Volume 9, Number 3 September 1999

Eugene B. Cooper

Coordinator’s CornerSteering Committee’sThanks

Our division continues to growand enjoys a reputation among thedivision Coordinators as being a pro-totype of how special interest divi-sions can serve their affiliates and,simultaneously, the greater good ofall ASHA members. Speaking for themembers of our Steering Commit-tee, we take pride in this reputationand are deeply grateful to all of youfor your continuing support rangingfrom the payment of your annualdivision dues, to attending the an-nual leadership conferences, to serv-ing on the Division 4 committees andtask forces, and to your willingnessto openly share your thoughts onhow the division can best serve thosewe are committed to serving.

Oliver Bloodstein ReceivesFraser Award

One of the most gratifying andmoving moments for me at the SixthAnnual Leadership Conference wasthe presentation ceremony at whichOliver Bloodstein received the Stut-tering Foundation of America’sMalcolm Fraser Award presentedeach year at the division’s AnnualLeadership Conference. It has beenmy good fortune to know Dr.Bloodstein for more than 40 years,and, for as old as I may grow to be, Iwill always look up to him as a greatman whose work so influenced myown. He was a role model for me asI began my academic career and he

continues to be one to this day. Iknow of no kinder, gentler, morecompassionate, articulate, creative,and caring professional than Dr.Bloodstein. We are all uplifted by hispresence at our conferences and, thistime, we got to tell him so.

Sixth Leadership ConferenceThe exploration of creativity in

the treatment of those who stutterproved to be a popular topic to 70plus affiliates meeting in San Diegoin late May, 1999. Presentations, rang-ing from a “strict” behaviorist point-of-view to a “free-the-spirit” typeapproach that could be described asbeing spiritually-based, energizedthe conferees in attempting to iden-tify guiding principles in the use ofcreativity in the treatment process.After 2 days of discussion, recordersfrom five break-out groups presentedto all conferees the consensus of theirgroup’s thinking on the issues in-volved. It was a stimulating confer-ence and participants were unani-mous in expressing their gratitude inbeing able to address the issues in-volved. We look forward to the writ-ten report of that Conference onwhich, of course, you will be asked tocomment before it is accepted as a

Oliver Bloodstein receives the MalcolmFraser Award from (left) JenniferWatson, Division 4 SteeringCommittee member, and Jane Fraser,Executive Director of the StutteringFoundation of America.

division-approved document. Steer-ing Committee member Jennifer B.Watson is to be commended for allher good work as the conference co-ordinator and for her willingness towrite the first draft of the conferencereport.

Seventh LeadershipConference

Plans for the Seventh AnnualLeadership Conference to be held inthe spring of 2000 are proceeding.The Coordinating Committee is fo-

In This Issue. . .

Coordinator’s Corner ........................ 1Cooper to Receive Honors of the

Association ....................................... 4Call for Nominations: Malcolm

Fraser Award ................................... 4From the Editor .................................. 5Commission’s Corner ........................ 5Consumer’s Corner ........................... 6Clinical Nuggets ................................. 8

Reflections on the National Stutter-ing Project Convention .................. 9

What is International StutteringAwareness Day ............................. 10

International Stuttering AwarenessDay 1999 Online Conference ...... 11

Educating Other Professionals AboutWhat Audiologists and Speech-Language Pathologists Do .......... 12

Specialty Commission Ballot(Attachment)

Fluency and Fluency Disorders 2 September 1999

1998 Steering CommitteeDivision Coordinator

Eugene B. CooperAssociate Coordinator

Nan E. Bernstein RatnerMembers

Walter H. ManningC. W. StarkweatherJennifer B. Watson

Newsletter EditorRobert W. QuesalAssociate EditorJ. Scott Yaruss

Production EditorJean C. White

1999 ASHA Executive BoardPresidentChair, Legislative CouncilChair, Executive Board

Donna Geffner

President-ElectJeri A. Logemann

Past PresidentNancy B. Swigert

Vice President for Academic AffairsNoma Anderson

Vice President for Administration andPlanning

Lyn Goldberg

Vice President for Governmental andSocial Policies

Kathleen B. Roberts

Vice President for Professional Practicesin Audiology

Richard H. Nodar

Vice President for Professional Practicesin Speech-Language Pathology

Nancy A. Creaghead

Vice President for Quality of Servicein Speech-Language Pathology

Glenda J. Ochsner

Vice President for Research andTechnology

Janis Costello Ingham

Executive DirectorFrederick T. Spahr

DisclaimerItems in this newsletter express theopinions and views of the individualauthors and, except where otherwiseexplicitly stated, do not represent anyofficial position or policy of the AmericanSpeech-Language-Hearing Association.

Printed in USA © 1999 ASHA

American Speech-Language-HearingAssociation10801 Rockville Pike • Rockville, MD 20852Tel 301-897-5700 • Fax 301-571-0457

cusing on identifying a site on theSoutheast coast for the conference inApril or May of 2000. You will bekept informed as to the time andplace when final arrangements havebeen made. Once again, we thankASHA for providing us with assis-tance in site selection.

The purpose of the LeadershipConference will be to focus attentionon innovative models and practicesfor the clinical training of cliniciansin the treatment of stuttering at boththe entry and the specialty levels ofprofessional practice.

Curriculum Relevant IEPsSchool practitioners rapidly are

becoming aware of the ramificationsof the recently released new federalguidelines for implementing the In-dividuals with Disabilities EducationAct (IDEA) amendments passed byCongress in 1997. The new guide-lines call for all Individualized Edu-cation Plans (IEPs) to be curriculum-relevant. ASHA’s School ServicesUnit has initiated a nationwide ef-fort to assist school practitioners incomplying with the new guidelines.

With ASHA’s continuing effortsat developing functional treatmentoutcomes measurements though itsNational Outcomes MeasurementSystem (NOMS) and our owndivision’s efforts at identifying andfostering the development of func-tional fluency treatment outcomemeasures, we find ourselves in a ex-cellent position to be responsive tothe call for an increased curriculum-relevancy in our treatment goals andobjectives. Both the 1997 and the 1998Division Leadership Conferencesdealt with identifying and assessingfunctional fluency treatment out-comes. Perhaps the most significantresult of those conferences was thedevelopment of a consensus that theaffective, cognitive, and behavioralcomponents of fluency disordersmust be included in any attempt toassess functional fluency treatmentoutcomes. Rather than focusing pri-marily on the behavioral componentsof an individual’s disfluencies, con-ferees agreed that affective and cog-

nitive factors are as important, if notmore so, than many of the behavioralcomponents that are popularly usedtoday by clinicians to assess fluencytreatment outcomes.

As you may recall, our Leader-ship Conferences on this issue firstdeveloped general statements of pre-ferred functional outcomes for flu-ency treatment from the perspectivesof the client, the parent, the clinician,the third-party payer, and society. Inthe succeeding year, the LeadershipConferees began to develop a seriesof seven-point scales (in keeping withthe NOMS project) to be used in as-sessing the affective, behavioral, andcognitive features of stuttering. Criti-cal features in each of the three di-mensions were identified. Each pointalong a seven-point scale for eachfeature was then identified and la-beled. Presently, the division’s TaskForce on Treatment Outcomes is be-ing organized and will be operationalby the end of the year. From a reviewof the preferred fluency treatmentfunctional outcome statements de-veloped by the annual leadershipconferees, the relevancy of those pre-ferred treatment outcomes to thecurricula-based goals in schools isreadily apparent. For example, weshould be and probably are moreconcerned with the child’s ability tocommunicate effectively than we arein the number of disfluencies the childexhibits. Yet, too frequently, we con-tinue to focus on disfluency countsas indicators of the severity of thechild’s fluency problem when ourresearch and our good common sensetells us fluency counts are one of theleast valid or reliable measures offluency treatment outcomes. I thinkthat the work our division has doneand is doing in identifying functionalfluency treatment outcomes will beof assistance to school clinicians seek-ing help in writing curriculum-rel-evant IEP goals. The goals of fluencytreatment as defined in recent Lead-ership Conferences are consistent, ifnot identical, to curricular goals per-taining not only to speech, language,and communication skills in general,but to such broad goals as develop-ing good citizenship.

Fluency and Fluency Disorders 3 September 1999

In addition to facilitating schoolclinicians’ efforts at making their flu-ency treatment program goals morerelevant to their clients’ school cur-ricula, we will be continuing our workwith the NOMS project staff in aneffort to increase the validity andreliability of its existing seven-pointscales for assessing fluency treatmentoutcomes. As you know, thousandsof clinicians in a variety of work-settings throughout the nation areparticipating in the NOMS projectby utilizing NOMS scales in theirassessment activities. We want to beconfident that those scales reflect ourprofession’s best estimate as to whatare the preferred functional treat-ment outcomes for those who stut-ter.

Diagnostic Code Change forStuttering

Division 4’s Steering Commit-tee is continuing its dialogue withASHA’s Private ReimbursementPolicy Director as to our Association’srequest to change stuttering out of itspresent location in the “NeuroticDisorders, Personality Disorders, andOther Nonpsychotic Mental Disor-ders.” While the Steering Committeefavors the placement of stuttering inthe section labeled “Symptoms,Signs, and Ill-Defined Conditions(syndromes),” others are suggestingwe move it to a section indicating aphysiological causality. I do not thinkit advisable to move in that direction.Many of us agree, based on the wealthof research before us, that chronicstuttering is indeed a syndrome withmultidimensional features resultingfrom the interactions of multiple co-existing etiologies. To continue tothink in the simplistic and time-worntwo-dimensional framework thatsuggests problems are the result ofeither physiological factors or of psy-chological factors is counterproduc-tive. I think the continuance of manyof our colleagues to think and towrite as if the chronic stuttering syn-drome can result soley from eitherphysiological factors or from psy-chological factors has not only im-peded efforts in educating the public

as to the nature of stuttering, but intreating those who are chronic stut-terers. A recent popular admonitionis to “think outside of your box.” Ithink we could all benefit from alittle more of that.

In the meantime, the SteeringCommittee will continue its effortswith ASHA in arriving at an agree-able alternative to stuttering beingclassed as a “neurotic disorder,” or,for that matter, as a physiologicaldisorder.

Council for Research inCommunication Sciencesand Disorders

At an ASHA-sponsored Forumon Interdisciplinary Research inCommunication Sciences and Disor-ders held in Chicago, IL May 21-23,1999, attendees representing over 30related professional organizationsapproved the establishment of an in-dependent organization to promoteinterdisciplinary research in the dis-cipline. One of the new council’smajor goals is not only that of pro-viding a forum for scientists in ourown discipline, but for scientists inall disciplines concerned with com-munication sciences and disorders.Speakers noted that while there maybe an “erosion” of research effortswithin our discipline, there is a veri-table “explosion” in research in com-munication sciences and disordersbeing conducted by others in disci-plines far beyond the “ASHA um-brella.” In view of this, confereesmoved to create an organization inwhich all scientists involved in re-search in communication sciencesand disorders (without regard to theirdiscipline) can be brought togetherfor the benefit of all.

ASHA researchers for yearsnoted with alarm that, with an in-creasingly small percentage of ourmembership engaged in basic re-search, our discipline was losing itsresearch base and soon would be nolonger capable of producing the newknowledge needed to sustain ourdiscipline. Fortunately, in the pasttwo decades, researchers from many

other research-based disciplines havepursued basic research in the com-munication sciences and disordersbecause, as we all know, the pro-cesses of communication and its dis-orders are of basic concern for most,if not all, disciplines. The new Coun-cil on Communication Sciences andDisorders will facilitate communica-tion between these researchers forthe betterment of all.

Following the approval of theCouncil’s Bylaws by an eight-mem-ber interim Board of Directors, thecouncil will be incorporated as a tax-exempt organization. The council’sgovernance will be determined pri-marily by representatives of spon-soring organizations who will serveas a Board of Directors empoweredto elect its own officers. As your rep-resentative to the InterdisciplinaryForum, I am pleased to report that Iwas appointed to serve as chair ofthe Bylaws Committee (with LauraWilber and Peg Williams). The finaldraft of the bylaws is currently un-der review by the council’s InterimBoard of Directors and, hopefully,The Council for Research in Com-munication Sciences and Disorderswill be an incorporated reality in thenear future. I’m delighted that ourdivision was there to support thecreation of the Council and that I wasable to take an active role on yourbehalf in the council’s development.

Coordinator ThanksAt the conclusion of the Sixth

Annual Leadership Conference inSan Diego, Walter H. Manning andJennifer B. Watson, on behalf of theDivision’s Steering Committee, pre-sented me with a Waterford CrystalClock for the time I have spent overthe last 7 years (6 as Coordinator)serving on the Division’s SteeringCommittee. Knowing that my sec-ond 3-year term as Coordinator ex-pires in December, they thought itappropriate to present this gift to meat this year’s Annual Leadership Con-ference. I deeply appreciate this giftand thank all those involved in mak-ing the award. I will have one morecolumn to write as Steering Commit-

Fluency and Fluency Disorders 4 September 1999

Cooper to Receive the Honors of theAssociation

Eugene B. Cooper, Division Coordinator for the past 6 of his 7 years onthe Division for Fluency and Fluency Disorders Steering Committee, is oneof five individuals receiving the Honors of the Association in 1999. TheHonors is the highest award given by ASHA. Cooper, the author of over150 publications primarily in the areas of fluency disorders and profes-sional issues, has presented over 200 workshops throughout the UnitedStates, Canada, England, Scotland, Wales, and The Netherlands. In addi-tion to serving on numerous discipline-related committees, boards, andcouncils over the past 40 years, Cooper served as charter executive officerfor four national organizations, including the Council of Academic Pro-grams in Communicative Disorders, the National Council of State Boardsof Examiners in Speech-Language Pathology and Audiology, and theNational Council for Communication Disorders. He currently serves asBylaws Committee Chair for the new interdisciplinary Research Councilfor Communication Sciences and Disorders. Cooper will be presented theHonors during the ASHA’s awards ceremony held in San Francisco inconjunction with its 1999 annual Convention.

tee Coordinator when I can moreadequately express my thanks toSteering Committee members pastand present and to all of you whomade these some of the most excitingyears of my professional life.

Call for Nominations:Malcolm Fraser Award

The Stuttering Foundation ofAmerica and the Special InterestDivision for Fluency and FluencyDisorders announce a call for nomi-

nations for the 2000 Malcolm FraserAward, an award bestowed on anindividual in recognition of excel-lence in the field of stuttering. Theaward, consisting of a plaque and$2,000 from the Stuttering Founda-tion of America, will be presentedat the 2000 Annual Leadership Con-ference of Division 4. Among othercriteria for eligibility, nomineesshould have highly respected, dis-tinguished careers in speech-lan-guage pathology (or closely relateddisciplines) with specific and mul-tiple contributions that have madesignificant positive impact on chil-

dren and/or adults who stutter.Contributions may be in the areasof clinical services, research, sup-port for persons who stutter, and/or professional training or devel-opment of clinicians. To requestnomination guidelines, please writeto: Klaas Bakker, Division 4 AwardsCommittee Chair, c/o ASHA, 10801Rockville Pike, Rockville, MD20852. Completed nominationpackets must be received at thesame address of ASHA by January15, 2000.

Eugene Cooper at the 1999Division 4 Leadership Conference

The Annual Meeting of Special InterestDivision 4 will be held on Thursday, November18, 1999 from 2:00 p.m. to 4:00 p.m. in the Con-vention Center, Room 120 at the ASHA Conven-tion in San Francisco.

See you there!

Don’t forget to join us. . .

Fluency and Fluency Disorders 5 September 1999

Bob Quesal

From the EditorWe are in the process of index-

ing all of the special interest divi-sion 4 newsletters from Vol. 1 allthe way through our current Vol. 9.That cumulative index should beincluded with the next issue of theDivision 4 newsletter, coming outin early 2000. In reviewing all of theDivision 4 newsletters that havebeen published since 1991, I notedthat months of publication tend tovary. That trend has continued dur-ing the 3 years that I have beeneditor, as well. One might wonderwhy the newsletter cannot be pub-lished in a more “regular” fashion.The simple answer is that we waituntil we have enough news for anewsletter, then put it all togetherand send it out. During the past 2years, we have had a “beginning ofyear” issue that has summed upDivision 4 events of the previousyear, a “pre-Leadership Confer-ence” issue that has set the stage forthe Annual Leadership Conference,and a “pre-ASHA Convention” is-sue that has summed up the Lead-ership Conference activities and setthe stage for events at the ASHAConvention. Because the Leader-ship Conference was held later thisyear than in previous years, ourfinal issue of the year is coming outa bit later than in the past 2 years.

In Commission’s Corner in thisissue, we have very important in-formation from Richard Curlee, thechair of the Specialty Commissionon Fluency Disorders, regarding anumber of issues relating to apply-ing for the Initial Cadre of FluencySpecialists. Anyone interested influency specialization should besure to send the appropriate form(s)to the Specialty Commission. OnceForm 101 is received, the Commis-sion will send you a packet of infor-mation designed to streamline theapplication process. The applica-tion forms (Forms 101, 102, and 103)were included in the past two is-

sues of the Special Interest Divi-sion 4 newsletter.

Once again, “Fearless Leader”Gene Cooper has put together aninformative Coordinator’s Cornerwith up-to-the minute informationabout a variety of factors that affectour division. As always, it is mustreading.

Scott Yaruss shares his insightsas a “fluenter” at the National Stut-tering Project (now National Stut-tering Association) Convention thissummer. Marty Jezer’s Consumer’sCorner piece contains Marty’s in-teresting and informative perspec-tives on the use of electronic de-vices in stuttering. We also havetwo new “Clinical Nuggets,” vari-

Richard F. Curlee

Commission’s CornerThe Specialty Commission on Fluency Disorders met

three times, before and after sessions, at the Leadership Con-ference in San Diego. These were our first face-to-face meet-ings since assuming office on January 1, and we had a lot moreto discuss than we had time. A focus of many of these discus-sions was how to make it easier for applicants to submit all ofthe documentation needed to support their application forrecognition in the Inaugural Cadre of Specialists. This led toour developing a form that requests the types of educational,clinical, and volunteer experiences an applicant has had whichdocuments the qualifications required to be recognized as aSpecialist in Fluency Disorders. Much time was spent devel-oping, revising, revising, and revising the form until werealized that mailing the latest draft was preferable to tryingto perfect it. So, a revised application packet (with the still tobe perfected form) will be sent to everyone who has expressedinterest or requested information about the Inaugural Cadreof Specialists.

Several prospective applicants have contacted the Com-mission about having to spend at least 100 clock hours eachyear in the management of clients with fluency disorders inorder to become and remain recognized as a Specialist inFluency Disorders. Such hours can be earned in a variety of

Continued on page 5

ous information about InternationalStuttering Awareness Day, and theusual assorted informative tidbits.In sum, we have enough informa-tion compiled to send out a news-letter.

As always, I want to encour-age everyone in Division 4 to sharewith me any ideas or suggestionsthey have for the newsletter. I canbe contacted via email: R–Quesal@wiu.edu; phone: 309-298–1955, ext.249; Fax: 309-298–2049; orU.S. Mail: Speech & Hearing Clinic,113 Memorial Hall, Western Illi-nois University, Macomb, IL 61455.Or you can wait and talk to me atthe Division 4 membership meet-ing ASHA Convention.

Fluency and Fluency Disorders 6 September 1999

ways—assessing clients, providingtreatment in clinic or outside set-tings, supervising treatment ses-sions, counseling clients or parentsof children with fluency disorders,or consulting with other cliniciansor professionals about such clients.Hence, fewer than 2 hours eachweek need to be provided, on aver-age, from the continuum of clinicalservices within the scope of clinicalpractice for this clinical population.

We have also been asked forinformation on how the Commis-sion uses the $150 application feenow required. The Commission,like all future specialty commis-sions recognized by the ClinicalSpecialty Board of ASHA, is re-quired to support itself, and its onlysource of funds are the fees it col-lects. It receives no ASHA support,because members’ dues cannot beused for such purposes. AlthoughCommission members volunteertheir time for meetings, respond-ing to inquiries and applicants, de-veloping forms and informationalmaterial, evaluating applications,communicating with other mem-bers and so forth, costs we incur forprinting, copying, filing, mailing,etc. have to be paid. Applicationfees are being used to cover thesesorts of costs at present. However,more substantial expenses are in-volved in obtaining tax-exempt sta-tus and liability insurance for theCommission and in the develop-ment, administration, and scoringof an examination, which still mustbe developed. The latter expensesare being covered initially by a start-up grant from Special Interest Di-vision 4. As the number of Special-ists, Mentors, new and renewal ap-plications increase, the Commissionwill likely need part-time clericalassistance, its own computer withappropriate database and account-ing software. Of course, only timewill tell if current application and

renewal fees will be sufficient tocover expenses.

The Clinical Specialty Boardhas been discussing alternativetitles that formally designate per-sons who are identified by this andother Commissions as specialists toclients and the general public andhow such titles might be protected.We responded to the Board’s re-quest for our opinion with, “Com-mission Recognized Specialist inFluency Disorders.” We also ex-pressed concerns that this title maynot prevent persons who are notCommission recognized from iden-tifying themselves as Specialists inStuttering or in some similar waythat would confuse clients and un-dermine the usefulness and cred-ibility of Commission RecognizedSpecialty programs. This is still anissue in search of a solution, and wewill keep you posted on what isdecided as we learn it.

Applications for the InauguralCadre of Fluency Specialists arebeing received at increasing ratesduring the second half of the year.Although the Commission is ableto act on completed applicationswithin 90 days, it has been advisedby the Clinical Specialty Board todelay formal actions on applica-tions until after it has adequate li-ability coverage. In the meantime,we hope that everyone who hassubmitted applications, and thosewho are waiting for us “to get ouract together” before applying, willcontinue to be patient. Each of usappreciates the patience that col-leagues have shown us throughoutthe year. Such understanding andcivility seem to be increasingly rarein today’s society, and we areacutely aware of our good fortune.

If you have additional ques-tions about any of these issues, otherconcerns, or wish to obtain furtherinformation and application mate-rials write: Specialty Commissionon Fluency Disorders, P.O. Box4475, Morgantown, WV 26504-4475.

Consumer’s Corner

Electronic FluencyAids

Marty Jezer

Marty Jezer is the author of Stut-tering: A Life Bound Up in Words(Basic Books, 1997). He was recentlychosen “Member of the Year” by theNational Stuttering Association.

This article is about electronicdevices for stuttering. Some callthem “fluency aids.” I prefer theterm “anti-struggling” devices, be-cause what they do is change thenature of my stuttering and, as aresult, remove the burden of stut-tered speech. Few people who stut-ter are familiar with them. Otherthan through self-help and Internetdiscussion groups, there is no wayfor the manufacturers of these de-vices to advertise their existence.In the past, some speech patholo-gists were hostile towards their use,but that hostility has diminished.While some professionals still op-pose their use as a matter of prin-ciple (stutterers should not dependon a “crutch” for fluency), manyprofessionals are simply unawareof their existence or, if they areaware, have never seen them used.

In addition to describing someof the devices, I will argue that elec-tronic devices can play an importantrole in helping stutterers communi-cate more effectively. They can beput to good use in therapy programs,especially in transfer situations. Andthey can help young people over-come the traumatic experience of giv-ing public presentations in school.These devices, I will argue, need tobe taken more seriously by the pro-fessional community.

A brief personal note: I’m 58and still, measurably, a severe stut-terer. I’ve had every kind of therapyimaginable. I’ve been through theHollins precision fluency shapingtwice, the second-time for free be-cause early on during my first 3-

Continued from page 4Commission

Fluency and Fluency Disorders 7 September 1999

week session, Dr. Ronald Webster,who heads the program, noted mydifficulty achieving a proper gentleonset, even within the confines ofthe clinic. I’ve used electronic de-vices since 1984. I still stutter, butnot as badly. I’ve become, thanks tothe example and encouragement ofmembers of Speak Easy and theNational Stuttering Association (for-merly National Stuttering Project)—as well as to the portable DAF andEdinburgh Masker devices I usewhen speaking—an effective publicspeaker, not only at self-help gather-ings but in meetings of people whodo not stutter.

The electronic devices I am fa-miliar with are the Edinburgh Maskerand those manufactured by ThomasDavid Kehoe of Casa Futura Tech-nology. I have used the Masker formore than 15 years. In the past yearor so, I’ve been experimenting withthe Casa Futura devices. All are por-table and battery-operated. Each con-sists of a small box-like unit that canbe worn (and hidden) on a belt or ina pocket. Two wires (hidden under ashirt) attach to the unit. One goes toa dime-sized throat microphone thatcan be taped (with double-sided tape)to a point on the neck near the vocalcords (it can also be held tight to thespot with an elastic band). The sec-ond wire goes to inconspicuous ear-phones (there are a variety in use).When you speak, you hear a particu-lar noise (depending on the device)and this will aid your fluency.

The Edinburgh Masker pro-duces white noise, a masking soundthat drowns out the sound of yourown voice. The noise stays on for afraction of a second after you stopspeaking. This allows you to moveeasily from one word to the nextwithout the masking sound switch-ing on and off. The Masker, whichcomes from the United Kingdom, isno longer being manufactured, butI’ve heard from the British Stammer-ers Association that production mightbe resumed.

Thomas David Kehoe, himselfa person who stutters, manufac-

tures three units. Two are portable.A pocket DAF (delayed auditoryfeedback) unit and a newer FAF(frequency-shifted auditory feed-back) unit. Kehoe also manufactur-ers a desktop model for use with atelephone. Phone companies in somestates will provide them free of chargeto people who stutter (for informa-tion, contact Casa Futura). The desk-top models are also used in clinics.They contain components that en-able clients to monitor their preci-sion-shaping fluency targets. Manyspeech clinics use them. I used thedesktop model for the telephone andwill attest to its effectiveness. But myfocus here is on the portable pocketmodels.

Electronic devices do not curestuttering; no unit I know of pro-duces perfect or automatic fluency.Each type of device seems to workdifferently for different people. Andstudies show different rates of im-provement for different people. Someunits have a carry-over effect, butnot for everyone. There is, I believe,a general consensus that these de-vices will improve the speech—to alesser or greater degree—for mosteveryone who uses them.

In my case, the more conscious Iam of using speech techniques (forme, slowing down and using volun-tary stuttering) the more success Ihave with the devices. Once I beginvocalization, my speech comesfairly easily. I still stumble on con-sonants but my speech moves for-ward. Speech is no longer an ex-hausting effort. I still stutter, but Ispeak effectively.

I don’t have much faith in sub-jective self-reporting (especially myown) and wish that my speech couldbe studied with and without one ofthese devices. Empirically, I knowthat they have made a difference.Friends who I’ve not seen in a longtime almost always comment onmy improved speech. More to thepoint, I speak more, and in all situ-ations. I always battled my fear ofspeech. To me, avoiding speech isworse than the actual spasms of

stuttering. But sometimes speechwas just too difficult—for me andmy listeners. There were manytimes, before I used the Masker,that I wanted to speak but chose tokeep silent.

Now, I don’t fear talking. Con-versation is no longer an issue forme. I consider myself fluent, eventhough I am still stuttering. Withthe help of my devices, I’ve joinedToastmasters, and have come todelight in public speaking, not onlyat self-help conventions for peoplewho stutter, but for audiences offluent people. A few days ago, Ispoke up at my local school boardmeeting. It was a heated topic, therewas a large audience, and it wasbeing broadcast live on cable ac-cess TV. I stuttered, but I held theattention of the audience. Withoutmy DAF unit, I wouldn’t have doneit. It wasn’t the fear of stuttering inpublic that would have stopped me.It was my level of disfluency; with-out my portable DAF, the audiencewould not have understood me.And that, not the fact of my stutter-ing, would have been humiliating.

I am most comfortable with theMasker, because I’ve used it long-est. The noise sometimes bothersme, as do the plastic (custom-shaped) earplugs. On hot days, myperspiration sometimes short-cir-cuits the unit. (C’est la vie.) TheCasa Futura devices also have thisproblem, though the FAF and DAFsounds are much easier to take thanthe white noise of the Masker.

The Masker (like the DAF) en-courages monotonic speech. It wasn’tdifficult to overcome this drawback.I learned very quickly to make my-self aware of inflection and speechdynamics. No one has ever called mea monotonous speaker.

The DAF is my unit of choicefor public speaking. It slows myspeech and seems to relax my speak-ing mechanism. I’ll use it next weekin a “humorous story” competitionat my Toastmaster chapter. And I’lluse it later at a writer’s convention

Fluency and Fluency Disorders 8 September 1999

when I’m on a panel about “mem-oir writing.” The problem with DAFis that it tends to pick-up backgroundnoise. Not only do you hear yourown speech in a delayed sequence,but you hear what other people aresaying with a similar delay. Thismakes conversation difficult. Kehoe’sunit allows you to lower the sensitiv-ity of the microphone pick-up. Thisdoes cut down background noise,but it also lowers the volume of theDAF. I know two users who do wellwith their pocket DAF in conversa-tion. I’m still trying to find an effec-tive balance.

Speaking with the FAF unit islike choral reading. You hear thesound of your own voice as you arespeaking. It’s possible to adjust thepitch, and I’m still trying to find theoptimum setting. Sometimes itworks well when the pitch is onlyslightly altered. Other times itworks better when what I hear isthe sound of my voice a half or full-octave lower. I’ve yet to try it at ahigher-pitch. For me, the FAF is awork-in-progress. It does lessen mydisfluency and diminish my facialand speaking tension. How much?I wish I were part of a study.

Many severe stutterers, whosuffer from what Eugene Cooper calls“chronic perseverative stuttering,”or CPS Syndrome, could make use ofthese devices. These are stuttererswho simply can’t communicate. Anelectronic aid could ease theirstruggle and allow them to commu-nicate—even with a residual stutter.

Ultimately, the choice is up tothe individual stutterer. But I wouldlike speech pathologists to presentthese units as an option, especiallyfor their clients who are havingtrouble transferring their tech-niques into real-world situations.

These units could also be of-fered to moderate stutterers as anaid to public speaking, job inter-views, and all those high-stress situ-ations where good communicationis necessary. A little boost in flu-ency could help them in their ca-

reers, in their studies, and in theirsocial and civic activities.

What about teens and children?I’d hate for children to become de-pendent on a device so much sothat they’d give up speech therapy.On the other hand, these units, es-pecially the DAF device, can be anaid to therapy, helping the client toslow down and use techniques,even in difficult transfer situations.

There is nothing more devastat-ing for a child who stutters than giv-ing an oral presentation in class andnot being able to get a fluent wordout. For many kids, the humiliationthey feel in class affects their self-esteem and their identity. Kids whoare defeated by speech may havedifficulty responding to therapy. Theweight of defeat is simply too over-whelming. An electronic device is nosubstitute for a sympathetic counse-lor, but it might make speaking inclass less traumatic. Speaking suc-cess in a classroom setting would, Iam sure, have a positive affect on theway children who stutter feel aboutthemselves. And this could have auseful carryover affect on their atti-tude towards therapy, and of help-ing themselves.

The Casa Futura devices and theEdinburgh Masker are not the onlyelectronic aids on the market, butthey are the ones I’m familiar with.My plea, again, is that specialists instuttering look at these devices asuseful adjuncts to formal therapy.And that researchers gather somedata on their effectiveness in real-lifetransfer situation. Electronic devicesmay, indeed, be a “crutch.” But someof us need them. People with hearingproblems are encouraged to use hear-ing aids. Why, then, aren’t peoplewho stutter encouraged to use flu-ency aids?

Not all will choose to use them,but the choice should be ours.

Resources: Thomas DavidKehoe, Casa Futura Technologies, POBox 7551, Boulder, CO 80306-7551,Phone [888] FLU-ENCY. Web site:http://www.casafuturetech.com

Clinical NuggetsGerald JohnsonUniversity of Wisconsin-Stevens Point

Motivational Trophiesfor Self-Help Groups

Many years ago, I attended aToastmasters Club meeting in Lan-sing Michigan, home of OldsmobileCars. One of the awards given outthat evening was a tie pin with aminiature sparkplug attached. Thiswas given to the person who“sparked and motivated” the meet-ing. Later in my career when I beganto run an adult self-help group calledAIMS: The American Institute forthe Management of Stuttering (ourlogo was a broken arrow and ourmotto was: “AIMS Knows Stutter-ing”) I was wracking my brain tofind ways to additionally motivatethe group. I remembered the spark-plug and thought this might work. Ibought a full sized sparkplug and a 11/2 x 4 inch block of wood and drilleda hole to hold the sparkplug. On theface of this “trophy” I burned intothe wood with a hot soldering iron“spark plug award.” I thought thiswould be great for the person whoreally got the group going, but whatabout the person who was strivingfor stuttering modification. It wasnot necessary for that person to befluent, but rather to be showing ex-emplary effort toward his/her goal.Having watched The Wizard of Ozwith our kids for 100 times, I was hitby the idea of the oil can and the TinMan oiling up the hinges of his jawand his squeaking out his first rustywords. There was my idea: get an oldsmall metal oil can and embed thespout into another block of woodand burn into the side of the wood“The Tin Man Award.” The mem-bers of the group at the end of themeeting would vote for the two per-sons who would “win” the awardsand to be able to take them homewith them until the next meeting.You can imagine the dynamics thattook place during the meeting and at

Fluency and Fluency Disorders 9 September 1999

the recipients home afterwards. Wehad great fun and intrigue with thesetwo trophies.

Beth McMillenToronto, Ontario

I heard an interesting story toldby a very wise man and I’d like toshare it.

There once was a little boy whowas just starting to talk. He gazed upat the moon, tugged on the man be-side him and uttered, “Moon.” Theman knelt down and together theyshared in the little boy’s amazementand the magical moment.

Now imagine that same littleboy looking at the same night skyand uttering, “M-M-M-M-Moon.”Somehow, they may not share thesame magical moment. The adult

may feel uneasy, anxious, or fearfuland his thoughts may turn to pastdifficulties or future obstacles. It isdifficult to stay in the moment andreally share the magic of communi-cation with a child who is strugglingto talk to you.

When I heard this story a knotformed in my stomach and I felt theterror I had felt when my own sonstruggled to speak with me. It was atthat moment that I really understood“Listen to what they say, not howthey say it.” I had heard it said many,many times, but I did not really un-derstand until that day. I did notnecessarily tell my son to slow downor relax. I felt like I was supportinghim without drawing attention to hisspeech, but I was worrying about thegirlfriend he wouldn’t have or theclass presentation he couldn’t give

Reflections on the National Stuttering Project ConventionJ. Scott YarussUniversity of PittsburghStuttering Center of Western Pennsylvania

rather than just staying in the mo-ment and sharing that time with mychild. It seems that children who stut-ter may have very different interac-tions with parents and friends thanchildren who do not stutter. This isan example of one of those magicmoments that take place atworkshops...The speaker was PhilSchneider, and this took place atHofstra University during a “Year ofthe Child who Stutters” workshop. Ialways thought that this story wouldmake a great therapy tool to helpparents identify their feelings andreactions to stuttering when theyimagined their own child inthe story.I would have told you I was handlingthings well, but this example provedotherwise. Once I could identify myfeelings and reactions, I was betterable to deal with them.

On June 23-26, 1999, the 16thAnnual Convention of the NationalStuttering Project was held inTacoma, WA. Nearly 500 people whostutter, their families, and a growingnumber of speech-language patholo-gists gathered together to learn aboutstuttering and to share their experi-ences living with stuttering. I hadheard from my friends and colleaguesabout their wonderful experiencesat previous NSP conventions, so Iwas looking forward to attendingmy first NSP convention.

The program included both edu-cational and motivational presenta-tions aimed at helping people whostutter and their families deal withstuttering in their daily lives. Thenumber of program highlights is sim-ply too great to mention all of them.Examples include: reviews of differ-ent theories about stuttering and vari-ous treatment philosophies; tutori-als about how people who stutter

can reduce their negative feelingsabout speaking, eliminate avoidanceof speaking situations, and increasetheir participation in life; and discus-sions of how people can combineparticipation in the National Stutter-ing Project with treatment. One pre-sentation that stands out in particu-lar was the moving and entertainingkeynote address by motivationalspeaker Lee Bussard, a person withcerebral palsy whose message is thatpeople are “more alike than differ-ent.” We can all learn and benefitfrom this message.

Perhaps the most moving as-pect of the convention for me was theYouth Program, which included aseries of separate workshops foryouth, teens, and their parents aimedat helping families come to termswith stuttering and minimize theimpact stuttering has on children’slives. These youngsters showedamazing courage and strength that

enriched and motivated all of theparticipants at the convention.

In addition to the more than 50workshops and presentations, theconvention was rich with social in-teraction, giving the feeling that thismeeting is more than just an oppor-tunity to learn about stuttering, butalso an extended family reunionwhere people from all walks of lifecan come together to share friend-ships forged by common experienceand concerns. The members of theNational Stuttering Project feel anddemonstrate a true and deep respectfor each another, and this adds anadditional dimension of dignity andexcitement to this convention.

One of the most important an-nouncements at this year’s conven-tion was that the National StutteringProject is changing its name. The newname, to be introduced graduallyover the course of the next year andthen formally launched at the con-

Fluency and Fluency Disorders 10 September 1999

vention in Chicago next year, is theNational Stuttering Association (NSA).According to Chairman Lee Reeves,“what started as a project, is cer-tainly not a project any more.” Thenew name recognizes the growth ofthe organization over the past twodecades from a small self-help groupto a much larger and more influen-tial association that touches the livesof thousands of people across thecountry.

In addition, the association an-nounced its formal involvement instuttering research with the creationof a Research Committee consistingof three speech-language pathologistresearchers and three people whostutter. The purpose of the commit-tee is to promote research on stutter-ing and to facilitate interactions be-tween the organization and research-ers interested in tapping the wealth

of knowledge and experience theorganization’s membership holds.The first research project officiallysanctioned by the committee, con-ducted at the convention, involvedthe collection of survey data regard-ing the National Stuttering Associa-tion membership, as well as prelimi-nary data on a series of experimentalmeasurement instruments designedto assess how stuttering impacts thedaily life of people who stutter.

As a first-timer at the conven-tion, I was impressed by the warmwelcome I received as a speech-lan-guage pathologist and person whodoes not stutter. The National Stut-tering Association’s membership,and particularly the board of direc-tors and other leaders, are truly in-terested in developing and enhanc-ing the relationship between peoplewho stutter and speech-language

What is International Stuttering Awareness Day?Michael Sugarman and Amy Johnson

Below was a joint effort by participants at the ISAD workshop “Think Globally. . .Act Locally — What YOUcan do for International Stuttering Awareness Day ̃ October 22, 1999” recently held at the National StutteringProject’s 16th Annual Convention in Seattle/Tacoma, Washington. This is a result of a one-hour brainstormingsession to focus attention on “What is International Stuttering Awareness Day”. Posters and brochuresavailable at ahava1951@aol.com or by writing ISAD, c/o Amy Johnson, P. O. Box 525, Gates Mills, OH 44040.

pathologists. This feeling was evi-dent throughout the convention,from the supportive attendance atworkshops presented by clinicians,to the public welcome and thanksgiven to clinicians at the welcomingceremony, to the recognition givento speech-language pathologists dur-ing the awards ceremony.

I strongly encourage all clini-cians who work with people whostutter to attend the National Stut-tering Association convention, notonly to learn more about people whostutter and to support this growingorganization, but also to become partof this large community of peopleinterested in stuttering. I am certainthat your experience will be as posi-tive and rewarding as mine. The nextconvention, which promises to bethe largest so far, will be June 22-24,2000 in Chicago.

Interaction between profession-als and consumers

Networking

Talking

Educating

Responding to needs

Nourishing the spirit

Asserting our rights

Telling the world

Inviting participation

Organizing activities withinyour community

Nurturing new programs

Advocating

Listening to each other

Strengthening worldwide efforts

Teaching

Understanding

Thinking in new ways

Teamwork

Early intervention

Reaching out

Initiating dialogue

Now is the time

Global awareness, acceptance &action

Advertising

Writing the media

Alone no more

Replenishing the spirit

Empathizing

New ideas

Empowering

Sharing one voice

Speaking freely

Distributing helpful informa-tion

Acknowledging our history

You can make a difference

Fluency and Fluency Disorders 11 September 1999

International Stuttering Awareness Day Online ConferenceJudith KusterMinnesota State University, Mankato

share their ideas. Consumers had anopportunity to learn from and just asimportantly, to have their ideas heardby the professional community.

This year’s conference promisesto provide another excellent experi-ence for participants, with invitedpapers by consumers and profession-als around the world. Among thecountries represented are the US,Canada, Argentina, Spain, India, Is-rael, Germany, the United Kingdom,Denmark, Belgium, Australia, andIceland.

Panel discussions, papers, andposter sessions (short research re-ports) will be placed online October1, 1999. The papers are designed toappeal to a general audience, includ-ing speech-language pathology stu-dents, school speech-language pa-thologists, private practitioners, uni-

For last year’s ISAD online con-ference, 50 people from 15 differentcountries wrote 37 different papersthat made up the conference. FromOctober 1 to October 22, 1998, theentire conference site had 23,585 re-quests for information with an aver-age of 1025 requests daily.(183,417,872 bytes were transmittedduring the summary period with anaverage of 7,974,690 bytes transmit-ted daily). Those requests came from31 different countries. Each paperwas read by an average of 175 people(which would be a good attendancefor a single paper at any conference!).

Feedback about the conferencewas extremely positive. People whodo not ordinarily have an opportu-nity to talk to the experts in the areaof stuttering could ask questions.People from around the world could

versity professors, and consumersfrom around the world. Interestedindividuals will be able to read thepapers which each will have athreaded discussion attached (like abulletin board where questions andanswers can be accessed at any time).In this way, individuals from aroundthe world will have easy access toask questions and to make commentson any of the papers they wish. Theauthors have agreed to respond toappropriate questions on thethreaded discussions.

The online conference will belinked at the top of the Stut-tering Home Page (http://mankato.msus.edu/~stutter) start-ing October 1, 1999 and is freely ac-cessible to anyone with a connectionto the Internet.

Reminder for Division 4 Affiliates

Affiliates who meet the criteria for inclusion in the InauguralCadre of Specialists in Fluency Disorders should submit FluencySpecial Interest Form 101 before assembling their applicationmaterials. A copy of the form was attached to the May Newsletter.The Commission will then forward additional guidelines and aform that ensures all of the information needed to process anapplication is submitted. Inaugural Cadre applications must bereceived no later than June 30, 2000. After this date, the criteria forrecognition as a Specialist in Fluency Disorders will change sub-stantially.

Beginning July 1, 2000, an applicant will have to develop a planfor completing 100 clock hours, each, of approved educational andguided clinical practice activities under the supervision of a Com-mission recognized Mentor, then pass an examination. Until then,applicants need only have the CCC-SLP, 5 years or more of post-CFY experience, continuing education (during the past 3 years)related to fluency disorders, and thorough knowledge of the natureand sustained experience in evaluating and treating persons with afluency disorder.

Any affiliate who plans to become a Commission RecognizedMentor must first be recognized as a Specialist in Fluency Disorders.

LeadershipConference 2000:Clinical Training inStuttering

The purpose of the two-and-one-half day Seventh Annual Lead-ership Conference is to focus atten-tion on innovative models and prac-tices for the clinical training of clini-cians in the treatment of stuttering atboth the entry and the specialty lev-els of professional practice. Follow-ing presentations by well-knownclinical instructors in fluency, con-ferees in small groups will identifyelements of effective clinical trainingfor the treatment of stuttering. Ple-nary sessions will be held as the con-ference proceeds to develop a con-sensus among conferees regardingguidelines for clinical training in thetreatment of stuttering.

Fluency and Fluency Disorders 12 September 1999

Editor’s Note: The following statement was developed by a 1999 ASHA Executive Board (EB) subcommittee. Thesubcommittee consisted of EB members (Jeri Logemann and Nancy Swigert, who worked with National Office staff membersDebra Busacco, Ellen Fagan, and Arlene Pietranton) appointed to address the issue of professional cross-training (i.e.,training individuals in another profession to perform activities within one’s scope of practice).

Educating Other Professionals About What Audiologists andSpeech-Language Pathologists Do

Many continuing educationofferings focus on the multi-disciplinary approach to evalua-tion and treatment of variouscommunication disorders. Such afocus can offer opportunities foraudiologists and speech-languagepathologists to educate other pro-fessions about what our profes-sions do. The real question, how-ever, in this competitive educa-tion and health care environmentis “Should we educate othersabout what we do or to do whatwe do?” This distinction is a criti-cal one for each speaker/educa-tor to consider. It is a critical ques-tion for all clinicians who work ina multidisciplinary or “team” en-vironment as well.

Educating other profession-als about what audiologists andspeech-language pathologists docan expand our service deliveryand allow us to reach childrenand adults with communicationdisorders who might not other-wise be referred to us or whomight be referred too late or laterthan the optimum. However,teaching other professionals to dowhat we do can be dangerous. Allof the particular aspects of whatwe do that make our treatmentsand evaluations successful can-not be taught in any short-termcontinuing education environ-ment to individuals who do nothave the intensive graduate edu-cation required for audiologistsand speech-language patholo-gists. How we successfully selectand apply the assessment andtreatment procedures we use de-pends upon our backgroundknowledge of normal and abnor-mal function in each of the areas

in which we work. Other profes-sionals do not come to our con-tinuing education programs withthat kind of educational back-ground. In addition, to teach an-other professional to do what wedo opens up the possibility of anunnecessary and potentially un-healthy competition that couldcompromise outcomes for pa-tients or even their well-being.

It is critical that every speakerparticipating in a continuing edu-cation program ask him- or her-self, “How can I teach about whatI do without misleading membersof the audience, which may in-clude other professionals, to thinkthat they are now prepared to dowhat I do?” Our scope of prac-tice, our clinical diagnostic andtreatment procedures, and ourcompetencies require the in-deptheducation we receive on the un-dergraduate and graduate levels.We sell our professions and ourclients short, as well as diminishthe value of our education, if wetry to teach others in a brief,multihour or even multiday con-tinuing education course/work-shop to do even a small part ofwhat we do.

As an ASHA CE Administra-tor you need to be aware of thispotential problem in courses yourorganization may offer. Talk aboutthis issue with your speaker(s) andprogram planner(s). Look carefullyat each speaker’s proposed contentand the expected outcomes forthe participants. If the speakerintends that as a result of success-ful completion of the course inquestion the participants will beable to “do” (perform, interpret,

analyze…), then it is importantthat specific prerequisites benoted so the participants under-stand what skills and knowledgethey should have before enroll-ing in the course. These prerequi-sites should be as specific as pos-sible (e.g., attendance limited tospeech-language pathologistswith prior experience in evaluat-ing patients with _____ disorder).Also, it is important to identifythe target audience for the course.It is difficult for a speaker to havedifferent outcomes in mind fordifferent audiences (e.g., speech-language pathologists will be ableto do _____; everyone else will befamiliar with what speech-lan-guage pathologists can do with_____). As the CE Administrator,it is your responsibility to makesure that the printed promotionalmaterials accurately describe thetarget audience, course content,prerequisites, and the expectedlearner outcomes so that all po-tential participants know what toexpect if they attend the course.Offerings that are administrative(rather than clinical) in naturemay be more appropriate for adiverse audience (e.g., “Under-standing the Impact of Reim-bursement Changes on Rehab Pro-fessionals”). Finally, with someofferings, it is good practice toprovide a disclaimer, such as thefollowing: “This 2-hour coursedoes not provide you with all theskills and knowledge necessaryto provide a comprehensive di-agnosis of swallowing disordersin infants.”