Another Kind of Letting Go
by Louise Heite
from Alaska, USA
Those of you who have read Adam DeMello's essay have doubtless noticed that he is presently "taking a break" from therapy. This section will deal with how and why he, his family, and I together decided to take the rather unusual step of suspending therapy for the immediate future.
I began working with Adam in the fall of 2001, when I took a job as speech therapist at Kenai Middle School in Kenai, Alaska. He impressed me right away with his open demeanor, his cheerfulness, and his willingness to work. More than that, he did not display any of the poor self-esteem that so often develops in young people around the age of puberty, particularly when they have an extra burden such as stuttering to try to integrate into their blossoming personalities.
Adam is a "moderately severe" stutterer, at least in terms of raw dysfluency count. However, he shows almost none of the physical tension or avoidance behaviors that usually plague people who are as dysfluent as he is. His stuttering consists almost entirely of open, unstruggled consonant-vowel syllables at the beginnings of words. He does avert eye gaze on occasion, but not often. In developmental terms, his stuttering resembles more nearly what one might find in a preschool child in the early stages of stuttering than what one might expect from an young teenager who has been stuttering most of his life.
Adam has been in speech therapy for a long time. He has described learning some therapy techniques that seem to be based on fluency shaping. He has expressed a preference for reduced rate of speech as a management mechanism. He has told me that he never avoids a word in a class discussion just to avoid stuttering, and his classroom teachers have confirmed that. In reference to his family background, he once laughingly referred to himself as "The Stuttering Hawaiian."
During therapy sessions, Adam did everything I asked. In an exercise designed to help him become aware of the details of his stuttering behaviors, he learned quickly to be aware of his articulatory postures and his eye gaze. He discovered that he could "head the stutter off at the pass," so to speak, by employing some stuttering management techniques, which were new to him. Like most people who encounter pseudostuttering for the first time, he found the idea of deliberately stuttering in order to diminish stuttering to be somewhat absurd, but he gave it a try anyhow. To his surprise, it did relieve some of the involuntary stuttering, but not as much as his reduced speech rate did.
Over the course of the year, it became increasingly clear to me that for Adam, his stuttering was a characteristic but not a problem -- at least, not enough of a problem that he wanted to take time from his busy and rich life to work on it. That is a very important distinction, which has some legal implications in the context of the Individualized Educational Plan (IEP).
The raft of Federal regulations that surround the IEP process require school staff to consider whether termination of therapy would do harm to the student. If we cannot document that the student's disability impacts either academic performance or social interactions in the school setting, the student may not be eligible for special education services, no matter how severe the disability. However, schools are required to make accommodations for students who have differences and disabilities but who do not necessarily qualify for special services, to enable them to perform to the best of their ability. Because Adam is an A-B student and holds positions of leadership among his peers, I had to consider carefully whether to dismiss him from therapy despite his stuttering, and to require accommodations instead.
As well-adjusted and self-directed as Adam is, it was evident to me that stuttering still held some threat to his future successes. He mentioned in his essay that the occasional bully can still hurt him, although he handles that occasional bullying with great aplomb. He still has some trouble maintaining eye gaze when he has a noticeable stuttering moment. The temptation to avoid words always lurks in the shadows. And, as any person who stutters knows, the severity of one's problem can vary greatly over the course of several years.
However, Adam wanted "out of jail," and I could not see any immediate reason not to grant him his "parole." Therefore, when his Individualized Educational Plan (IEP) conference came due in the Spring, I proposed to him and to his mother that he take a vacation from speech therapy. I outlined my concerns to both of them, but I also stated that for the time being at least, Adam did not seem to be very interested in pursuing therapy. In a team decision, we placed him on "monitoring" status, which retains his eligibility for speech services, but does not require him to visit the speech room on a regular basis. Nevertheless, if he should experience a setback, he can quickly return to direct services without having to go through all the paperwork that would be required if we had dismissed him outright.
I really wish that I could claim some credit for Adam's remarkable success in learning to deal with his stuttering and, as he has said it, "getting on with life." I can't. I have to take my hat off to his family, to his prior therapists, to the teachers who have recognized his talents and encouraged them, and most of all to a remarkable young man who has learned a lesson at a very young age that many people decades older than he is are still struggling to master.
-Discussion-
August 20, 2002