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From: Darrell Dodge
Date: 14 Oct 2004
Time: 14:38:09 -0500
Remote Name: 198.81.26.41
Hi Vasu: With regard to the replacement behavior, I actually *was* talking about "playing with the stutter and pulling out of it." When you pull out of it, you're really doing a gentle onset on the subsequent sound. That's the integration we're talking about. We would reinforce the "fluency shaping" part by working on a smooth and easy mouth opening. This is not addressed in most "pure" fluency-shaping programs with which I'm familiar. Of course, this is going to end up looking very different for different people at different times. You're absolutely right that situational fears need to be addressed. These confrontations are facilitated by success in making speech modifications. And situational fears are often what brings people who stutter to therapy in the first place. We work this into therapy as much as possible, particularly in group therapy. But people usually make changes on their own. They'll start using the phone instead of driving across town, ordering at the drive-in, not leaving the room just before introductions, accepting promotions, changing jobs, joining professional associations, doing volunteer work, taking a class, trying Toastmasters, etc. etc. Thanks again for your questions and comments. - Darrell