COMPONENT 9. FACILITATION OF DEVELOPMENT OF SELF-AWARENESS AND SELF-MONITORING SKILLS, AS THEY RELATE TO FLUENCY
Rationale: They client must be able to effectively identify, through adequate self-monitoring skills and self-awareness, those elements which are interfering with his/her fluency. Development of these skills is crucial to the attainment and maintenance of fluency.
Research:
Conture (1990) - has observed that as the client learns more about the "where" as well as the "when" of their stuttering patterns, they begin to learn more about how these behaviors interfere with speech.
Cooper and Cooper (1985) - strongly believe that school-age children who stutter must develop self-awareness of stuttering patterns and associated behaviors as part of their intervention program.
Ham (1986) - "elements of self-analysis should be available as part of the stutterer's own knowledge and be functional during any situation in which he or she participates" (pg.69).
Perkins (1973) - states that awareness of the specific stuttering behaviors that must be managed is crucial.
Van Riper (1973) - strongly advocates teaching the dysfluent child to identify his/her own primary and secondary stuttering behaviors.
Activities/Techniques:
1. Tape record - Use of audiotaped speech samples is helpful in initial identification of primary or audible secondary behavior(s) as well as continued identification of inappropriate rate and audible tension. Audiotaping is also helpful during the later stages of therapy to improve self-monitoring skills. The client may be asked to assess a sample of his/her speech for effectiveness of technique use.
2. On-line identification - The clinician first identifies primary and secondary behaviors or easy and hard speech for the child. Then the child gradually begins the identification of these behaviors himself/herself. It is helpful to contrast the identified behaviors with easier forms of saying the word or describing what made the word hard. Cooper and Cooper (1985) developed the "Apple Core" worksheet which provides a visual demonstration of one's stuttering (the apple core) and what one does because they stutter (the seeds).
3. Identifying behaviors in the clinicianŐs speech is a helpful way to initially increase the childŐs awareness.
4. Contrast drills - Using word lists, the client is instructed to produce each word - first hard, then easy. The clinician aids the client in identifying what made each word hard or easy.
5. For the latter stages of therapy, the clinician must cue the client to monitor those aspects of his/her speech which may be interfering with fluency. Gestural cues may be adequate; however, verbal cueing such as "Did that feel hard?", "Is your mouth open enough?", and "Did you feel that you had no air for speech?" may be more helpful.