[17]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">Breathing</span><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;"><a href="http://butlerspeechtherapy.blogspot.com/2009/06/breathing.html"><span style="color: blue;">http://butlerspeechtherapy.blogspot.com/2009/06/breathing.html</span></a></span><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></span></div>
</div>
<div id="ftn18" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref18" name="_ftn18" style="mso-footnote-id: ftn18;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[18]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;">The Arm
Bump <a href="http://butlerspeechtherapy.blogspot.com/2009/03/arm-bump.html"><span style="color: blue;">http://butlerspeechtherapy.blogspot.com/2009/03/arm-bump.html</span></a>
</span><o:p></o:p></div>
</div>
<div id="ftn19" style="mso-element: footnote;">
<div class="MsoFootnoteText" style="margin: 0in 0in 0pt;">
<a href="https://www.blogger.com/editor/static_files/blank_quirks.html#_ftnref19" name="_ftn19" style="mso-footnote-id: ftn19;" title=""><span class="MsoFootnoteReference"><span style="mso-special-character: footnote;"><span class="MsoFootnoteReference"><span style="font-family: "trebuchet ms" , "sans-serif"; font-size: 10pt; line-height: 115%;"><span style="color: blue;">[19]</span></span></span></span></span></a><span style="font-family: "trebuchet ms"; font-size: x-small;">
</span><span style="font-family: "calibri light" , "sans-serif"; font-size: 8pt;"><a href="http://butlerspeechtherapy.blogspot.com/2010/09/new-beginnings-stress-relaxation.html"><span style="color: blue;">http://butlerspeechtherapy.blogspot.com/2010/09/new-beginnings-stress-relaxation.html</span></a></span><span style="font-size: x-small;"><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></span></div>
</div>
</div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-59615766354228832422012-09-30T13:52:00.002-04:002020-04-11T14:14:01.084-04:00Online Conference About Stuttering<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">The
ISAD Conference is an interactive online event taking place from October 1<sup>
</sup>- 22. <span style="mso-spacerun: yes;"> </span>Please take advantage of
this remarkable chance to chat with the authors of several papers on
stuttering. There is even an <i style="mso-bidi-font-style: normal;">Office Hours
– the Prof In</i> link at which you can post any question about stuttering. Look
for the ISAD conference link by visiting the Stuttering Home Page, <a href="http://www.stutteringhomepage.com/"><span style="color: blue;">www.stutteringhomepage.com</span></a>. </span><span style="font-family: "calibri" , "sans-serif";">I have
a <i style="mso-bidi-font-style: normal;">Clinical Nugget </i><span style="mso-spacerun: yes;"> </span>this year called Fluency <i style="mso-bidi-font-style: normal;">Lessons for Window Shopping</i>. It is co-written with a high school
student and describes our visits to local retail stores as a method of
carryover of new speech skills. </span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">As
I prepared to chat with people from around the world, I reflected upon my 30
years as a speech-language pathologist. Sixteen of them were almost
exclusively working with children who stutter. Why? Well, let’s begin with a memory.<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">My
paternal grandmother died of Parkinson's when I was about nine years old. <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>I can close
my eyes and recall her dark green home, the small galley pantry, the living
room where we watched Art Linkletter’s talent show, the screened porch that
wrapped around<span style="mso-spacerun: yes;"> </span>the front of the house,
the push button light switches, and the toad who lived in a hole beside the
foundation. And, I recall my grandmother’s slurred and stuttered speech. The connection
between the warmth I felt in her presence and my decision to specialize in
fluency therapy startled me one afternoon in the 1980’s during casual
conversation with an elderly woman. Long lost memories of my grandmother flooded
my mind and I experienced one of those ethereal moments when one’s life seems
to make sense.<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">Early
in my career and for far too many years, I counted stuttered syllables and tried
to implement highly structured and apparently logical speech therapy. I basked
in the glow of hard-earned diplomas from intense and expensive higher educational
institutions. Over time, I discovered that therapy was very different from
classroom work and research projects. When a dedicated student experienced
relapse, I was forced to question my education and my attitude. Confused and
humbled, I had learned that work with clients is not described well using logic
or percentages.<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">For
licensed, certified health care professionals, the client -clinician
relationship is defined by the American Speech Language Hearing Association
(ASHA) Code of Ethics. (1) There are ASHA publications on recommended best
practice. Continuing education and clinical practice requirements for ongoing
recertification and license renewal keep professionals current. <span style="mso-spacerun: yes;"> But sometimes one</span> wonders what is real and what is paperwork.<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">In
the past 20 years, my own therapeutic method has become more personal at the
same time in which the profession of speech language pathology moved in a
different direction. The profession has become more <i style="mso-bidi-font-style: normal;">efficient</i>.
Data collection – for the benefit of insurance and educational institutions – seem
to be paramount now. <span style="mso-spacerun: yes;"> </span>Experts continue to
press for large scale research studies in stuttering to accommodate the medical
trend toward evidence based practice. (2) <o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">What
influences treatment method and outcome? Research suggests there may be
subtypes of stuttering. Attention deficit, phonological disorders, dyslexia and
other issues can co-occur with stuttering. The transfer of more fluent speech
to daily life is still the lock without a key. While the latest research in
genetics is promising, how does this change the lesson plan? (3) Every client comes to therapy as a unique individual. I worry
about<span style="mso-spacerun: yes;"> </span>demands for efficiency with an emphasis
on data collection because therapy is not about stuttering – it’s about people.
It seems to me that any data used to promote a treatment approach would need to
include detailed descriptions of the individuals for whom it was “successful.” Will
that happen?<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">My
transition to a more personal treatment approach was nurtured by conventions of
the National Stuttering Association and Friends: The Association of Young
People Who Stutter. Attendees at these meetings expressed frustration with
speech therapy. I was taken aback, discouraged and then grateful. I would come
home and listen to my clients more carefully. My lesson plans changed to be
more conversational and fun. But, new referrals to my practice were confused: why
didn’t I have more rigorous demands for fluent speech? They were at the
beginning of a journey that I and a few other SLPs had been traveling for a
while. A small group of exceedingly dedicated SLPs (I was not one of them.) established the first ASHA Specialty
Commission (4) and worked hard to address the multiple issues that make for a comprehensive
approach to speech therapy for stuttering. <span style="mso-spacerun: yes;"> </span>There’s no quick fix, only a personal path of
ups and downs and variable results. (5)<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">Now
I ask about my clients’ lives and share a little of my own. Students get small
prizes for just showing up. Homework expectations are replaced by
congratulations for any evidence of personal responsibility. I match the efforts
of my clients. Those who attended regularly and reliably receive highly individualized
lesson materials. <span style="mso-spacerun: yes;"> </span>Attention to affective
and cognitive issues equal that of speech motor change. Written reports are<span style="mso-spacerun: yes;"> </span>lengthy and include footnotes (very
inefficient and time consuming!) My role is one of giving my very best to the
few who are invest the same. Is this effective? Clients decide. Informal,
annual data collection and ongoing conversation keep us focused on
collaborative goals. Unsatisfied clients move on to other service providers.<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">Fluency
enhancing strategies haven’t changed for many years and dissatisfaction with
them has become more public. (6) I feel the most significant change has been a
lowering of expectations for fluency to avoid rewarding covert behavior. This therapy
option coincides with a greater appreciation of the client’s perspective,
exquisitely documented in the film <i style="mso-bidi-font-style: normal;">Transcending
Stuttering </i>(7)<i style="mso-bidi-font-style: normal;">. </i>Treatment methods
are controversial to this day, as demonstrated by articles published in 2012
issues of the ASHA journal<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Language Speech Hearing Services in Schools.</i>
<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">Talking
is different from playing the piano, hitting a baseball, or learning to read,
IMHO. Speech sounds are elusive and invisible. Listeners make snap judgments
about a speaker’s competence, cultural identity, and eligibility for future
relationships based on how they speak. It is societal expectations that drive
clients into speech therapy. A Ted Talk titled <i style="mso-bidi-font-style: normal;">The Disabled Listener</i> (8) extols the profound value of respectful
listening.<span style="mso-spacerun: yes;"> </span>Watch it and ask yourself how
you might become a better listener.<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">Now
the client trumps any specific treatment approach. My clients assume complete
responsibility for scheduling sessions. They are equal partners in treatment
design and implementation. Quite frankly, this is a horrible business model,
and so, <span style="mso-spacerun: yes;"> </span>I continue studies in the field
of literacy to expand my practice caseload. The warmth I felt listening to the
stuttered speech of my grandmother returns whenever I put relationship before data
and (illusions of) efficiency. My small contribution to the 2012 ISAD
conference reflects this commitment to the individual. <o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">Many
grateful thanks to A. C. for his contribution to this effort. </span></div>
<div style="text-indent: 0.5in;">
</div>
<div style="text-indent: 0.5in;">
<span style="font-family: "calibri" , "sans-serif";">Judy<o:p></o:p></span></div>
<br />
<div style="text-indent: 0.5in;">
</div>
<span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";"></span></span></span><br />
<span style="font-family: "calibri";"></span><br />
<span style="font-family: "calibri";"></span><br />
<span style="font-family: "calibri";"></span><br />
<span style="font-family: "calibri";"></span><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(1)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><a href="http://www.asha.org/policy/ET2010-00309/"><span style="color: blue;">http://www.asha.org/policy/ET2010-00309/</span></a>
<span style="mso-spacerun: yes;"> </span></span></span></div>
<span style="font-family: "calibri";">
</span>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-family: "calibri";"><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(2)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;">Nippold, M.A. & Packman, A. (2012). Managing
Stuttering Beyond the Preschool Years. </span><i><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;">Language <span style="mso-spacerun: yes;"> </span>Speech Hearing Services in Schools</span></i><span style="font-family: "times new roman" , "serif"; font-size: 12pt; line-height: 115%;"> (43) p.<i> </i>340.</span></span></div>
<span style="font-family: "calibri";">
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(3)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%;">Rowden-Racette,
K. (September 18, 2012). In Search of Stuttering's Genetic Code. <i style="mso-bidi-font-style: normal;">TheASHALeader <span style="mso-spacerun: yes;"> </span><span style="color: blue;"><a href="http://www.asha.org/Publications/leader/2012/120918/In-Search-of-Stutterings-Genetic-Code.htm">b</a>roken link</span></i></span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(4)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;">Specialty Board on Fluency Disorders, now out of date</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(5)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%;">Schnieder,
P. (2004) Riding the Fluency Instability Roller Coaster. <a href="http://www.mnsu.edu/comdis/isad7/papers/schneider7.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad7/papers/schneider7.html</span></a>
</span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(6)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%;">Voice
Unearthed: Hope, Help, and Wake-Up Call for the Parents of Children Who Stutter
<a href="http://www.voiceunearthed.com/"><span style="color: blue;">http://www.voiceunearthed.com/</span></a> <span style="mso-spacerun: yes;"> </span></span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(7)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%;">Schnieder,
P. (2005). Transcending Stuttering: the Inside Story <span style="mso-spacerun: yes;"> </span></span><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><a href="http://www.mnsu.edu/comdis/isad8/papers/pws8/schneider8.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad8/papers/pws8/schneider8.html</span></a></span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;">(8)<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;">Lansing, S. E. (June 8, 2011) The Disabled
Listener: They can talk, they can hear, they just don’t listen. TEDxTalks <a href="http://www.youtube.com/watch?v=hrAxNijdJVY"><span style="color: blue;">http://www.youtube.com/watch?v=hrAxNijdJVY</span></a></span><span style="mso-bidi-font-family: Calibri;"> </span><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Calibri;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<br /></div>
</span><br />
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="font-family: "times new roman";">
</span></div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-40748887420395144762012-09-06T22:22:00.001-04:002020-04-11T14:18:39.834-04:00Bullying Prevention and Intervention Laws Could Support Children Who Stutter<br />
<br />
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>National Stuttering Association (NSA)
conventions inspire me to rethink speech therapy. That’s why I love to attend.
This year’s convention, held in Tampa, Florida, left me pondering how to place greater
emphasis on advocacy as an essential communication skill. Advocacy goals could
easily dovetail with America’s growing concern over bullying (1). New local laws
in many states require school districts address this problem.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "trebuchet ms";">Skill at personal advocacy is a
valid therapy objective. It used to be that speech-language pathologists (SLPs)
focused on fluency. But success with speech change varies one person to the
next and science has not yet figured out why. <span style="mso-spacerun: yes;"> </span>In the meantime, therapy outcomes have broadened
to include multiple aspects of communication. <span style="mso-spacerun: yes;"> </span>Some SLPs take advantage of this trend to justify
special education for children who stutter (CWS)(2).Others do not. <span style="mso-spacerun: yes;"> </span>I have watched this process over the past 30 years.
I witnessed and I read heated arguments between university professors over
exactly what the role of the SLP should be. While this divisive dialogue drags
on, what can a parent do right now to help the child who stutters?<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "trebuchet ms";">I propose parents find out if their
state has enacted a law regarding bullying. <span style="mso-spacerun: yes;"> </span>I expect that when a parent provides the
school with brochures from the Stuttering Foundation (3) <u>AND</u> a printout
of their district’s legally mandated <i style="mso-bidi-font-style: normal;">Bullying
Prevention and Intervention Plan</i>, we may see more CWS receive greater
attention. Laws to promote a “healthy school climate” benefit all children.
This means that when CWS are denied special legal protections because they are
denied special education, their parents may have a legal alternative.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt; text-indent: 0.5in;">
<span style="font-family: "trebuchet ms";">The 187<sup><span style="font-size: x-small;">th</span></sup> General Court
of the Commonwealth of Massachusetts on May 3, 2010, approved “An Act Relative
to Bullying in Schools.” (4) The Department of Elementary and Secondary
Education responded with <i style="mso-bidi-font-style: normal;">Bullying and
Prevention Resources </i>(5) and a<i style="mso-bidi-font-style: normal;"> Model
Bullying and Intervention Plan</i> (6).<i style="mso-bidi-font-style: normal;"> <span style="mso-spacerun: yes;"> </span></i>My own school district copied this plan,
adding details about specific programs (7) and the administrative hierarchy
responsible for their implementation.<span style="mso-spacerun: yes;"> </span>My
district also has a <i style="mso-bidi-font-style: normal;">District Improvement
Plan </i>that includes “Safe Learning Environment” as a target. I believe presenting
this kind of information to school personnel adds weight and credibility to parents’
pleas for support for their children. <i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>“The finding that the
risk of being bullied in adolescents who stutter is high when compared to their
fluent peers should be of considerable concern. Speech-language pathologists
need to be aware of this information as they often serve as the strongest
advocates for students who stutter in the school setting.” (8) <span style="mso-spacerun: yes;"> </span>Research indicates that children who stutter
“are mimicked, made fun of, called names, physically bullied, and sometimes
subjected to threats… It is clear that stuttering is an identifiable difference
that invites bullying.” (9) This information is vital because mandatory
professional development for school personnel must include “research findings
on bullying, including information about specific categories of students who
have been shown to be particularly at risk for bullying in the school
environment…[with] a particular focus on the needs of students…whose disability
affects social skills development.” (10) <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "trebuchet ms";">Social skills development in adolescents includes
“initiating interactions, self-disclosure, and intimacy in conversations and
activities…assertiveness, responsiveness, and versatility. These skills allow
speakers to make requests, actively disagree, express their feelings, initiate,
maintain, and disengage in conversations…in multiple settings and with
different conversational partners…” (11) Some school age children who stutter
are at risk of falling behind in the development of these social/communicative
skills because they avoid situations in which speech is difficult and in which
they risk ridicule.<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span><b style="mso-bidi-font-weight: normal;">“For adolescents who stutter, changing motor speech behaviors may not
result in accompanying attitudinal and cognitive changes. Programs that
reinforce assertiveness skills, positive communication models, acceptance of
stuttering, and ways of dealing with stuttering may actually assist in dealing
with potential co-occurring issues like bullying.”</b> (12)<o:p></o:p></span></div>
<br />
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<span style="font-family: "trebuchet ms";">Again and again my students avoid
advocating for themselves. How many times have I heard children say that teachers
and friends understand stuttering already so there is no need to discuss
it?!<span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Everybody
knows I stutter and it’s no big deal, </i>they say. Yet these same children
report avoidance and negative attitudes on written checklists. They cry about
school assignments, allow others to speak for them, ‘forget’ to talk with teachers,
limit class participation and/or avoid after school activities because they are
experiencing so much stress over their speech. I respond by accepting the
client in the moment. But maybe a little confrontation wouldn’t hurt. Exactly
how could they handle some of these problems proactively?<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms";">Has speech therapy flaunted fluency
in a variety of disguises? My lesson plans involve fluency enhancing
techniques, voluntary stuttering, desensitization, situation hierarchies,
English Language Arts, DAF, Audacity ®, and even concepts of cognitive
behavioral therapy. Do all of these perpetuate a promise that the end-goal is greater
fluency? When can a CWS share personal experiences, hopes and dreams, thoughts
and feelings in a friendly conversational way that would shed light on social skills
competency? How can speech therapy allocate time to the complementary goals of
speech change and social skills development? </span></div>
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<span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>Activities which blend social skills training
with speech therapy could draw from resources approved by the school district, pragmatic
language therapy materials already on the SLP’s bookshelf (14), or
reader-friendly publications for the layperson (15). For example, scripts and
role plays [Model Plan, IV. A. p. 6] could be about a stuttering-related
problem. A program specifically for stuttering is available for grades 3-6 from
the University of Alberta, Edmonton, Canada. (16)<span style="mso-spacerun: yes;"> </span>The point is to be proactive. A person who
stutters has the responsibility to “be conscious that he or she has the power
to promote awareness about stuttering and its ramifications.” (17) An SLP can
facilitate the development of advocacy skills by making it a greater priority
and interfacing with bullying prevention programs. <o:p></o:p></span></div>
<br />
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<span style="font-family: "trebuchet ms";">My friend, Marybeth Allen, ran a
workshop at the NSA convention for elementary school age children. It was
called “What Bugs You?” Marybeth is a Clinical Supervisor at the University of
Maine, the sweetest person ever, and my roommate. As I managed a craft hot glue gun,
Marybeth charmed the children into making bugs out of styrofoam containers,
fuzzy sticks, pompoms, colored paper and markers. Then she gave them a small
piece of paper on which to write what bugs them about stuttering. They put their
hand-written complaints into the bug. Topping of the list of complaints was
teasing and bullying. <o:p></o:p></span></div>
<br />
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<span style="font-family: "trebuchet ms";">New bullying prevention and
intervention laws may offer CWS some well-deserved special consideration. These
laws may not qualify CWS for special education services, but, hopefully they
will enlighten school personnel. Sadly, a publication by National Stuttering
Association written specifically for SLPs, parents, teachers, administrators,
and CWS is out of print. (18) It explained issues unique to CWS.<span style="mso-spacerun: yes;"> I g</span>et the feeling that many of these children
are “below the radar,” keeping their stuttering and their suffering to
themselves. Let’s hope that bullying prevention and intervention programs will
improve the lives of our children as depicted in this video shared on the a google group not now available.</span></div>
<br />
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<span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span></span><a href="http://www.youtube.com/watch?v=IN0eDJl4M8Q&feature=youtu.be"><span style="color: blue; font-family: "trebuchet ms";">http://www.youtube.com/watch?v=IN0eDJl4M8Q&feature=youtu.be</span></a><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></div>
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</div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "trebuchet ms";">Thank you,<o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="margin: 0in 0in 10pt;">
<span style="font-family: "trebuchet ms";">Judy<o:p></o:p></span></div>
<br />
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</div>
<br />
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</div>
<br />
<div class="MsoListParagraphCxSpFirst" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(1)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">stopbullying.gov
</span><a href="http://www.stopbullying.gov/"><span style="color: blue; font-family: "trebuchet ms";">http://www.stopbullying.gov/</span></a><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(2)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Scott,
L. (2010) Decoding IDEA Eligibility. [DVD] available at </span><a href="http://www.stutteringhelp.og/"><span style="color: blue; font-family: "trebuchet ms";">www.stutteringhelp.og</span></a><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(3)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Stuttering:
Straight Talk for Teachers, 8 Tips for Teachers, </span><a href="http://www.stutteringhelp.org/"><span style="color: blue; font-family: "trebuchet ms";">www.stutteringhelp.org</span></a><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></div>
<br />
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<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(4)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Massachusetts
General Laws, </span><a href="http://www.malegislature.gov/Laws/SessionLaws/Acts/2010/Chapter92"><span style="color: blue; font-family: "trebuchet ms";">http://www.malegislature.gov/Laws/SessionLaws/Acts/2010/Chapter92</span></a><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></div>
<br />
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<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(5)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Bullying
Prevention and Intervention Resources, broken link</span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(6)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>Model Bullying Prevention and Intervention
Plan, broken link</span><span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(7)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Open
Circle: Getting to the Heart of Learning,<span style="mso-spacerun: yes;">
</span></span><a href="http://www.open-circle.org/"><span style="color: blue; font-family: "trebuchet ms";">http://www.open-circle.org/</span></a><span style="font-family: "trebuchet ms";"> ;<o:p></o:p></span></div>
<br />
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<span style="font-family: "trebuchet ms";">Massachusetts Aggression Reduction Center, </span><a href="http://webhost.bridgew.edu/marc/"><span style="color: blue; font-family: "trebuchet ms";">http://webhost.bridgew.edu/marc/</span></a><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(8)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Blood,
G. & Blood, I. (2004) Bullying in Adolescents Who Stutter: Communicative
Competence and Self-Esteem. <i style="mso-bidi-font-style: normal;">Contemporary
Issues in Communication Science and Disorders, </i>31, p.76.<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(9)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Langevin,
M & Prasad, N.G.N. (2012) A Stuttering Education and Bullying Awareness and
Prevention Resource: A Feasibility Study. <i style="mso-bidi-font-style: normal;">Language,
Speech, Hearing Services in Schools, </i>43, p. 345.<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(10)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Model Bullying Prevention and Intervention Plan,
p. 4, II.B.(iv), broken link</span><span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(11)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Blood G. & Blood, I p. 70.<o:p></o:p></span></div>
<br />
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<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(12)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Ibid. p. 76 <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(13)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Massachusetts Department of Elementary and
Secondary Education, Guidelines on Implementing Social and Emotional Learning
(SEL) Curricula, </span><span style="color: blue; font-family: "trebuchet ms";"><a href="http://www.doe.mass.edu/bullying/SELguide.pdf">b</a>roken link</span><span style="font-family: "trebuchet ms";"><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(14)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">I happen to own Kelly, A. (2002) Talkabout. UK:
Speechmark Publishing Ltd.<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(15)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Cooper, S. (2005) Speak Up and Get Along!
Minneapolis, MN: free spirit publishing. <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(16)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Institute for Stuttering Treatment and Research.
Teasing and Bullying: Unacceptable Behavior (TAB) </span><a href="http://www.tab.ualberta.ca/"><span style="color: blue; font-family: "trebuchet ms";">http://www.tab.ualberta.ca/</span></a><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(17)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">International Stuttering Association, Rights and
Responsibilities of People Who Stutter </span><a href="http://www.isastutter.org/what-we-do/bill-of-rights-and-responsibilities"><span style="color: blue; font-family: "trebuchet ms";">http://www.isastutter.org/what-we-do/bill-of-rights-and-responsibilities</span></a><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(18)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Flores, T. Ed. (2004 ) Bullying and Teasing:
Helping Children Who Stutter , </span><a href="http://www.westutter.org/"><span style="color: blue; font-family: "trebuchet ms";">www.westutter.org</span></a><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-25459957744217396772012-06-07T13:20:00.003-04:002020-04-11T14:21:43.128-04:00Rating Scales to Measure Change<br />
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<span style="font-family: "trebuchet ms";">I just read a speech/language
therapy report that contained daily fluency ratings for an entire school year.<span style="mso-spacerun: yes;"> </span>Two graphs were attached to the report, one illustrated
the teacher’s ratings and one illustrated parent ratings. Quite impressive!</span></div>
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</div>
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<span style="font-family: "trebuchet ms";">I used to ask parents to jot down a
few notes about their children’s fluency at home. I requested they make brief
videos and/or audio recordings. Very few parents did so and some were so
apologetic about noncompliance that I feared I’d made matters worse. Ideally, speech
therapy is supposed to keep track of speech fluency in a variety of settings;
but, just how to accomplish this is a challenge. </span></div>
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</div>
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<span style="font-family: "trebuchet ms";">Rating scales offer a simple way to
do this. A rating scale translates a subjective judgment into a number on a
continuum, say 1 – 10 for example. Some rating scales have carefully defined the
numbers. I adapted this kind of rating scale to supplement my notes for almost every
speech therapy session I have with every student. It is a 9-point scale
originally developed to measure social interaction. (1) <span style="mso-spacerun: yes;"> </span>Points 1-2 have this definition: “Quality of
the behavior is poor; there is no evidence of a habit beginning. The quantity
and duration of the examples are negligible or inappropriate.” There are five such
explanations on this scale. Numbers 8-9 are defined as “Quality of the behavior
is outstanding, and the behavior is used creatively in the interaction.
Quantity and duration of the examples are appropriate.” I added a blank spaces to
write in the behaviors being measured at each session.</span></div>
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</div>
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<span style="font-family: "trebuchet ms";">There are plenty of relevant
behaviors and characteristics worth measuring in the field of fluency. With respect
to speech, let’s consider the child who stuttered on 20 percent of syllables in
September and still stuttered on 20 percent of syllables in June. One might
glance at this data and assume the child had not made any progress. <span style="mso-spacerun: yes;"> </span>A decrease in oral-motor tension over this
period of time would have been excellent progress, although invisible in a
measure of percent syllables stuttered. This hypothetical child could have been
experiencing tense blocks and prolongations in September but predominantly
relaxed part-word repetitions in June. Let’s take a look at a few rating
scales. What do they measure and how?</span></div>
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</div>
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<span style="font-family: "trebuchet ms";">A rating scale may define only a
few numbers along a continuum. The <u>Test of Childhood Stuttering Observational
Rating Scales</u> measures <i style="mso-bidi-font-style: normal;">Speech Fluency</i>
and <i style="mso-bidi-font-style: normal;">Disfluency-Related Consequences</i>. (2)
<span style="mso-spacerun: yes;"> </span>It has only 4 points: 0 = Never, 1 =
Rarely, 2 = Sometimes, 3 = Often. There are nine items in the <i style="mso-bidi-font-style: normal;">Speech Fluency</i> section including
descriptions of blocks, prolongations and repetitions. There are also nine
items in the <i style="mso-bidi-font-style: normal;">Disfluency Related Consequences
</i>section including secondary behaviors, avoidance, and emotional reactions. I
use this scale for initial screenings and for monitoring progress. I’m not completely
satisfied with the sensitivity of a 4-point scale to reflect the subtle improvements
that are characteristic of fluency therapy. Note: this scale is completed by adult
listeners. </span></div>
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<span style="font-family: "trebuchet ms";">I used the <u>Assessment of the
Child’s Experience of Stuttering</u> (ACES) when it was available in a free
draft version (2006). This was a lengthy, 100-item<span style="mso-spacerun: yes;"> </span>scale divided into four sections - <i style="mso-bidi-font-style: normal;">General Information</i>, <i style="mso-bidi-font-style: normal;">Your Reactions to Stuttering</i>, <i style="mso-bidi-font-style: normal;">Communication in Daily Situations</i>, and <i style="mso-bidi-font-style: normal;">Quality of Life.</i> Each item was rated on
a 5-point scale with three definitions: 1 = Always, 3 = Sometimes, 5 = Never. A
student’s responses were added to determine <i style="mso-bidi-font-style: normal;">Impact
Scores</i> that corresponded to <i style="mso-bidi-font-style: normal;">Impact
Rating</i> definitions: mild, mild-to-moderate, moderate, moderate-to-severe,
and severe. I found the ACES was sensitive to therapeutic progress for older
teens. It seemed too overwhelming for my elementary school age clients. When
the final revision was published commercially (3), I stopped using the draft
form. Note: this scale is completed by the speaker.</span></div>
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<span style="font-family: "trebuchet ms";">Some scales define only the
endpoints. The <i style="mso-bidi-font-style: normal;">Adolescent Communication
Questionnaire (12) </i> is a list of 39 speaking situations rated on a 5-point scale.
The directions state: “How much confidence do you have about doing each of the
behaviors listed below? Circle the number that best represents your
confidence.” 1 = No way. I would be too uptight to speak and <span style="mso-spacerun: yes;"> </span>5 = No problem. I would be very confident
speaking. (4) Another scale that measures communication attitudes uses seven
data points to measure comfort level, confidence, and feelings of success. (5) The
word “extremely” appears at the extreme endpoints in one of them: 1 = Extremely
Successful and 7 = Extremely Unsuccessful. Note: these scales are completed by
the speaker.</span></div>
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<span style="font-family: "trebuchet ms";">There are a few qualitative
differences between rating scales worth mentioning. First, for some scales (1,
4), larger values represent greater success. On others (2, 3, 5), larger
numbers represent greater severity of a problem.<span style="mso-spacerun: yes;"> </span>The <i style="mso-bidi-font-style: normal;">Predictive
Cluttering Inventory</i> (6) uses a scale with the largest number placed on the
<u>left</u> side of the continuum unlike all the other scales I’ve described. Second,
it is very important to document <i style="mso-bidi-font-style: normal;">who,
what, when, and where</i> every time a rating is chosen. Fluency is notorious
for its variability. I think it is safe to say that no one stutters all the
time in the same way. And third, without training for agreement, everyone
creates their own definitions for points along the scale. (7) Very anxious
parents or highly sensitive speakers may rate dysfluencies much more severely
than an SLP or teacher. How about the pediatricians who counsel parents to wait
and see if their toddlers will outgrow stuttering? I imagine they rate
dysfluencies quite mildly. </span></div>
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<span style="font-family: "trebuchet ms";">Why use a rating scale? Besides the
demand for data in our present educational system, numbers can be easier to compare
over time. In the report I mentioned earlier, teacher ratings on a 10-point
scale indicated stuttering decreased quite dramatically from the beginning to
the end of the school year. I expect this data represents careful collaboration
between the teacher and the school-based SLP. My congratulations to everyone
involved in this case. It’s always a delight to discover <span style="mso-spacerun: yes;"> </span>school district willing to help children who
stutter. How can I and others adapt this kind of collaboration to meet the unique
needs of other students?</span></div>
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<span style="font-family: "trebuchet ms";">One possibility is to define points
along the 1-10 scale. Combined with training for listener agreement, carefully
worded definitions may help us compare across listeners with some accuracy. Then
we might feel more confident that a teacher rating of 7 could be the same as a
parent’s rating of 7. If training is not possible, it is still helpful to pursue
the question of why fluency ratings change <u>for one listener over time</u>. This
could reveal new and/or confirm known strategies that were especially effective.
This is not carefully controlled research, but I would argue it is still
beneficial. </span></div>
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<span style="font-family: "trebuchet ms";">A little aside: when data is
collected as part of a research study, a statistical analysis determines whether
or not change is <i style="mso-bidi-font-style: normal;">significant</i> and not due
to chance. Well-designed research has many controls in place so that
experimental results confirm or deny a specific hypothesis.<span style="mso-spacerun: yes;"> </span>For example, well-designed studies have a <i style="mso-bidi-font-style: normal;">control group</i> of people who receive no
treatment. <span style="mso-spacerun: yes;"> </span>If the control group <u>does
not</u> change during the course of the experiment yet the treatment group <u>does</u>
change after receiving treatment, one might argue that treatment was responsible
for the change. Such research is difficult to do with children who stutter
because it means withholding treatment for those children in a control group. </span></div>
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<span style="font-family: "trebuchet ms";">Ratings focus our attention on individual
issues that affect fluency and communication. <span style="mso-spacerun: yes;"> </span>This focus helps us to understand and control
for those factors to promote greater fluency, healthy attitudes (8), and more
effective communication. Let’s return to our example of measuring of stuttering
frequency. Sometimes children may stutter less because they successfully
generalize fluency enhancing skills <u>and</u> educate the listeners in their
environment.<span style="mso-spacerun: yes;"> </span>Or, it might be that
greater fluency is the result of a parent/caregiver-implemented, home-based
therapy plan. (9) <span style="mso-spacerun: yes;"> </span>In these examples,
everyone can feel empowered and optimistic about prognosis for improvement. </span></div>
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<span style="font-family: "trebuchet ms";">Alternately, it may be that children
stutter less because they are talking less or avoiding difficult words. These
are maladaptive speech/language/communication behaviors. Many experts in the
field propose that it is healthier for a child to express herself freely while
stuttering than to reduce verbal output for the sake of fluency. </span></div>
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<span style="font-family: "trebuchet ms";">Sometimes fluency fluctuates in
conjunction with life events. Illness, fatigue, moving to a new home, family
changes, academic demands, annual celebrations, and growth spurts in language
development can all affect fluency. In these cases, it would be cruel to hold a
child accountable for increases in stuttering. Stuttering management is a
multifaceted endeavor that requires team work between parents, teachers,
caregivers, SLPs and others. It is a puzzling disorder that demands patience,
understanding, and kindness from everyone involved. </span></div>
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<span style="font-family: "trebuchet ms";">Here’s what I mean, an infant sibling
may keep all the other family members awake at night and impatient during the
day. We don’t expect a young child to automatically know how to cope in this
situation. A young child is not likely to say, “Hey! Mom and dad! I need help
falling back to sleep when that charming new little kiddo wakes me up with his
crying in the middle of the night! And, by the way, could we schedule some more
time for me!” <span style="mso-spacerun: yes;"> </span>However, this child might
have more angry outbursts, be less cooperative, and demonstrate more dysfluency instead, IMHO.
Does this child need environmental management or direct fluency therapy? <span style="mso-spacerun: yes;"> </span>Rating scales may help determine the
effectiveness of the chosen treatment.</span></div>
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<span style="font-family: "trebuchet ms";">Perhaps <span style="mso-spacerun: yes;"> </span>the older child has discovered his stuttering is
affecting his grades.<span style="mso-spacerun: yes;"> </span>He may be frustrated
by failed attempts to change his speech on his own and has stopped raising his
hand in class. <span style="mso-spacerun: yes;"> </span>He might be noticing an
inability to keep up with the rapid, fluent speech of his peers. This child may
need a treatment plan that includes learning more about speech physiology and instructs
him in ways to advocate for himself. Rating scales related to quality of life issues,
self-confidence and communication attitudes could be crucial to a total
treatment program. (10)</span></div>
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<span style="font-family: "trebuchet ms";">Rating scales can be a valuable
asset in fluency therapy. (11) We need to consider several choices of what to
measure, how to define points along the continuum, and how we expect the
results to affect future treatment. I’m looking forward to using rating scales
more often and more creatively in my own practice. </span></div>
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<span style="font-family: "trebuchet ms";">On a scale of 1-5 (where 1= most
unsatisfactory and 5 = most satisfactory) , I hope you have a <u>10</u> kind of
day! </span></div>
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<br /></div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(1)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">MacDonald,
J.D. & Carroll, J.Y. (1992) A Social Partnership Model for Assessing Early
Communication Development: An Intervention Model for Preconversational
Children. <i style="mso-bidi-font-style: normal;">Language, Speech, Hearing
Services in Schools,</i> 23, p. 115.</span></div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(2)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Gillam,
R. B., Logan, K.J., Pearson, N.A. (2009) Austin TX: PRO-ED</span></div>
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</div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(3)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Yaruss,
J.S., Quesall, R., Coleman, C. (2010) <u>Overall Assessment of the Speaker’s
Experience of Stuttering</u> (<u>OASES</u>), Pearson Education, Inc.,<span style="mso-spacerun: yes;"> no link</span></span></div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(4)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Bray,
M.A., Kehle, T. J., Lawless, K.A., Theodore, L.A., (2003) The Relationship
Between Self-Efficacy to Depression, <i style="mso-bidi-font-style: normal;">American
Journal of Speech Language Pathology</i>, 12, p. 431.</span></div>
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</div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(5)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Gottwald,
S.R. (2011) “Rating Scales as a Clinical Tool” </span><a href="http://www.mnsu.edu/comdis/isad15/papers/therapy15/gottwald15.html"><span style="color: blue; font-family: "trebuchet ms";">http://www.mnsu.edu/comdis/isad15/papers/therapy15/gottwald15.html</span></a><span style="font-family: "trebuchet ms";">
</span></div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(6)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>Daley, D. (2007) “Cluttering: Characteristics
Identified as Diagnostically Significant by 60 Fluency Experts” </span><a href="http://www.mnsu.edu/comdis/isad10/papers/daly10/daly10.html"><span style="color: blue; font-family: "trebuchet ms";">http://www.mnsu.edu/comdis/isad10/papers/daly10/daly10.html</span></a><span style="font-family: "trebuchet ms";">
</span></div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(7)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">One
teen directed me to his favorite online comic strip, xkcd, one that poked fun
at use of a 1-10 rating scale of pain. </span><a href="http://xkcd.com/883/"><span style="color: blue; font-family: "trebuchet ms";">http://xkcd.com/883/</span></a><span style="font-family: "trebuchet ms";">
<span style="mso-spacerun: yes;"> </span></span></div>
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</div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(8)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Yaruss,
J. S. & Coleman, C., Stuttering Center of Western Pennsylvania, “Helping
Children Who Stutter Develop Healthy Communication Attitudes,” broken link</span></div>
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</div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(9)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">Lidcombe
Program, Australian Stuttering Research Center, link has changed</span></div>
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</div>
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<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(10)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-family: "trebuchet ms";">Blood, G. The POWERR Game, Stuttering Foundation, broken link</span></div>
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<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 10pt 0.5in; mso-list: l0 level1 lfo1; text-indent: -0.25in;">
<span style="mso-bidi-font-family: "Trebuchet MS";"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(11)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-family: "trebuchet ms";">O’Brian,
S., Packman, A., Onslow, M. (2004) Self-Rating of Stuttering Severity as a
Clinical Tool, <i style="mso-bidi-font-style: normal;">American Journal of
Speech-Language Pathology</i>, 13, 219-226.</span><br />
<span style="font-family: "trebuchet ms";"></span><br />
<span style="font-family: "trebuchet ms";">(12) M. A. Bray, et. al. (2003) The Relationship of Self-Efficacy and Depression to Stuttering. <em>American Journal of Speech Language Pathology,</em> Vol. 12, 425-431, the rating scale is on page 431.</span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-17349540955106365162012-04-23T17:28:00.001-04:002020-04-11T14:23:22.676-04:00Conversations with Children Who Stutter<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Children who stutter might enjoy some support with
conversation. A teenage student recently said to me, ‘I’m not very good at
putting my ideas into words,’ and I’m willing to bet this is partially from
lack of practice. Children who stutter, unable to keep pace with fluent
speakers, sometimes withdraw from conversations and miss out on developing this
form of self expression. Others forge ahead, speech/language systems
struggling, like a car in serious need of a tune up. How can parents and others
create conversations that encourage children who stutter to say what they want
to say, when they want to say it and do so with easier speech?<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">1.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Take the time. <o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"><span style="mso-tab-count: 1;"> </span>In “The
Flight from Conversation”, (1) Sherry Turkle reports that some of us are so
plugged-in to technology “we’ve become accustomed to a new way of being ‘alone
together.’” People are engaging in fewer extended, face-to-face conversations
as they e-mail, text, and twitter to readers in other places. As parents and friends
of children who stutter, we may need to plan ahead to deliberately engage our
children in conversation during those free moments after school, in the car, in
shared activities, at a mealtime, and/or before bedtime. <o:p></o:p></span></span></div>
<br />
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<br /></div>
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">2.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Practice whenever possible.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">“Hello, Gramma? It’s me – Michael.”
This conversation appears in the comic <i style="mso-bidi-font-style: normal;">For
Better or For Worse</i> in my Sunday paper. (2) Michael, about 8 years old, is
talking on the phone. “Tell her about your hockey tournament,” prompts his
mother, who is sitting nearby. “Uh - we won our hockey tournament,” says
Michael. “Thank her for the sweater she sent you,” says Mom. “Thanks for the
sweater you sent me,” mimics Michael. And so the comic continues, Michael’s
mother coaching him through a conversation with his grandmother.<span style="mso-spacerun: yes;"> </span>As adults, we can find ways to show our
children how to discuss TV shows, movies, books, video games, school projects,
social concerns, family issues, extra-curricular activities, and hopes and
dreams. Topics of conversation arise naturally when parents share in their
children’s activities.<o:p></o:p></span></span></div>
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">3.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Learn<span style="mso-spacerun: yes;">
</span>new skills.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Adults develop skills for talking
with<span style="mso-spacerun: yes;"> </span>supervisors, customers,<span style="mso-spacerun: yes;"> </span>co-workers, parents, spouses, and friends.
They read self-help books to learn the knowledge, jargon, and conversational
expectations appropriate for managing conflict, purchasing a car, increasing
sales, and nurturing relationships, among other things. <u>How to Talk So Kids
Will Listen and Listen So Kids Will Talk</u> is<span style="mso-spacerun: yes;">
</span>a time-tested book about talking with children. And, there is a sequel
for talking with teenagers. These books are easy reads that<span style="mso-spacerun: yes;"> </span>illustrate “new methods of communication…that
parents could teach themselves…with hundreds of examples of helpful
dialogue…[and] cartoons that …show the skills in action. “(3)<span style="mso-spacerun: yes;"> </span>The Stuttering Foundation offers a few tips
specifically for talking with children who stutter. (4) <o:p></o:p></span></span></div>
<br />
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<br /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt 0.75in; mso-list: l1 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">4.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">It’s ok to stutter – easier when
possible.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Stuttering that a) occurs less
frequently and<span style="mso-spacerun: yes;"> </span>b) involves less
oral-motor tension than your child typically experiences is considered “easy
stuttering.” Easy stuttering might take the form of repeating whole words
instead of parts of words, as in “game-game-game” instead of ga-ga-game”, or,
repeating a sound fewer times, as in “g-game” instead of “g-g-g-ame. “<span style="mso-spacerun: yes;"> </span>Blocks and prolongations that are briefer and
accompanied by less oral-motor and facial tension may be ‘easy stuttering’ for
your child. You might notice easier stuttering once a week, then<span style="mso-spacerun: yes;"> </span>twice a week , then every day.<span style="mso-spacerun: yes;"> </span>Maybe you’ll notice ways to help your child
stutter more easily.<o:p></o:p></span></span></div>
<br />
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<br /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt 0.75in; mso-list: l1 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">5.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Ask about factors that affect
stuttering.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Stuttering can interact with other
conditions such as ADHD (6), language demands (7, 8, 9) and thoughts and
feelings (10).<span style="mso-spacerun: yes;"> </span>Conversations with a speech
language pathologist can help you manage situations to support easier speech. (
5)<span style="mso-spacerun: yes;"> </span>A speech hierarchy is a list of
speaking tasks that control conditions to make fluency easier for your
child. Ask about where your child’s speech homework falls on such a hierarchy so that
you can discuss the SLP's long term therapy plan.<o:p></o:p></span></span></div>
<br />
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<br /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt 0.75in; mso-list: l1 level1 lfo1; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">6.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">Five minutes may need to become ten.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">a.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">“I have this game at home” may take 2
seconds to say fluently.<o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt 1in; mso-list: l2 level1 lfo3; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">b.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">“I-I-I-I have th…..is g-g-g-game at
home” may take 5 seconds.<o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt 1in; mso-list: l2 level1 lfo3; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">c.</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">“(pause) III (slow/gentle beginning
sound) have /(pause) thhhiis (slow/gentle sound) g {freeze} game at home” may
take 10-15 seconds.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";"> A compassionate and patient listener will allow plenty of
extra time for a child to reduce oral-motor tension through the use of fluency
enhancing techniques such as pausing, slow/gentle beginning sounds, reduced
speaking rate, freezing, and cancellation. It is the rare listener indeed who
understands that conscious speech-language-motor planning is a time consuming
and laborious process at first. When listeners prefer fast and fluent speech,
children may avoid words on which they expect to stutter, holding back on all
they wish to express. “I used to do that all the time,” a child recently said
to me. Now, he talks more and stutters more, which actually gives us more
opportunities for conversation and change.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "calibri";">The value of conversation became
apparent as I met my students at local retail stores to work on the
carryover.<span style="mso-spacerun: yes;"> </span>While experimenting with
different ways to give feedback about speech goals, I stumbled upon the obvious.
The most valuable feature of these lessons is not the feedback about speech. It
is the hour-long, sustained conversation. Validating a child’s thoughts and
feelings via attentive, sensitive, respectful, and prolonged conversation is
the foundation for carry over work. In Turkle’s article, <span style="mso-spacerun: yes;"> </span>she writes,<span style="mso-spacerun: yes;">
</span>“ A 16-year old boy who relies on texting for almost everything says
almost wistfully, ‘Someday, someday, but certainly not now, I’d like to learn
how to have a conversation.’”<span style="mso-spacerun: yes;"> </span>I think we
can start<span style="mso-spacerun: yes;"> </span>that lesson today.<o:p></o:p></span></span></div>
<br />
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(1)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 10pt;"><span style="font-family: "calibri";">S. Turkle (2012) The Flight From Conversation. New
York Times, April 21.<o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(2)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 10pt;"><span style="font-family: "calibri";">Boston Sunday Globe, April 22, 2012.<o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(3)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 10pt;"><span style="font-family: "calibri";">A. Faber and E. Mazlish (1980) <u>How to Talk So Kids
Will Listen & Listen So Kids Will Talk</u>, NY, NY: Avon Books.<span style="mso-spacerun: yes;"> </span>p. viii.<span style="mso-spacerun: yes;">
</span>See also A. Faber and E. Mazlish (2005) <u>How to Talk So Teens Will
Listen & Listen So Teens Will Talk</u>, NY, NY: Harper Collins.<o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(4)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 10pt;"><span style="font-family: "calibri";">7 Tips for Talking with Your Child. Stuttering
Foundation, </span><a href="http://www.stutteringhelp.org/Default.aspx?tabid=632"><span style="color: blue; font-family: "calibri";">http://www.stutteringhelp.org/Default.aspx?tabid=632</span></a><span style="font-family: "calibri";">
<o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(5)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span></i><span style="font-size: 10pt;"><span style="font-family: "calibri";">M. J. Cooley
Hidecker, R. S. Jones, D. R. Imig (2009). Unsing Family Paradigms to Improve
Evidence-Based Practice. <i style="mso-bidi-font-style: normal;">American Journal
of Speech Language Pathology, 18, 212-221.<o:p></o:p></i></span></span></div>
<br />
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<span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(6)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 10pt;"><span style="font-family: "calibri";">J. Donaher (2011) ADHD and Children Who Stutter.<span style="mso-spacerun: yes;"> </span>Stuttering Foundation, broken link</span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(7)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span></i><span style="font-family: "calibri";"><span lang="FR" style="font-size: 10pt; mso-ansi-language: FR;">K. Ntourou, E. G. Conture, M. W. Lipsey (2011). </span><span style="font-size: 10pt;">Language Abilities of Children Who Stutter : a
Meta-Analytical Review. <i style="mso-bidi-font-style: normal;">American Journal
of Speech-Language Pathology, 20, 163-179.<o:p></o:p></i></span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(8)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span></i><span style="font-size: 10pt;"><span style="font-family: "calibri";">Trautman, L.
S., E. C. Healey, J. A. Norris (2001) the effects of Contextualization on
Fluency in Three Groups of Children. <i style="mso-bidi-font-style: normal;">Journal
of Speech and Hearing Research, 44, 564-576.<o:p></o:p></i></span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(9)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span></i><span style="font-size: 10pt;"><span style="font-family: "calibri";">C. T. Byrd,
K. J. Logan, R. B. Gillam (2012) Speech disfluency in School-Age Children’s
Conversational and Narrative Discourse. <i style="mso-bidi-font-style: normal;">Language,
speech, Hearing Services in Schools, 43, 153-163<o:p></o:p></i></span></span></div>
<br />
<div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0pt 0.5in; mso-list: l0 level1 lfo2; text-indent: -0.25in;">
<i style="mso-bidi-font-style: normal;"><span style="font-size: 10pt; mso-bidi-font-family: Calibri;"><span style="mso-list: Ignore;"><span style="font-family: "calibri";">(10)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span></i><span style="font-size: 10pt;"><span style="font-family: "calibri";">L. Scott (2010) Imprementing Cognitive Behavior
Therapy with Children. Stuttering Foundatin, </span><span style="color: blue; font-family: "calibri";"><a href="http://secure.stutteringhelp.org/Merchant5/merchant.mvc?Screen=PROD&Store_Code=SFA&Product_Code=6500&Category_Code=V">b</a>roken link</span><span style="font-family: "calibri";"><i style="mso-bidi-font-style: normal;"><o:p></o:p></i></span></span></div>
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-3081323781954419872012-03-24T10:01:00.002-04:002020-04-11T14:26:15.162-04:00Reading Fluency: Red Herring or Red Flag?<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">Reading aloud is an enjoyable and
enriching way to spend time with others.<span style="mso-spacerun: yes;">
</span>It’s also a way to practice more fluent speech. Children’s books,
magazines and websites offer entertaining literacy activities for every
interest and age group.<span style="mso-spacerun: yes;"> </span>Game playing cards,
museum and amusement park brochures, and written conversations between
characters of video games are opportunities to practice ‘speech tools’ even for
just a few minutes.<span style="mso-spacerun: yes;"> </span>Stickers, nickels,
smiles, hugs, thumbs-up, shared reading and other small rewards reinforce the notion
that easier speech is meant for more situations than just the speech therapy
office. <o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Reading testing is not quite as
fun. Reading tests measure accuracy, fluency, words-per-minute, and basic
comprehension. <i style="mso-bidi-font-style: normal;">Reading fluency</i> in
particular, figures prominently in our data driven educational system.<span style="mso-spacerun: yes;"> </span>While this data point may be a well - intentioned
way to assess reading ability, I’m concerned about how it affects my students
who stutter. The National Stuttering Association has a free brochure <b style="mso-bidi-font-weight: normal;">Stuttering and Reading Fluency</b> (1)
which states, “A child should not be penalized for moments of stuttering when
assessing reading fluency. Fluency of speech is not the same as fluency of
decoding.” We need to inform teachers of this.<o:p></o:p></span></span></div>
<br />
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<br /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 0pt; text-align: justify; text-indent: 0.5in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>Every student I have ever met has a need for
speed when reading aloud. Since reading tests are timed and reading fast is
rewarded, it’s important to know that reading rate affects stuttering. (2) <span style="mso-spacerun: yes;"> </span>When does reading dysfluency represent a
stuttering problem and when does it represent a reading problem? In preparing
this article, I came to the conclusion that this question is nearly
irrelevant.<span style="mso-spacerun: yes;"> </span>The more important question is
whether or not a child’s depressed reading scores are warning signs of a more
serious problem with grade level literacy.<o:p></o:p></span></span></div>
<br />
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<br /></div>
<br />
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">The definition of reading is a
matter of some debate. <span style="mso-spacerun: yes;"> </span>A recent
proposal, called the “narrow view of reading,” offered this perspective. <span style="mso-spacerun: yes;"> </span>“The essence of the proposal [the narrow view]
was to change the way in which reading is assessed. If high-stakes assessments
differentiated among word recognition, domain-general reading comprehension,
and specific subject knowledge, the reading crisis would be over because the
focus would change to the true crisis in American education – knowledge
deficiencies in the sciences, history, math, literature, and other content
domains that are important for success in the 21<sup>st</sup> century.” (3)
Here we have decoding (word recognition) relegated to one small part of reading
while the complexity of comprehension is given greater attention. <o:p></o:p></span></span></div>
<br />
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<br /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 0pt; text-align: justify; text-indent: 0.5in;">
<span style="font-family: "trebuchet ms";"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;">Misconceptions</span></b><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"> <b style="mso-bidi-font-weight: normal;">about reading</b> include:<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpFirst" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">a)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">“word
recognition and reading comprehension are related skills that can be accurately
reduced to one measurable score or level,<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 1in; mso-add-space: auto; mso-list: l2 level1 lfo1; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">b)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">improvements
in word recognition will always lead to improvements in reading comprehension,
and<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">c)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">measures
of reading comprehension assess the same thing.” (4)<o:p></o:p></span></span></div>
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<br /></div>
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<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: justify; text-indent: 0.5in;">
<span style="font-family: "trebuchet ms";"><span style="font-size: 12pt; line-height: 150%;">Turns out, a problem with the <i style="mso-bidi-font-style: normal;">narrow view of reading</i> lies in its
implementation. If reading is defined only in terms of word recognition
(decoding), students who decode single words adequately may be dismissed from
reading programs, even if they continue to struggle with the deep reading
comprehension necessary to perform well at grade level. General education teachers
are not trained to teach language skills and comprehension strategies; they are
responsible for subject content. “Given the present climate of accountability
to curriculum standards, they [teachers] are reluctant to do anything they view
as distracting from the teaching of content that will appear on high stakes
tests.” </span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;">(5) </span><span style="font-size: 12pt; line-height: 150%;">Given the
narrow view of reading, that means no one is designated to help students with
reading comprehension strategies. That is, unless school based speech-language
pathologists (SLP) are allowed to provide services that focus “on the language
underpinnings of comprehension.”</span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"> (6)</span><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
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<br /></div>
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<span style="font-family: "trebuchet ms";"><u><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Arial;">“Adolescent literacy professionals are trying to
counter the popular and oft-quoted ideas that before fourth grade, children are
<i style="mso-bidi-font-style: normal;">learning to read and after that they are
reading to learn…</i>we know there is much to learn about reading past the
fourth grade…”</span></u><span style="font-size: 12pt; line-height: 115%; mso-bidi-font-family: Arial;"> (7)<o:p></o:p></span></span></div>
<br />
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<br /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: justify; text-indent: 0.5in;">
<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">Reading is hard work for some
children. Besides problems with decoding, language processing problems may prevent
them from fully comprehending increasingly complex material. Some processing
problems arise from a lack of background (world) knowledge, unfamiliar
vocabulary, complex syntax, and information that is implied but not explicitly
stated. Poor readers tend to read less than skilled readers. Children who find
reading easy <span style="mso-spacerun: yes;"> </span>and fun like to read more.
Consequently they can spend hours and hours of time decoding unfamiliar vocabulary,
deciphering complex sentences, linking information from one part of a text to
another, talking with others about what they have read, and anticipating
information in later pages and even later volumes of a story series. All the
while, they are absorbing more world knowledge as well.<o:p></o:p></span></span></div>
<br />
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<span style="font-family: "trebuchet ms";"><span style="font-size: 12pt; line-height: 150%;">An emphasis on improving word
recognition assumes that “by improving the reader’s overall word knowledge and
decoding abilities, comprehension will simultaneously improve.”</span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"> (8)</span><span style="font-size: 12pt; line-height: 150%;"> <span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Decoding
instruction</i> for unfamiliar words can include reading them aloud for the
child, reviewing phonetics, rereading, looking-up definitions, and word practice
drills. While these teaching strategies have proven useful, research suggests
that <i style="mso-bidi-font-style: normal;">meaning-based feedback</i> may be even
more effective with respect to reading comprehension, oral language, and
expressive vocabulary. With meaning-based feedback, “The teacher acts as a
mediator who assists in establishing the content of the author’s message before
reading, setting the scene, simplifying complex sentences, establishing
relationships between and across text units, and discussing or expanding upon
unfamiliar vocabulary or concepts in context. The teacher constantly monitors
the oral reading for indications that the author’s message is not being understood.”
</span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;">(9)</span><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">The larger implications of reading
comprehension become apparent when we look ahead to the literacy skills required
of the next generation. “Adolescents entering the adult world in the 21<sup>st</sup>
century will read and write more than at any other time in human history. They
will need advanced levels of literacy to perform their jobs, run their
households, act as citizens, and conduct their personal lives. They will need
literacy to cope with the flood of information they will find everywhere they
turn. They will need literacy to feed their imaginations so they can create the
world of the future.” (10)<o:p></o:p></span></span></div>
<br />
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<span style="font-family: "trebuchet ms";"><span style="font-size: 12pt; line-height: 150%;">Our journey from word recognition to
reading comprehension makes its next stop at “high literacy”. High literacy “includes
the ability to use language, content, and reasoning in ways that are
appropriate for particular situations and disciplines, involving students’
abilities to engage in thoughtful reading, writing, and discussion about
content.” (11) SLPs are well prepared to collaborate with others on this road.
They are knowledgeable about the phonological, semantic, grammatic, and
pragmatic complexities of communication in speaking, listening, reading, and
writing. The Common Core Standards</span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"> (12) </span><span style="font-size: 12pt; line-height: 150%;">released in June 2010 include
language as a unique category, inviting SLPs to address the “underlying
language requirements of rigorous curricula and intervene with students
directly or work with other professionals to provide differentiated instruction
and intervention.”</span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"> (13)</span><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";"><span style="mso-tab-count: 1;"> </span>At
this point, the relevance of reading fluency, and even stuttering, feels like a
distant memory. I do not wish trivialize the ability to read or speak fluently
at any grade level. But, let’s find some additional meaning in reading test
scores. When a child who stutters performs poorly on a reading test, we need to
ask questions. What kind of dysfluency was evident: decoding, stuttering, or
both? Was the child penalized for stuttering? Was the child given the option to
deliberately reduce speaking rate as a fluency strategy? How did the child
perform on each comprehension test question and why? How well does the child
<u>read,comprehend, and talk about</u> curriculum texts? <span style="mso-spacerun: yes;"> </span>Does the child
enjoy reading? Does the child seek reading opportunities at home? School
districts are surviving shrinking budgets by cutting personnel and services. <span style="mso-spacerun: yes;"> </span>When a child is denied services, I wish it was
more trasparent whether the decision was truly based on the child’s need or the availability of funded programs.
<o:p></o:p></span></span></div>
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<u><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">Reading Resources<o:p></o:p></span></span></u></div>
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">All
about Adolescent Literacy </span></span><a href="http://www.adlit.org/"><span style="font-size: 12pt; line-height: 150%;"><span style="color: blue; font-family: "trebuchet ms";">http://www.adlit.org/</span></span></a><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></span></div>
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">Boy’s
Life: the Official Publication of the Boys Scouts of America </span></span><a href="http://boyslife.org/"><span style="font-size: 12pt; line-height: 150%;"><span style="color: blue; font-family: "trebuchet ms";">http://boyslife.org/</span></span></a><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;">
</span><o:p></o:p></span></span></div>
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">Cobblestone
& Cricket: 14 Award Winning Magazines </span></span><a href="http://www.cricketmag.com/home.asp"><span style="font-size: 12pt; line-height: 150%;"><span style="color: blue; font-family: "trebuchet ms";">http://www.cricketmag.com/home.asp</span></span></a><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></span></div>
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";">Highlights:
Fun with Purpose </span></span><a href="http://www.highlights.com/"><span style="font-size: 12pt; line-height: 150%;"><span style="color: blue; font-family: "trebuchet ms";">http://www.highlights.com/</span></span></a><span style="font-size: 12pt; line-height: 150%;"><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">National Geographic Kids </span></span><a href="http://kids.nationalgeographic.com/kids/?source=NavKidsHome"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="color: blue; font-family: "trebuchet ms";">http://kids.nationalgeographic.com/kids/?source=NavKidsHome</span></span></a><span style="font-family: "trebuchet ms";"><span style="font-size: 10pt; line-height: 150%; mso-bidi-font-family: Arial;"> </span><span style="font-size: 12pt; line-height: 150%;"><o:p></o:p></span></span></div>
<br />
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Public Television for Kids<span style="mso-spacerun: yes;"> </span></span></span><a href="http://pbskids.org/"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="color: blue; font-family: "trebuchet ms";">http://pbskids.org/</span></span></a><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></span></div>
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Reading is Fundamental </span></span><a href="http://www.rif.org/"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="color: blue; font-family: "trebuchet ms";">http://www.rif.org/</span></span></a><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></span></div>
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<span style="font-family: "symbol"; font-size: 12pt; line-height: 150%;"><span style="mso-list: Ignore;">·<span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";">
</span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Reading Rockets </span></span><a href="http://www.readingrockets.org/"><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="color: blue; font-family: "trebuchet ms";">http://www.readingrockets.org/</span></span></a><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></span></div>
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<u><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">References
<o:p></o:p></span></span></u></div>
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(1)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><a href="https://www.z2systems.com/np/clients/nsa/product.jsp;jsessionid=18DCFBA0F60FDF81D4CDE10DC168B959?product=45"><span style="color: blue; font-family: "trebuchet ms";">https://www.z2systems.com/np/clients/nsa/product.jsp;jsessionid=18DCFBA0F60FDF81D4CDE10DC168B959?product=45</span></a><span style="font-family: "trebuchet ms";">
<o:p></o:p></span></span></div>
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<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(2)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Vanryckeghem,
M. et. al. (1999) The Main and Interactive Effect of Oral Reading Rate on the
Frequency of Stuttering, American Journal of Speech-Language Pathology, 8,
164-170. <o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(3)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Alan G.
Kamhi (2009) Solving the Reading Crisis – Take 2: The Case for Differentiated
Assessment, Language, Speech, and Hearing in Schools, 40, p. 213.<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(4)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Ibid. p.
214<o:p></o:p></span></span></div>
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<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(5)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Barbara J.
Ehren (2009) Looking Through an Adolescent Literacy Lens at the Narrow View
of<span style="mso-spacerun: yes;"> </span>Reading, Language, Speech, Hearing
Services in Schools, 40, p. 193.<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(6)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Ibid. p. 193<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(7)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Ibid. p.
193<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(8)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">L. K.
Crowe (2003) Comparison of Two Reading Feedback Strategies in Improving the
Oral and Written Language Performance of Children with Language-Learning
Disabilities, American Journal of Speech Language Pathology, 12, p. 17.<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(9)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Ibid. p.
18<o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(10)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">B.J. Ehren
& K. Murza (October, 2010) The Urgent Need to Address Workforce Readiness
in Adolescent Literacy Intervention, Perspectives on Language Learning and
Education,3, p.93 (a publication of ASHA SIG 1) with a reference to Moore, D.
W. et. al. (1999) Adolescent literacy: A position statement Newark, DE:
International Reading Association </span><span style="color: blue; font-family: "trebuchet ms";"><a href="http://www.reading.org/downloads/positions/ps1036_adolescent.pdf">b</a>roken link</span><o:p></o:p></span></div>
<br />
<div class="MsoListParagraphCxSpMiddle" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(11)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Ibid. p.
93.<o:p></o:p></span></span></div>
<br />
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<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(12)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><a href="http://www.corestandards.org/"><span style="color: blue; font-family: "trebuchet ms";">www.corestandards.org</span></a><span style="font-family: "trebuchet ms";"> <o:p></o:p></span></span></div>
<br />
<div class="MsoListParagraphCxSpLast" style="line-height: 150%; margin: 0in 0in 0pt 0.75in; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -0.25in;">
<span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: "Trebuchet MS"; mso-bidi-theme-font: minor-latin;"><span style="mso-list: Ignore;"><span style="font-family: "trebuchet ms";">(13)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span></span><span style="font-size: 12pt; line-height: 150%; mso-bidi-font-family: Arial;"><span style="font-family: "trebuchet ms";">Ehren
& Murza,<span style="mso-spacerun: yes;"> </span>p. 97<span style="mso-tab-count: 1;"> </span><o:p></o:p></span></span></div>
Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-79596806647025571642012-02-27T17:45:00.000-05:002015-02-02T12:35:07.600-05:00Alan Badmington: Voice of Hope<br />
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<span style="font-family: Arial;">Alan’s story
appears in every<span style="mso-spacerun: yes;"> </span>International Stuttering
Awareness Day (ISAD) online conference from<span style="mso-spacerun: yes;">
</span>2002-2011. It’s a story that deserves repeating.<span style="mso-spacerun: yes;"> </span>Alan applies concepts of change with
remarkable results. He is a living, breathing example of a person who began
stuttering at age 3, reached a time in his life when he committed to change,
and then engineered his own total transformation. “I had achieved increased
fluency in a controlled environment,” writes Alan,”...[next] I had to deal with
personal issues involving communication with others...I drew up a plan of
action...I needed to do certain things over and over again until the behaviors
became familiar ....” (2003) Alan is a voice of hope for our children.</span></div>
<br />
<br />
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<span style="font-family: Arial;">All<span style="mso-spacerun: yes;"> </span>of Alan’s ISAD papers, his poem (9), and his
comic book story for children. Have a consistent message:</span></div>
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<span style="mso-tab-count: 1;"><span style="font-family: Arial;"> </span></span></div>
<br />
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<span style="font-family: Arial;"><span style="mso-tab-count: 1;"> </span>“If you are in a comfort zone,
afraid to venture out</span></div>
<br />
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<span style="font-family: Arial;"><span style="mso-tab-count: 1;"> </span>Remember, every stutterer was once
consumed with doubt</span></div>
<br />
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<span style="font-family: Arial;"><span style="mso-tab-count: 1;"> </span>So don’t hold back - just take that
step and seek those pastures new</span></div>
<br />
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<span style="font-family: Arial;">Embrace
your future with a smile, success is there for YOU.” (2003)</span></div>
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<span style="font-family: Arial;">“Changing the
Words Around” (2004) is a masterful children’s story written by Alan Badmington
and illustrated by Chris Badgett-Richards. (8)<span style="mso-spacerun: yes;">
</span>The main character is a hedgehog who copes with stuttering by avoiding
sounds that are too difficult to say. Alan himself recalls avoiding half the
alphabet. “I could not use words commencing with the letters ‘b’, ‘c’, ‘d’,
‘f’, ‘g’, ‘j’, ‘k’, ‘m’, ‘n’, ‘p’, ‘s’, ‘t’, and ‘v’... and “became a ‘walking
Thesaurus’”. (2005) Alan used word substitution, replacing <span style="mso-spacerun: yes;"> </span>words that were easier to say for the more
difficult ones. “I did not appreciate the harmful implications of such
behavior. No-one had ever explained that each time I avoided a word or letter,
the fear level increased.” (2006) Alan’s hedgehog orders slightly burnt toast
to avoid saying the /m/ in muffin, despite lots of mental rehearsal and the
best intentions. He betrays a friend and delays emergency home repair help
because of sound fears that escalate into automatic, uncontrollable, word
avoidance. The effect this avoidance has upon others leaves him feeling guilty
and creates a limited image of himself and his potential. </span></div>
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<br /></div>
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<br /></div>
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<span style="font-family: Arial;">“As someone who
commenced stuttering in early childhood, I developed many negative beliefs
about my speech behavior. As I experienced continuing difficulties throughout
my life, these beliefs became engrained...I learned avoidance techniques in
relation to words, sounds and situations. I perceived anything that challenged
my limited self-image as a threat to my well being.” (2003) See <span style="mso-spacerun: yes;"> </span>“How I Changed My Stuttering Mindset” (2005)
for a lengthy list.</span></div>
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</div>
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<br /></div>
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<span style="font-family: Arial;">Recognizing and
then challenging avoidance is a central message in Alan’s writings. “Each time
we avoid something, we strengthen its influence over us. We can evade for so
long, but the time will come when the situation demands that we have to say a
specific word, or speak in a particular situation. When that happened, I found
that my fear level had increased so much that I stuttered more severely.” (2007)
Alan applied “new techniques to the physical side” of speech to improve
fluency. (2009) Then, “[I] adopted a holistic approach, and working on
different areas of my life, my speech improved as a by-product.” (2009) <span style="mso-spacerun: yes;"> </span></span></div>
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</div>
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</div>
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<br /></div>
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<span style="font-family: Arial;">I wondered what
science might underlie Alan’s story. Stuttering is “a condition that is
heterogeneous in its symptoms and behavioral patterns.” (1)<span style="mso-spacerun: yes;"> </span>The onset and development of stuttering is
different from person to person <span style="mso-spacerun: yes;"> </span>“with
respect to predominant disfluencies (e.g., prolongations vs. repetitions),
onset characteristics (e.g., sudden vs. gradual), language skills (e.g.,
precocious vs. delayed), and relative profiles of strength/weakness (e.g., weak
phonology/weak language skills vs. weak phonology/strong language skills)…” (2)
<span style="mso-spacerun: yes;"> </span>Could it be that Mr. Badmington had a
stuttering subtype that was particularly responsive to his treatment approach?</span></div>
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</div>
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<br /></div>
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<span style="font-family: Arial;">Alan’s belief
that stuttering is a multifaceted disorder (3) may be consistent with the
scientific <span style="mso-spacerun: yes;"> </span>theory that language is “a
learned skill, based on a functional language system (FLS) that is distributed
over many parts of the human brain.” (4) If successful communication requires
many areas of the brain to work “in parallel, redundantly, in different
anatomical sites” (5), then treatment addressing multiple aspects would seem to
make sense. I may need to throw away my colorful plastic model of the brain
highlighting how different parts affect behavior. It is outdated, akin to the
ancient theory of phrenology. (6) “Neophrenological theories do not claim that
a bump on a person’s skull can tell you that he is honest. However, they claim
that activity confined to a particular part of the brain regulates a complex
aspect of behavior.” (7) I view this as good news. It means our children can
work to overcome stuttering in multiple ways.</span></div>
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<br />
<span style="font-family: Arial;"></span></div>
<span style="font-family: Arial;"></span><br />
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<span style="font-family: Arial;"><br /></span>
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<span style="font-family: Arial;"><span style="font-family: "Arial","sans-serif";">Let’s make
Alan’s achievements more than a testimonial. Let’s think about Alan’s story in
light of the idea that there is no single disorder called “stuttering” but
rather different subtypes.</span><span style="background: white; color: black; font-family: "Arial","sans-serif"; mso-fareast-font-family: Arial;">First, we do not know exactly the type, frequency, or severity of Alan’s disfluency. Would that
have made difference? Second we do </span>not know details about the onset of his
stuttering other than it began at age 3 and he received early therapy but <span style="mso-spacerun: yes;"> </span>“did not recall any major difficulties
until…11 years” of age. (2005) Was early intervention somewhat effective,
perhaps establishing early neural foundations for fluency? Third, how might
Alan’s exceptional language skills have contributed to his stuttering and to his
recovery?. He “edited several magazines; held secretaryship of numerous
organizations; [was] advisor to a fictional crime series on British
television…written humorous verse and other poetry…[wrote slogans] to win
hundreds of prizes…[and wrote] speeches/poems for use by other people.” (2008) These
questions might reveal important information; perhaps the subtype of stuttering
Alan experienced might have predicted the kind of stuttering treatment he found
effective.</span></div>
</div>
<span style="font-family: Arial;">
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</span></div>
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<span style="font-family: Times New Roman;">
</span></div>
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<br /></div>
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We could consider
the role of temperament as well. So as not to make a long article even longer,
I will simply wonder aloud if Alan was gifted with an outgoing personality. Maybe
this<span style="mso-spacerun: yes;"> </span>amplified the devastating effect
that stuttering had upon his quality of life. For example, he deplored being demoted
to a desk job. Also, his role model was a public speaker. “…April 1, 2000 when
I witnessed a PWS recounting how he had won several speaking trophies in formal
competition…was such a defining moment that the date is indelibly imprinted on
my memory.” (2011) I mean really - how many of us want to be a public speaker! Embracing
a new vision of himself as a public speaker, drawing upon years of challenges
he must have overcome as a police officer, and embarking on a rigorous action
plan, Alan “discovered incredible opportunities for growth.” (2011) </div>
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<br /></div>
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<br /></div>
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<span style="font-family: Times New Roman;">
</span></div>
<span style="font-family: Times New Roman;"><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 0pt; text-align: justify;">
<span style="font-family: Arial;">I am truly grateful
to Alan Badmington for being a voice of hope. I was thrilled to read that his
ideas were preserved in a series of video-recordings at Arkansas State
University. (2010) Yet, testimonials are not enough for speech language
pathologists (SLPs) who now must work in a climate of Evidence Based Practice.
There must be some science supporting treatment decisions. I recently read, once
again, that an SLP practicing fluency therapy must know all of the current
treatment options and for whom they will be most effective. I find this professorial
advice intimidating and unrealistic. Until research clarifies stuttering
subtypes and then prescribes corresponding treatments, how do clinicians know
for sure ‘what works’ for any given individual? In addition, it seems to me humanly
impossible to implement every possible treatment adequately. It seems more appropriate
that I explain my bias’ about stuttering, support that bias with research articles, and outline my preferred therapy methods.
Referring to other SLPs as needed demonstrates my respect for their specialized
competence. </span></div>
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<span style="font-family: Arial;"><span style="font-family: Times New Roman;">
</span></span></div>
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<br /></div>
<span style="font-family: Arial;"><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 0pt; text-align: justify;">
At the end of “Changing
the Words Around”, <span style="mso-spacerun: yes;"> </span>the main character buys
muffins at a 2-for-1 sale, one for himself and one for his best friend. <span style="mso-spacerun: yes;"> </span>The time had come: a decision to change, a
vision of success, a rigorous processes of challenging fear, creative and persistent
follow through, and just perhaps, a stuttering subtype responsive to this plan
of action.</div>
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<span style="font-family: Times New Roman;">
</span></div>
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<br /></div>
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<span style="font-family: Times New Roman;">
</span></div>
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“One
day, I decided, enough was enough</div>
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<span style="font-family: Times New Roman;">
</span></div>
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I
made myself promise, (although it was tough)</div>
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<span style="font-family: Times New Roman;">
</span></div>
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To
say what I wanted, whatever the letter</div>
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<span style="font-family: Times New Roman;">
</span></div>
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At
times, I still struggled, but I felt so much better. “ (8) </div>
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</div>
</span><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 0pt; text-align: justify;">
<span style="font-family: Times New Roman;">
</span></div>
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<br /></div>
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</div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(1)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">Carol
Hubbard Seery et. al., (2007)<span style="mso-spacerun: yes;"> </span><span style="mso-bidi-font-weight: bold; mso-fareast-font-family: "Times New Roman";">Subtyping
Stuttering II : Contributions from Language and Temperament,<span style="mso-spacerun: yes;"> </span>NIH Public Access p. 14 </span></span><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082140/"><span style="color: blue; font-family: Arial;">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082140/</span></a><span style="font-family: Arial;">
</span></div>
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</div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(2)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">Ibid.
p. 2</span></div>
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</div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(3)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">John
Harrison (2002) ”How I Recovered from Stuttering”<span style="mso-spacerun: yes;"> </span></span><a href="http://www.masteringstuttering.com/recovery-stuttering.htm"><span style="color: blue; font-family: Arial;">http://www.masteringstuttering.com/recovery-stuttering.htm</span></a><span style="font-family: Arial;">
</span></div>
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</div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(4)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">Philip
Lieberman (2002) <u>Human Language and Our Reptilian Brain</u>, Cambridge, MA:
Harvard University Press, p. 1</span></div>
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</div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(5)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">Ibid.
p. 6</span></div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(6)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">Phrenology:
“The study of the shape and protuberances of the skull, based on the now
discredited belief that they reveal character and mental capacity.” </span><a href="http://www.thefreedictionary.com/phrenology"><span style="color: blue; font-family: Arial;">http://www.thefreedictionary.com/phrenology</span></a><span style="font-family: Arial;">
<span style="mso-spacerun: yes;"> </span></span></div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(7)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">Lieberman,
P. <span style="mso-spacerun: yes;"> </span>p. 23</span></div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(8)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span style="font-family: Arial;">Alan
Badmington (2004) “Changing the Words Around” </span><a href="http://www.mnsu.edu/comdis/isad7/papers/badmington7/badmington17.html"><span style="color: blue; font-family: Arial;">http://www.mnsu.edu/comdis/isad7/papers/badmington7/badmington17.html</span></a><span style="font-family: Arial;">
</span></div>
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<span style="mso-list: Ignore;"><span style="font-family: Arial;">(9)</span><span style="font-size-adjust: none; font-stretch: normal; font: 7pt/normal "Times New Roman";"> </span></span><span class="googqs-tidbit1"><span style="font-family: Arial;">“EVERYONE'S DIFFERENT” </span><a href="http://www.mnsu.edu/comdis/isad7/papers/badmington7/badmington27.html"><span style="color: blue; font-family: Arial;">http://www.mnsu.edu/comdis/isad7/papers/badmington7/badmington27.html</span></a><span style="font-family: Arial;">
</span></span></div>
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<u><span style="font-family: Arial;"><strong>Alan
Badmington’s International Stuttering Awareness Day articles<o:p></o:p></strong></span></u></div>
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<span style="font-family: Arial;">2002: “<span style="mso-bidi-font-weight: bold;">For Better - For Worse” <a href="http://www.mnsu.edu/comdis/isad5/papers/weddingvows.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad5/papers/weddingvows.html</span></a>
<o:p></o:p></span></span></div>
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<div style="margin: 0.25in 0in 4pt;">
<span style="font-family: Arial;"><span style="font-size: 11pt; font-weight: normal;">2003: <span style="mso-spacerun: yes;"> </span>“</span><span class="googqs-tidbit1"><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;">STEP
OUTSIDE: Why expanding comfort zones can improve our stuttering</span></span><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;"> and lead
to more fulfilling lives” <a href="http://www.mnsu.edu/comdis/isad6/papers/badmington6.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad6/papers/badmington6.html</span></a>
<o:p></o:p></span></span></div>
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<span style="font-family: Arial;">2004: “ IT'S GOOD TO TALK ABOUT IT” </span><a href="http://www.mnsu.edu/comdis/isad7/papers/bridgebuilders7/alan7.html"><span style="color: blue; font-family: Arial;">http://www.mnsu.edu/comdis/isad7/papers/bridgebuilders7/alan7.html</span></a><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Arial;">2005: “How I changed My Stuttering Mindset” </span><a href="http://www.mnsu.edu/comdis/isad8/papers/badmington8.html"><span style="color: blue; font-family: Arial;">http://www.mnsu.edu/comdis/isad8/papers/badmington8.html</span></a><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Arial;">2006: “<span class="googqs-tidbit1">Technology: A friend or
foe of someone who stutters?” <a href="http://www.mnsu.edu/comdis/isad9/papers/badmington9.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad9/papers/badmington9.html</span></a>
<o:p></o:p></span></span></div>
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<span style="font-family: Arial;"><span class="googqs-tidbit1">2007: “TWO THINGS I WISH I'D
KNOWN ABOUT STUTTERING WHEN I WAS YOUNGER”</span> <span class="googqs-tidbit1"><a href="http://www.mnsu.edu/comdis/isad10/papers/messages10/badmington10.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad10/papers/messages10/badmington10.html</span></a>
</span></span></div>
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<span style="font-family: Arial;">2008: “Thanks To My Stutter, I'm
Never Lost For Words” </span><a href="http://www.mnsu.edu/comdis/isad11/papers/gift11/badmington11.html"><span style="color: blue; font-family: Arial;">http://www.mnsu.edu/comdis/isad11/papers/gift11/badmington11.html</span></a><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Arial;">2009: “How Beliefs and Self-image
Can Influence Stuttering” </span><a href="http://www.mnsu.edu/comdis/isad12/papers/badmington12.html"><span style="color: blue; font-family: Arial;">http://www.mnsu.edu/comdis/isad12/papers/badmington12.html</span></a><span style="font-family: Arial;">
</span></div>
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<span style="font-family: Arial;">2010: “<span class="googqs-tidbit1">Helping
tomorrow's therapists gain a greater insight into stuttering”</span> <span class="googqs-tidbit1"><a href="http://www.mnsu.edu/comdis/isad13/papers/tales13/badmington13.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad13/papers/tales13/badmington13.html</span></a>
<o:p></o:p></span></span></div>
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<span class="googqs-tidbit1"><o:p><span style="font-family: Arial;"> </span></o:p></span><span class="googqs-tidbit1"><span style="color: black; font-family: "Arial","sans-serif"; font-size: 11pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Arial; mso-fareast-language: EN-US;">2011:
“Sporting Milestone Helps To Set My Stutter On Right Track” <a href="http://www.mnsu.edu/comdis/isad15/papers/turning15/badmington15.html"><span style="color: blue;">http://www.mnsu.edu/comdis/isad15/papers/turning15/badmington15.html</span></a></span></span></div>
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<br />Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0tag:blogger.com,1999:blog-3698866522577265651.post-29945086676744503222012-01-31T08:46:00.000-05:002020-04-11T14:28:30.961-04:00A Parent Group: Unity, Acceptance, Trust<br />
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<span style="font-family: "trebuchet ms";">The inaugural parent group meeting in January was very
promising. Three of us chatted over tea and hot chocolate at a local
restaurant. (Next time we'll have cookies!) The 7:30 pm start time was after
the dinner crowd had gone home, leaving the dining area with few distractions
and greater privacy. When the meeting ended, I was genuinely grateful for our
time together. </span></div>
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<span style="font-family: "trebuchet ms";">There was no agenda or informative handouts. Instead, I
trusted the moment. This was mildly frightening for me, a person professionally
trained to write lesson plans. Fortunately, the two mothers who attended
immediately warmed to one another and easily found areas of mutual concern.
Each wanted to nurture their children's communication skills for assertive
self-expression, classroom participation, social interaction, family support,
personal growth, and increased fluency. They did most of the talking, just as
I'd hoped.<o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>I've been a part of
many small groups for a variety of reasons. I've volunteered for religious and
secular committees, educational organizations, and recreational clubs. I've
been a leader and a follower, always acting within a superimposed framework to
achieve short term goals. As I wondered about a format for this parent group, I
discovered two completely different approaches.</span></div>
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<span style="font-family: "trebuchet ms";">One was a parent program called the MAGIC Project (2). MAGIC
stands for Maximizing Academic Growth by Improving Communication and was
organized by speech language pathologists in a large urban school district. The
5-hour, 1-day format was tightly controlled and included instructional goals.
Parents were taught concepts of child development, how good communication
skills improved academic performance, and how to follow through at home in ways
that were consistent with school expectations. While the format did include
group discussion, the feeling of parents-as-students didn't resonate well with
me. <o:p></o:p></span></div>
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<span style="font-family: "trebuchet ms";">Since I didn't want to instruct<span style="mso-spacerun: yes;"> </span>a parent group, I picked up a book on how to
facilitate one. (1) "The main belief behind group facilitation is that
full cooperation between all people is both possible and desirable--values of
equality, shared decision-making, equal opportunity, power sharing and personal
responsibility are basic to full cooperation." (p.2) I liked the sound of
that. A facilitator is present and flexible, honoring both the individuals and
the group. A facilitator does not add content to discussions, but rather
fosters a safe, creative space for group members to find "unity,
acceptance and trust." (p. 44)<span style="mso-spacerun: yes;">
</span>Purpose, vision, and learning emerge from member interaction. </span></div>
<br />
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<span style="font-family: "trebuchet ms";">Ground rules are required regardless of what form my parent
group may take. Members need to be responsible for choosing how much personal
information as they wish to share. My role as speech language pathologist
demands that I respect confidentiality and will not divulge any personal
information about group members. Mutual respect is paramount. Everyone's
situation is a unique conglomeration of experiences, values, personal
qualities, education, personal history and more. Sometimes advice is welcome
but not usually.<span style="mso-spacerun: yes;"> </span>People generally prefer
to talk about what's on their minds and know that others are truly listening.
Everyone learns a little something from one another this way.</span></div>
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<span style="font-family: "trebuchet ms";">I'm looking forward to finding a balance between teaching
and facilitating. I will share what I know about communication and fluency when
it seems appropriate, certainly not in the form of a syllabus or agenda. I
expect the parents will be the real teachers. They say 'When the student is
ready the teacher will appear.' I'm ready. </span><br />
<br />
<br />
<span style="font-family: "trebuchet ms";">p.s. Visit the National Stuttering Association Family Radio Show for world-wide support at broken link</span></div>
<br />
<br />
<br />
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<span style="font-family: "trebuchet ms";">1.<span style="mso-spacerun: yes;"> </span>Hunter, D.,
Bailey, A., Tayor, B. (1995) The Art of Facilitation: How to Create Group
Synergy. Fisher Books.<o:p></o:p></span></div>
<br />
<br />
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<span style="font-family: "trebuchet ms";"><span style="mso-spacerun: yes;"> </span>2.<span style="mso-spacerun: yes;"> </span>Farber, J.G. & Goldstein, M.K.
(1998) “Parents Working With Speech-<o:p></o:p></span></div>
<span style="font-family: "trebuchet ms";">Language Pathologists to Foster Partnerships in Education,” <span style="mso-spacerun: yes;"> </span><i style="mso-bidi-font-style: normal;">Language,
Speech, Hearing Services in Schools,</i> 29, 24-34.<o:p></o:p></span><br />
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Judy Butlerhttp://www.blogger.com/profile/07797330063447297490noreply@blogger.com0