prevention of stuttering From: Jessica Schneider Date: 10/4/99 Time: 11:35:47 PM Remote Name: 209.105.54.105 Comments The ongoing project in Denmark has some very worthy goals. It is mentioned in the report that for the last decade, intervention toward young children has focused on the prevention of stuttering. My question is, what are the methods used to do this? What kinds of things are the speech therapists using to prevent stuttering? Re: prevention of stuttering From: Hermann Date: 10/5/99 Time: 1:42:38 AM Remote Name: 194.255.2.112 Comments Hi Jessica, Mainly the speech therapists are using parent counseling. In the more severe cases where counseling does not suffice, the children are referred to more direct treatment working with the stuttering symptoms as well as couseling. In Denmark the therapeutic approach working with stuttering in young children is inspired by ao. Carl Dell and Woody Starkweather. But many speech therapists are still afraid of working with school age children. The main reason being not feeling qualified for that work. Regards Hermann Re: prevention of stuttering From: Re prevention Date: 10/5/99 Time: 1:58:55 AM Remote Name: 194.255.2.112 Comments Jessica, Perhaps I should add, that the term "prevention" is used in the sense to ameliorate the stuttering and/or prevent stuttering from becoming a life-long social handicap. The stuttering in itself is not "prevented" (since it is already present), but the ramifications are - hopefully - prevented (and many speech therapists claim that they do not any longer meet those very severe school age stutterers they met a decade or two ago - this is a controversial issue though: other speech therapists claim that they are there, but they are typically covert stutterers, and you are not skilled enough to find them). Regards Hermann Diagnoses in the school classroom From: Les Anderson Date: 10/5/99 Time: 11:08:40 AM Remote Name: 209.52.196.4 Comments Mr. Christmann, There is another very important problem with early intervention that you failed to touch upon in your paper. The child in classroom who is just beginning school and who is showing the early signs of stuttering. The university teacher's curriculum does not teach anything to teachers about recognizing the onsets or the early signals of a child who is starting to stuttering. Many children have been misdiagnosed by a teacher as just being shy, not paying attention so cannot verbally answer questions, is a slow learner or is a loner because the child avoids contact with other children. I have heard of cases were children who stuttered have been put into special classes because it was thought that the child had a learning disability. I think we all recognize the school classroom or playground can be devastating place for a child who stutters How would you propose that a child receives the proper diagnoses in situations as mentioned above? This is a critical age for children who stutter to receive attention for their speech difficulties, but if the teacher has no idea what these tell tale signals, who refers these children to the school's SLPs? Les Anderson Re: Diagnoses in the school classroom From: Hermann Christmann Date: 10/7/99 Time: 10:18:23 AM Remote Name: 194.255.2.112 Comments Les, I think we have met. I attended the ISTAR clinic in Edmonton in July 1992, where you came and addressed us, during a lunch break as far as I recall. Although I did not address the role of the school teacher in my paper, I, and other parties are fully aware of that problem. In our country, teachers don't get any education in stuttering, and this is indeed a black spot. Quite often I meet teachers who have taught for decades, who tell me they have never had a stuttering student in any of their many classes during those decades! My personal opinion is that there are many, and more than you would suppose, students in school who are very "clever" at hiding their stuttering, and their teachers have no idea at all that they stutter. In The Stuttering Association we are working on having "handicap", including stuttering, as a part of the curriculum for teachers. In the meantime we can try and inform teachers and we can encourage speech therapists to inform teachers about stuttering and its many subtle representations. Thank you for responding. Warm regards Hermann prevention of stuttering From: Jessica Schneider Date: 10/5/99 Time: 7:23:54 PM Remote Name: 209.32.248.92 Comments Thank you for taking the time to answer my question. Your explanation and clarification of "prevention" was very helpful. Re: prevention of stuttering From: Hermann Date: 10/7/99 Time: 10:22:58 AM Remote Name: 194.255.2.112 Comments Jessica, You may look into Starkweather et al. Stuttering Prevention, a clinical method. Englewood Cliffs. Prentice Hall. 1990. As far as I remember they have a discussion there on different types af prevention. Hermann Re: prevention of stuttering From: Woody Starkweather Date: 10/21/99 Time: 3:44:13 PM Remote Name: 155.247.229.221 Comments Hi Everyone: There is indeed such a discussion in our book, but we simply adopted the definition of prevention given by the American Speech-Language-Hearing Association, which is that there are three levels of prevention -- primary prevention, which prevents a problem develop in the first place, secondary prevention, in which a disorder is recognized in its earliest stages and is prevented from becoming a chronic condition, and tertiary prevention, which prevents and existing problem from becoming worse. Our stuttering prevention program is aimed at secondary and tertiary prevention. Woody Re: prevention of stuttering From: Hermann Christmann Date: 10/22/99 Time: 3:14:35 AM Remote Name: 194.255.2.112 Comments Hi Woody, Thank you for the elaboration. Hermann parent groups From: Brenda Natala Date: 10/20/99 Time: 3:40:20 PM Remote Name: 206.131.108.2 Comments Why do you think parent groups are difficult to sustain? With parents of young children, and parents of children who are mild stutterers, I have felt that perhaps the parents are reluctant to identify their child as a stutterer. They hope that stuttering will go away through maturation or therapy, therefore, they are not ready to see their child labelled as a serious stutterer that necessitates attending support groups. Here in the US, parents are very busy and under alot of stress with careers, sports, and music lessons, etc. That may also contribute. I am impressed by your intervention program and feel you are way ahead of us here in Minnesota. We who work in the schools have high caseloads and lack the specialized expertise on fluency. There is also a shortage of private practitioners who specialize in fluency. Keep up the good work! I look forward to hearing your results next year at ISAD 3. Re: parent groups From: Hermann Christmann Date: 10/22/99 Time: 3:27:55 AM Remote Name: 194.255.2.112 Comments Brenda, Why parent groups are difficult to sustain - is indeed the 64.000 dollar question. I have no clear explanation, only some tentative contemplations. As you mentioned, parents often hope, that their child will outgrow the stuttering, especially as it often is very variable in youngsters. Further, entering into a group requires an active decision - may be a threshold to many. Interests are divided, some parents focus only on their own child and its needs, others are more prone to do a more outgoing or "political" job working for better services in the field etc. Many need som kind of initial "push" to be engaged in a group. That could be a parent group established as an integrated part of the therapy. I have the impression, that those groups established in connection to a treatment are the most stable, although they also tend to evaporate after a certan time. Hermann Re: parent groups From: Hermann Christmann Date: 10/22/99 Time: 3:42:54 AM Remote Name: 194.255.2.112 Comments Brenda, I forgot to comment on the rest of your letter. What you tell about the schools and the therapists in Minnesota...well, it could be translated directly into Danish and it would perfectly describe the state here in Denmark. That is one of the reasons for initiating the project. Hermann Comment on Intervention From: Lynn K. Bender Date: 10/21/99 Time: 4:28:10 PM Remote Name: 136.234.50.67 Comments I commend you for the undertaking of such a project. I have always been a proponent of early intervetion. I look forward to what type of results you achieve in the coming years. Good Luck!! Re: Comment on Intervention From: Hermann Christmann Date: 10/22/99 Time: 3:29:11 AM Remote Name: 194.255.2.112 Comments Lynn, Thank you very much. Hermann