**SPHP 219 class—there are a few slides with ** on them. These slides will NOT be on test 3.

Basic CounselingConfidential

Non JudgmentalActive Listening

Effective FeedbackCulturally Sensitive

Age of ClientEducation of Parents

Family Values, Resources

Effective treatment of families and PWS means addressing all aspects of stuttering

Physical, Cognitive and Emotional Aspects of Stuttering.

SLP job provide appropriate therapy

Counsel you about the feelings that you experienceDevelop a framework for thinking about stuttering

Develop practice exercises that fit your lifestyle and personality

Develop a healthy attitude about stutteringProvide resources (NSA,SFA)

sort through media hypeconference with family, school, work

Are you desensitized to stuttering?

Your skill set is limited So is mine

Be honest with yourself, your client and your supervisor about your strengths and needs

Obtain support from mentors, CEU courses, outside agencies to craft a program that works

Establish credibility with honest exchange of information

I will provide treatment for you/your child as long as I feel you are receiving the

best services. Like most SLP’s we rarely see PWS because

only 5% of children and 1% of the adults stutter. Its very

unusual for any SLP to have the opportunity to treat a large

number of PWS.

Establish your treatment goals and when/if you will refer out.

Plan in the beginning for the transition to the next phase of growth.

An outside referral may be for a limited time or may be a permanent transition.

Sample wording for transition:

I know you appreciate the services I have provided. As we discussed when we started working together my professional obligation is to refer you to others

when needed.

I have taken you as far as I can and your needs will be better served if I refer you to an expert who may

support your goals.

Counseling Be Honest about Stuttering

Unless you are a PWS, admit you don’t know how it feels to stutter.

Ask most PWS and they will tell you they get pretty upset when a therapist nods and says:

Gee, I know how it feels.

It’s okay, don’t be nervous.

Don’t worry, when I’m nervous I stutter too.

Acknowledge they are the experts regarding the experience of stuttering

You might say:

I can imagine how frustrating it might be.I don’t stutter can you share with me how it

feels to stutter?

If you were to share with your parents/spouse/employer what its like to

stutter what would you tell them?

Establish top three goals for the PWS

Establish top three goals for associated

support network.

For PWS

Establish the range of their stuttering symptoms.

What happens most often?

Provide chart with range of symptoms and samples.

Use their language, terms and descriptions.

For PWS

Acknowledge the sadness, the grief, the lost opportunities

and the effect on their life.

Do they accept their stuttering?Do they feel its their fault?

What do they feel before, during and after the moment of stuttering?

For PWS

Establish goals regarding advocating and advertising that they

stutter.

Be careful not to minimize their feelings.

Create a positive goal for homework

My wording-let’s build from thereThat’s a good start

For Spouse or Parent of PWS:

Ask about origin, progression, what helped, what didn’t work, techniques, technology, behavioral cognitive strategies, community resources, groups, reading,

videos, movies, intense programs, NSA, SFA, friends, support network, finances, coping skills, family history of stuttering, cluttering, learning issues, research, drugs,

counseling, emotional concerns, Toastmasters.

For a child who stutters review:

Their strengths, activities they enjoy, do they know why they came to see you today, do they like the way they talk, show pictures of how they feel, have they been

bullied or teased, do they know anyone else who stutters, what do they call their bumpy speech, use art, building, make books, play therapy, watch videos if child

is ready.Don’t videotape or play back tapes of PWS unless they

are ready.

For SLPDo the clients goals reflect your needs or theirs?

No guinea pigs

Example: “I want to work on _____.” (you open the 1st page of the therapy book you just purchased.)

Instead build on past positive experience: “You mentioned you successfully used vowel prolongations in past

therapy, let’s start using that with rote activities, then use vocabulary specific to your occupation.”

Let me know if any task is too easy, it’s too difficult, or if it’s just a little challenging.

For SLP Show client chart with numbers to establish

common rating system. Ask client to provide feedback using numbers or

colors.

Assure client that while you work with them you will always model techniques first ,use techniques as a team and when they are ready they will practice

technique alone.

Wording: prefer that ______, ready for ______, in or out of comfort zone, ready to risk.

When your with me, you’re safe, our discussions are confidential and you’re free to stutter.

For SLP

Do You Have Preconceived Ideas About PWS That Hinder Your Treatment

Effectiveness?

Examine Your Beliefs About PWS.

Review Current Research Before and During the Treatment of PWS.

For SLP-what to expect

Which of the following statements is likely to be spoken by a PWS?

I know what I want to say and wish others would just wait for me to finish talking.

I feel like my head is going to explode if one more person tells me to slow down.

What’s wrong with me-why can’t I control my stuttering?

For SLP-what to expect

Which of the following statements is likely to be said by an adult PWS?

I wish that I had been treated for stuttering at an earlier age.

I am frustrated with all the misinformation about stuttering.

Most SLP’S know a lot about PWS.

People with autism, aphasia and physical disabilities are treated and understood better than PWS.

For SLP-what to expect

The parent of a child who stutters usually:

Is concerned that they caused their child’s stuttering.

Wonders if they are doing anything to prolong stuttering.

Feels guilty that they can’t help their child.

Have tried their own solutions.

For SLP-what to expect

Parents often react differently to child that stutters based on their own Hx, mental health and coping

skills

Mom – May not help child due to Dad’s resistance

Dad who stutters– May be resistant due to guilt, blame, shame “I gave this to my child.”

For SLP-what to expect

Discuss with parents

What if you knew in advance that:your child would stutter?

Have dyslexia? Win a gold medal?

What have you learned from your child?

For SLP-what to expect

The parent of a child who stutters usually:

Feels embarrassed and confused about what to do when someone comments about their child’s

stuttering.

Feels frustrated and confused about treatment-they consulted three SLP’s and all three provided

conflicting advice.

For SLP-what to expect

The Parent of a child who stutters is comforted and served best when you:

tell them the truth.provide concrete examples of stuttering.

help them to recognize all aspects of stuttering.help them to respond to the comments of others.reassure them and strengthen their skills as their

child’s stuttering fluctuates.provide the most current research, techniques and tools for the efficient management of stuttering.

For PWS

Explore their feelings about stuttering.Use therapy tools which explore their

feelings.

All feelings are okay.It’s what you do with the feelings that

matter.

For PWS

How much pain has stuttering caused in their life?

Do they feel it has altered their education, social life or choice of

occupation?

For PWS

If you could change one thing about your experience with stuttering what

would it be?

What character traits have you developed as a result of stuttering?

Explore their strengths.

For PWS

Things I like about myself.

Things I would like to change.

Increase PWS awareness of perceptions

Are their perceptions accurate? Distorted thinking is common

Complete these sentences:People think that kids/PWS are _____

My Teacher thinks kids who stutter are _____My employer thinks PWS are _____

I think that PWS are _____My Friends think that PWS are _____

Don’t ignore the negative, rather, channel into more productive

statements.

Channel negative energy into positive.

Provide written, tactile and verbal resources for home assignments.

As an SLP you have the power to impact the life of a PWS, their family

and our societyAs an SLP you have tremendous power

to influence PWS

Students who stutter are still alone in an articulation group

Articulation is addressed over stuttering

Stuttering gets worse, the window is closed

Articulation vs. Stuttering treatment

PWS are more vulnerable because of low incidence

Less money, less research, invisible disability, not great for TV or radio

spots

PWS & NSA** Group Attendance

Nice to belongPlace to practice

Learn from othersHelp others/mentor

Understand spouses experienceAppreciated for true self not as PWS first

PWS & NSA**No Group Attendance

“Not joiner”Private person

Not ready to admit they are part of “that group”Group Distance

Resources are limitedEmbarrassed to be PWSAngry with SLP’s, MD’s

Tired of talking about stuttering

SummaryTreatment needs to be about PWS goals

Evidence basedTimely

Combined eclectic approachNot cookbook therapy

Individual, group and real worldOver learn skills to speak under stress

You are critically important

You have power

Enhance PWS’ life by providing the best care

Stuttering Resources **

FluencyCoach Free Software-AAFOnline Metronome-Pacing

SpeechEasy-FAF in or behind earMySpeech-personal AAF device

Friends – The National Association of Young People who Sutter

National Stuttering Association (NSA)Roseville-Sacramento NSA Chapter Group

Stutter TalkThe Stuttering Home Page

ToastmastersCalifornia Department of Vocational Rehabilitation