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Stuttering Therapy: Empowering Students to Achieve

the Impossible

HANDOUTS: Packet #2

Marilee L. Fini, M.A. CCC/SLP MLF Speech Therapy

Cleveland, OH E-mail: mlf_speech@yahoo.com Website: mlf-speech-therapy.com

Phone: (440) 684-1440 The material in this manual is copyrighted by Marilee L. Fini. Permission is granted for reproduction and use of p. 5-18 for therapy purposes only.

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REFERENCES ASHA. (2007). Scope of Practice in Speech-Language Pathology {Scope of Practice}. Retrieved from www.asha.org/policy ASHA. (2015). Childhood fluency disorders: Signs and symptoms. Retrieved from http://www.asha.org

Boyle, M. (2011). Mindfulness training in stuttering therapy: A tutorial for speech-language pathologists. Journal of Fluency Disorders, 36, 122-129.

Boyle, M. (Speaker). (2012, February 19). Mindfulness in Stuttering Treatment [Audio podcast]. Retrieved from http://stuttertalk.com/mindfulness-in-stuttering-treatment-321 Chmela, K., & Reardon, N. (2001). The school-age child who stutters: Working effectively with attitudes and emotions. Publication No. 5. Memphis TN: Stuttering Foundation of America. Cochrane, S. (2015, July). Mindfulness. Lecture presented at the annual conference of the National Stuttering Association, Baltimore, MD. DiLollo, A. ( 2008, August). Re-storying communication: Counseling in speech-language pathology. {PDF document}. Lecture presented online for SpeechPathology.com. Ford-Brown, L. (2014). DK Guide to public speaking. Upper Saddle River, N.J.: Pearson Education, Inc. Games, D. & Reeves, N. (2010). School-age stuttering therapy: The tools and toolbox, too {PowerPoint slides}. Retrieved http://www.ohioslha.org/pdf/Convention/2010% 20Handouts/Fluency%20SC12%20Reeves%20Games.pdf Goldstein, C., Ladeas, S. & Sabourin, K. (2015, July). Face your fear and embrace your power. {PDF document}. Lecture presented at the annual conference of the National Stuttering Association, Baltimore, MD. Gregory, H. (2013). Public speaking for college & school. New York, NY: McGraw-Hill. Impossible. (n.d.) In Dictionary.com. Retrieved from http://dictionary.reference.com Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory/Research/Practice/Training, 38(4), 357-361. Luterman, D. (2014, July). Sharpening your counseling skills. Lecture presented at the Annual National Stuttering Association Convention, Washington, D.C.

Luterman, D. (Speaker). (2008, November 18). Dr. David M. Luterman: Counseling people who stutter and their families {Audio Podcast}. Retrieved from http://stuttertalk.com/2008/ Prins, D. & Ingham R.J. (2009). Evidence-based treatment and stuttering-Historical perspective. Journal of Speech, Language, and Hearing Research, 52, part 1, 254-263. doi: 10.1044/1092- 4388(2008/07-0111) Reardon, N. (2003, October). School-age stuttering therapy: Just the tools, ma’am. Lecture presented at the annual Fall OSSPEAC Convention, Cincinnati, OH. Reardon-Reeves, N. (2010, July). Real stories from real life clinicians {PDF document}. Lecture presented at the annual meeting of the National Stuttering Association, Cleveland, OH. Reeves, N. (2015, July). Helping children who stutter: Creating positive communication environments. {PDF document}. Lecture presented at the annual conference of the National Stuttering Association, Baltimore, MD.

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Reeves, N. & Yaruss, S. (2013). School-age stuttering therapy: A practical guide. McKinney, TX: Stuttering Therapy Resources, Inc. Rentschler, G. (2008, October). What they don’t teach in grad school [PDF document]. Retrieved from http://www.learningace.com/doc/2991778/3f283ddd15ffe738d38de3a599e03101/handout-rentschler

Riley, J. (2002). Counseling: An approach for speech-language pathologists. Contemporary Issues in Communication Disorders 29, 6-16. doi: 1092-5171/02/2901-0006

Special Interest Division on Fluency and Fluency Disorders. (1995). Guidelines for practice in stuttering treatment. (10.1044/policy.GL1995-00048). Retrieved from http://asha.org/docs/html/GL1995- 00048.html Yaruss, J.S. (2009, May). What every speech language pathologist should know about stuttering. {PDF document}. Lecture presented on-line for SpeechPathology.com. Yarrus, J.S. (2014). Effective Treatment for school-age children who stutter: An advanced course {PDF document}. Retrieved from http://www.alabamashaa.org/files/Handouts%202014/Yaruss-School- AgeChildrenStutter Yaruss, J. S. & Quesal, R. W. (2001, November 20). The many faces of stuttering: Identifying appropriate treatment goals. The ASHA Leader, 6. Retrieved from http://leader.pubs.asha.org/article.aspx?articleid=2292557 Zebrowski, P. M. (2007). Treatment factors that influence therapy outcomes of children who stutter. In E. Conture and R. Curlee (Eds), Stuttering and Related Disorders of Fluency (3rd ed.). New York: Thieme p. 22-28.

SURVEYS Andre S. & Guitar B. (1979). The A-19 Scale for Children Who Stutter. In B. Guitar. (1998), Stuttering:

An integrated approach to its nature and treatment (2nd ed.) (pp. 189-190). Maryland: Williams & Wilkins.

Andrews, G., & Cutler, J. (1974). Stuttering therapy: The relation between changes in symptom level and

attitudes. Journal of Speech and Hearing Disorders, 39, 312-319. (Modified Erickson Scale of Communication Attitudes (S-24) is contained in this article)

Yaruss, J. S., & Quesal, R. W. (2006). Overall assessment of the speaker’s experience of stuttering (OASES): Documenting multiple outcomes in stuttering treatment. Journal of Fluency Disorders, 31, 90-115.

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ORGANIZATIONS/RESOURCES

Friends The Association of Young People Who Stutter Directors: Lee Caggiano/ John Ahlbach 145 Hayrick Lane, Commack, NY 11725-1520 Phone #: 1-866-866-8335 E-mail: Lcaggiano@aol.com Website: www.friendswhostutter.org

National Stuttering Association Executive Director: Tammy Flores 119 W. 40th Street, 14th Floor New York, NY 10018 Phone #: 1-800-937-8888 E-mail: info@WeStutter.org Website: www.WeStutter.org

Stuttering Foundation of America Director: Jane Fraser 3100 Walnut Grove Rd., Suite 603 P.O Box 11749 Memphis, Tennessee 38111-0749 Phone #: 1-800-992-9392 Website: www.stutteringhelp.org

Resources on the INTERNET Marilee Fini’s Website: www.mlf-speech-therapy.com www.stutteringhomepage.com {Excellent resources for stuttering} http://www.mnsu.edu/comdis/kuster/schools/SID4page2.html {Internet resources for working with preschoolers} www.mnsu.edu/comdis/kuster4/part60.html {Contains a list of many resources for kids and teens who stutter} http://www.mnsu.edu/comdis/kuster/isadarchive/onlineconference.html {International Stuttering Awareness Day}

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CHILD CASE HISTORY

QUESTIONS TO ASK PARENTS 1. When did your child begin to stutter? 2. Is there any family history of stuttering? 3. Does your child have any other speech and language problem? 4. When is stuttering most decreased? When is it most increased? 5. Can you recall any unusual event near the onset of stuttering? 6. Describe how your child stutters. 7. What do you do when your child stutters? 8. Is your child aware of stuttering? 9. Does your child avoid any speaking situations due to stuttering? 10. What are your goals for speech therapy? QUESTIONS TO ASK CHILD 1. When did you begin to stutter? 2. What do you think caused your stuttering? 3. What is the hardest part about stuttering? 4. Does anyone ever tease you about stuttering? 5. When is it most difficult to talk? 6. When is it easiest to talk? 7. Do you ever try to avoid talking because of stuttering? 8. How do you feel when you are stuttering? 9. What do others do when you stutter? 10. What do you want to work on in therapy?

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ADULT CASE HISTORY

1. When did you begin to stutter? 2. As a child, did you have any other speech and language problems besides stuttering? 3. What do you believe caused your stuttering? 4. Does anyone in your family stutter? 5. Have you had any previous speech therapy? 6. Are there times when your stuttering is increased or decreased? 7. Do you avoid certain speaking situations due to fear of stuttering? 8. Do you use any tricks to get the words out? 9. How has stuttering affected your self-esteem? 10. How has stuttering affected your career choice? 11. How has stuttering affected your relationships? 12. What are your goals for speech therapy?

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Hierarchy of Feared Situations

1st

2nd

3rd

4th

5th

6th

Easy

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EXERCISE: VOLUNTARY STUTTERING Word Level I, I Mom, Mom, MOM Ba, ba, ba, BALL Pa, pa, pa, pa, pa, pa, pa, pa, pa, pa, POP M…..ovie (hold “m” sound for 5 seconds) O……………n (hold “o” sound for 15 seconds)

Sentence Level Mommy, Mommy, Mommy come here! We are going to the st, st, STORE. W….. hen (hold “w” sound for 5 seconds) will we go? I want to go see Gr, Gr, Gr, Gr, Gr, GRANDMA. It has b…………een (hold “b” sound 10 seconds inaudibly) a l……….ong (after 5 seconds of holding the “l” sound, increase tension and shake your head and then say the word) day!

Conversational Level Have a 2-minute conversation with your partner about the weather and voluntary stutter 5x during the conversation.

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PRACTICING TECHNIQUES

Techniques to Practice: Slow Rate Easy Starts Freezing the Moment Pull-outs Voluntary Stuttering I would say the following to introduce the technique: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ The activity that I would use to first introduce this technique would be: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ In the past, my experience with using techniques with clients has been the following: _____________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________ In regards to using techniques in stuttering therapy, I would like to be able to: ___________________________________________________________ ___________________________________________________________ ______________________________________________________________________________________________________________________

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thisThis

Hierarchy of Fered Situations

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Exercise: Client Counseling Activity 1. Mark is 10 years old and went on the playground to play with his friend. He had a friend who was in trouble. When Mark went to talk to an unfamiliar teacher who was in charge of the playground, he stuttered severely and could not get out a word. The teacher brushed him aside and said he didn’t have time to wait for him to say what he had to say. Mark was so upset, he began crying in class and the teacher sent him down to the principal because she couldn’t help him calm down and he was beginning to disrupt the class. The principal hears that this incident may be speech related so he

called you down to the office immediately to counsel Mark. The principal leaves you alone with Mark to talk to him.

2. Lisa is 13 years old and comes to you one day very upset about her stuttering. There was

a new student that came into her class and did not know about her stuttering. During a group activity, Lisa worked with this new student who made fun of her stuttering. Lisa’s teachers and classmates didn’t notice but Lisa felt really bad about it. She has not told anyone about it.

3. Jacob is 17 years old and he was very excited to go on a college interview to a medical school that is his first choice. At the interview, he stutters quite severely and he becomes very embarrassed. After the interview, he is convinced that this will have a negative impact on his chances of getting into this school. He comes to school therapy on Monday and is very devastated and says, “I will never get into medical school and I can never be a physician.” How would you apply your counseling skills?

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STUTTERING: WRITING TOPICS

1. What are my thoughts about starting speech therapy?

2. How do I feel about my current speech? 3. How would I like my speech to be? What would I change in my speech?

4. What are my thoughts while in the stuttering moment?

5. What scares me most about stuttering?

6. What is most embarrassing about stuttering?

7. What aspects of stuttering anger me?

8. What are my thoughts about a particular feared speaking situation?

9. In what ways do I hide my stuttering? Why do I hide my stuttering?

10. What aspects of stuttering cause me discomfort?

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Scripts for Puppet Shows Play #1 Child: I want a n----ew mouth. Mom: Why? Child: My mouth doesn’t doesn’t work; it gets st-st-st-uck. Mom: O, it does, that must feel bad. Child: Yes, it does… Mom: Sometimes when kids are learning to talk they go through bumpy times with their speech. It will get better. Child: Other kids do this too? Mom: O, yes and it’s OK to have bumpies….You’re just learning to talk. Child: It is??? Mom: O, yes…

Play #2 Mom: Come on Billy, it is time to go to school. Billy: I am am am not going. Dad: Billy, come on you have to go to school. Billy: I AM NOT GOING TODAY! Julie: O, scared to go to school because you talk so funny…. Dad: That’s enough Julie. Your brother sometimes stutters. Julie: It sounds funny and kids tease him all the time. Yesterday, there was a bunch of kids laughing at him while he was reading aloud. Mom: Billy, is this true? Billy: Y…….es

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Mom: Why didn’t you tell us? Billy: I didn’t want anyone to know. Mom: Why not? Billy: I hate how I ta-ta-talk. It sounds so funny and I am not like the other kids. Mom: It must be hard to talk differently than everyone else. Billy: It It It is. Mom: Just because sometimes you stutter, doesn’t mean you can’t talk. You have such great things to tell us, it just might take a little longer. Billy: But, k-k-kids don’t th-th-think so. Mom: I am going to call the teacher and we are going to stop this teasing. You need to go to school because you have so much to give and share with everyone. You tell such funny jokes….. Billy: OK, I’ll get dressed.

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What’s working in my speech?

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ART ACTIVITY DIRECTIONS: Draw a picture of how it feels to be in the moment of stuttering

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Being O.K. Despite STUTTERING!!!!! By: Marilee L. Fini, M.A. CCC/SLP

As a child who stuttered I just wanted to be told that I was going to be O.K. in

life. I was always worried about what my life would be like with this thing called

“stuttering.” Would I be able to have a job? Would I be able to get married?

Would I be able to be a productive member of society? I wanted to be told that

I was O.K. just like I was, stuttering and all. I never felt that way until I was

much older. As a child who stuttered I believed that my speech was going to hold

me back from the life that I wanted. I didn’t understand that I was in charge. I

believed what others said that it would be hard to find a job and I could not have

the life that I so yearned for because of my stuttering. None of this came true. I

had a job before anyone else did in my class and I got married to a wonderful

man! My life has surpassed my dreams as a child who stuttered. I have been

blessed with so many opportunities and have been given the chance to touch

people’s lives in such a real way through my speaking. I am O.K.! I ask you to

reassure kids who stutter that they will be O.K. in life. Their stuttering doesn’t

define them or who they will be but it is simply a challenge that they can choose

to embrace and be able to have the life they so desire!

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Mailing List In signing up for this mailing list, I am giving permission to receive an E-mail newsletter by Marilee Fini about stuttering as well as any mailings related to stuttering events. Name ____________________________________________________________ Address ____________________________________________________________ City/State/Zip ___________________________________________________________ ____________________________________________________________ E-mail ____________________________________________________________ Phone # ________________________________

Check all that apply:

School SLP SLP-other setting

Teacher School psychologist

Counselor Social Worker

Parent of child who stutters

Other ______________

Feedback Form Provide a 2-3 sentences about what you thought about the

workshop and the speaker. ________________________________________________________________________________________________________________________________________________ _____________________________________________________________ _____________________________________________________________ May we use your comments that you have written above as well as your name, title and city/state in future promotional materials

concerning Marilee Fini’s speaking. ___YES ___ NO