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From: Joseph Dewey
Date: 08 Oct 2005
Time: 14:41:25 -0500
Remote Name: 24.10.194.97
Hi Lindsay. Most of my therapy centered around slowing my speech down. I think I've mentioned that this is an important ability for every clutterer to develop, but that this is really only the first step toward really dealing with cluttering. This was done in a variety of ways, from using the DAF machine to modeling my therapist. I think that modeling my therapist's speech was extremely beneficial, and I think we should have done more of that. I remember that they had a pitch machine, where I spoke into it, and it recorded different pitches, etc. The stuff they gave me was way too advanced for the level that I was at, so it was really frustrating, but it could have been really helpful if they would have started with very remedial pitch exercises. Something that I did recently which was really helpful and similar to the pitch machine was singing on Xbox Karaoke at a friend's house...It's got an indicator to show how your voice changes notes. Another popular therapy that I've heard is reading one word at a time from a book through a cutout. I think that this would be beneficial, because clutterers tend to skim rather than to read. Also, so much is unknown about cluttering that at this point your cluttering client may know more about cluttering than you do. Also, the cluttering client is likely to be pretty smart and very interested in problem solving, and so I think that each SLP should ask the cluttering client, "What do you think the best therapies would be for you?" Give the client the time in between the session to think about it, and I think you'll get some excellent responses. One of the best suggestions for therapies comes from an article Dr. Charles Van Riper wrote, as part of St. Louis' and Myers' book. It goes: "We have been able to help some of these people learn to control their unruly tongues enough to speak very well when the occasion so demands. Few, however, will be able to sustain this in other speaking situations. The prognosis for attaining even this limited goal is not favorable unless, somehow, you can establish a fairly close relationship based on mutual respect... At first don't ask him to speak slowly even though, when he does so, his communication will markedly improve. You'll find that he cannot tolerate the slower rate. Instead, find other ways of slowing him down until that tolerance is increased. Try reading in unison and begin by using a very fast rate yourself, then gradually returning to a more normal rate. Have him learn to shadow your speech and then the speech of others. Have him repeat phrases and sentences that you utter with different tempos. Have him write down the words he wants to say before saying them. Have him tap the words of his forthcoming utterance before he speaks them or hums them. Record samples of his rapid confused speech, desensitize him to them, then have him translate. Have him teach you how to speak clutteringly. Using recorded samples, jointly analyze the omissions, repetitions, slurrings and other cluttering features. With prepared written material teach him how to clutter on purpose before trying to say it better. Have him echo both your deliberately cluttered speech and then your normal version. Using more prepared sentences, have him read them faster and faster until complete breakdown occurs, then listen to the recording. A most valuable technique is to teach him to pause and to tolerate that pause for increasing lengths of time. For this, you will have to use modeling and various signals to indicate when to stop and when to get going again. Adequate pausing will slow down his speech more than any amount of exhortation to talk slowly. The clutterer's speech is highly disorganized, and he needs some training in this area. Memorization of short quotations that may be useful in the future can help. Have him provide a running commentary on what is happening in the children's playroom. Telling a joke well takes considerable discipline so have him collect them to tell you. Take turns finishing each other's unfinished sentences. Use Shannon's guessing technique. Do some role playing of situations in which he must speak coherently such as applying for a job or asking a girl for a date or giving directions to a stranger hunting for a store. Explore his ability to do mental multiplication verbally, not silently. Throughout your therapy sessions, devote some time to producing his oral autobiography and record it but only after practice has enabled him to do a short portion of it without any cluttering behaviors. Make this a cumulative project. Now that you've read this, read it again and ask yourself what the purpose of each suggested activity might be. You must not limit yourself to these suggestions. I'm sure you will be able to invent better ones. You will meet many failures and difficulties, but persevere. He needs your help if he is to hope to speak at all adequately. Care for him and confer with me often."