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From: Ellen-Marie Silverman
Date: 18 Oct 2007
Time: 12:43:38 -0500
Remote Name: 205.188.117.17
[[" . . . I was wondering as an SLP, do you often encounter parents who want their children to change, but children who do already love themselves for who they are, and are not interested in experiencing change in their speech? If so, how do you approach such a situation? . . ."]] >>> Dear SLP Student, you raise a very germane question for which I am not able to provide a definitive answer, but I do have a suggestion or two. Let me just state that I have encountered more than once the circumstance where a child was refusing the therapy the parents wished to provide for their child. And in each instance, I felt the therapy was having no positive effect but, probably and unfortunately, a negative one. As soon as I was convinced that continuing with the therapy I was able to offer might be unhelpful in the long run, I explained that to the parents/caregivers as the reason I was no longer willing to work with their child. One client comes to mind. I encountered him when he was seven and stuttering often and with considerable effort. His father spent more than 30 minutes of the first meeting trying to coax him to enter the therapy room. When he finally did, he was essentially mute, only willing to nod or shake his head to "yes/no" questions. I saw him several times after that, confident I could reach him since I had a pretty good track record of connecting well with children. While his demeanor did soften and he was willing to speak to me, I found him basically resistant to any suggestion or direction I gave him to involve himself in a task or activity, so within approximately six sessions, I discharged him believing he essentially viewed our interaction as a contest of wills. About 8 weeks ago, I was surprised with a call from his father seeking voice therapy for himself. He told me that his son, now 23, had been an extremely poor student, had made many unfortunate choices, but had straightened himself out after enlisting in the US Army and he now had a "very nice" girlfriend and had chosen to enter college. So, I'm not sure whether, as the child he was when I treated him, he was unwilling to change. With hindsight, I think he may have been oppositional. With children who behave as he did, I now would always seek input from a psychologist to determine whether or not the child was showing oppositional behavior and whether speech therapy could be structured to take that into consideration to help him speak with less struggle and shame. So, as usual, as life is layered and complex at every instant, we as SLP's need to take time to make the most thoughtful decisions we can about what we can offer each client. >>> Thanks for asking this most relevant question. Sincerely, Ellen-Marie Silverman