school age stuttering therapy · sig 4 (fluency and fluency disorders) specialty board of fluency...

2/23/19

© Nina Reeves www.NinaReeves.com 1

SCHOOL AGE STUTTERING THERAPY:

Where Do We Start? PART 2

Nina Reeves, M.S. CCC-SLP BRS-FD Board Certified Specialist-Fluency Disorders www.ninareeves.comwww.stutteringtherapyresources.comFluency Specialist: Frisco ISD Fluency Specialist Consultant: San Diego Unified School DistrictCo-Owner/Director Stuttering Therapy Resources, Inc.

Housekeeping

■ Handouts for all of today’s sessions are posted on www.ninareeves.com/resources■ UNTIL March 31st!!

■ Join my mailing list at ninareeves.com/SLPSignupfor more resources

http://www.ninareeves.com

http://www.stutteringtherapyresources.com

http://www.StutteringTherapyResources.com

2/23/19


Just a reminder:

■Many slides contain student work and likenesses

■ Therefore, due to HIPPA regulations, no photographs nor recordings can be made of the presentation slides.

2/23/19


Onsite-special!■ Our entire catalog at Stuttering Therapy Resources

is 10% off for attendees during this presentation only

www.StutteringTherapyResources.com

Use Discount Code ONSITE at checkout

■ AND…enter a drawing for a free resourcefor educating teachers about stuttering

– LIKE us on Facebook (@StutteringTherapyResources)– FOLLOW us on Twitter (@StutterResource)– POST a picture on Instagram (@stutteringtherapyresources)– Post a picture, quote, or idea from the workshop

■ Remember to tag STR in your post. Every postearns you another entry in the drawing

– I will contact you by social media if you win!

■ I know that I cannot possibly present everything you want or need to know about how to start stuttering treatment for school age who stutter in the span of 3 total hours (Parts 1 and 2)

■ So, I will attempt to address the major points of foundational knowledge and skills

WHILE ■ Also providing you with resources for further

education and learning activities

http://www.stutteringtherapyresources.com/

2/23/19


FOUNDATIONAL KNOWLEDGE AND SKILLS

How to Start Therapy: Part 2

Foundational Knowledge/Skills (overview 1)

■ Learning about SPEECH– Explore the “speech machine” – Tuning into speech/communication of

self & others– Playing with speech (ways our voices

work) – “Catch mes” (different voices) – Tight & loose big muscles– Relaxation: What it is and what it isn’t

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The “Speech Man” (Ramig & Bennett, 97)

■ Why are we learning this? – It is the“underlying map” for everything else we do

– Discover the process of speech

– Increase proprioceptive awareness of the “speech works”

■ What are the steps? – Develop visual “Speech Man” by playing with speech and

having child make discoveries

– Discuss each part of the speech mechanism and how it helps to create speech

Talking about Talking (Dean Williams)

■ Speech Machine and how it works (Ramig & Bennett and others)

■ “Ways our voice works” (playing with talking)

■ Tight vs loose muscles (play with speech) ■ “Catch me” games (Dell and others)

– Including“Ways Our Voice Works”

Exploration of Speech (con’t)

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More Foundational Knowledge & Skills

■ Learning about STUTTERING -101■ What is stuttering?

– Facts/Myths – Famous people who

stutter– Types of stutters– Teaching others about

stuttering

Let’s get to know stuttering!

■ Have fun with this!

■ Facts and myths

– Dispel and learn

■ Famous people who stutter

■ Using the terminology

– The “S” word

– Types of stutters

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Even More Foundational Knowledge & Skills■ Learning about STUTTERING -202

■ Self-Monitoring– Tight & Loose speech muscles– “Catch mes” (with stutters now)– “Speech Detective” – Stay in the moment – Freeze & release

Remember…■ The student is becoming an “expert”

(Murphy) at knowing about talking, stuttering, and communication.

■ Therefore, the student can and should be starting the process of becoming his/her own advocate

■ This can be done by having the student teach others about talking and stuttering

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Introducing Speech Handling Strategies (and why I no longer call them “tools”

Guiding Principles – NO HARD AND FAST RULESUse your knowledge of the child and your clinical judgment to make determinations!

“Techniques”: Consider the Following..1. Start with foundational knowledge and skills that the student has not learned or does not remember!

Students need to understand how speech is made. They also need to know and understand the disorder of stuttering (to the extent they can given their age, level of awareness, cognitive abilities and readiness/impact).

2. Map out the array of speech handling techniques

Not every child needs every tool (or at least not all at once), but it is imperative that they understand the breadth of the possibilities for handling speech in the long term.

3. Always integrate “types” of tools, as needed.

This means stuttering modification, fluency enhancing, and communication skill techniques are ALL a part of the process.

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“Strategies:” Consider the Following…(cont)4. Integration takes clinical intuition and common sense True integration includes not feeling the need to do “all stuttering modification,” and then moving to “all fluency enhancing tools.” It also means that we don’t need to wait until a child has mastery of a specific skill before “weaving in” another technique. 5. Techniques are learned and explored at word/phrase levels and then introduced and practiced at increasing levels of linguistic complexity; along with increasing levels of difficulty in the child’s created situational hierarchies.

Types of Techniques: These are INTEGRATED in the process of therapy

Stuttering Modification

*For children who “stutter enough” that they could (eventually) identify a moment of stuttering as it is occurring.

*For children who are sensitive to and/or avoid stuttering

* These techniques are practiced with “fake stuttering” at first, and then practiced in real instances of stuttering, as the child increases his ability to identify his own stuttering moments.

Fluency Enhancing

*For children who don’t avoid stuttering and are not overly sensitive to stuttered moments

*Also for children who exhibit only mild stuttering behaviors and little to no struggle and/or no avoidance behaviors

Communication Skills

* Not every child will need help in this area. However, it is important to understand that enhancing communication skills such as eye contact, turn taking, initiating conversations, and handling time pressure can be helpful to children who stutter

2/23/19


FOR THOSE OF YOU LEAVING US…

Otherwise, See you after lunch forStuttering and Concomitant Issues Parts 1 and 2

Selected Resources■ Chmela & Reardon (2001). The School Age Child who Stutters: Working Effectively with Attitudes and

Emotions, Stuttering Foundation: Memphis, TN

■ Chmela, K. (2011). Focus on Fluency, Super Duper Inc: Greenville, SC.

■ Gregory, H. H., & Hill, D. (1980). Stuttering therapy for children. In Seminars in Hearing (Vol. 1, No. 04, pp. 351-362). Copyright© 1980 by Thieme Medical Publishers, Inc.

■ Guitar G. (2014) Stuttering: Basic Clinical Skills Memphis, TN: Stuttering Foundation.

■ Ramig, P. R., & Bennett, E. M. (1997). Clinical management of children: Direct management strategies. Nature and treatment of stuttering: New directions, 2.

■ Reardon-Reeves & Yaruss, 2013 School-Age Stuttering Therapy: A Practical Guide, Stuttering Therapy Resources, Inc: McKinney, TX

■ Sheehan, J. (1970). Stuttering; research and therapy. New York: Harper & Row.

■ Yaruss, J. S. (1998). Describing the consequences of disorders: Stuttering and the International Classification of Impairments, Disabilities, and Handicaps. Journal of Speech, Language, and Hearing Research, 41(2), 249-257.

■ Yaruss, J. S. (2007). Application of the ICF in fluency disorders. Seminars in Speech and Language, 28(4), 312-322. Yaruss, J. S. (2010). Evaluating and treating school-aged children who stutter. Seminars in Speech and Language,31(4), 262-271.

■ Yaruss, J. S., & Quesal, R. W. (2004). Stuttering and the International Classification of Functioning, Disability, and Health: An update. Journal of Communication Disorders, 37(1), 35-52.

http://www.worldcat.org/search?q=au:Guitar,+Carroll,&qt=hot_author

2/23/19


Organizations/ResourcesAmerican Speech-Language-Hearing Association

Phone: 1-800-638-8255

Website: www.asha.org

SIG 4 (Fluency and Fluency Disorders)

Specialty Board of Fluency Disorders

www.stutteringspecialists.org

National Stuttering Association (NSA)

119 W. 40th Street

14th Floor

New York, NY 10018

Email: [email protected]

Phone: 1-800-We Stutter

Website: www.westutter.org

Stutter Talk: www.stuttertalk.com

International Fluency Association: www.ifa.org

The Stuttering Home Page

www.stutteringhomepage.com

Stuttering Foundation (SFA)

P.O. Box 11749

3100 Walnut Grove Road #603

Memphis, TN 38111

Phone: 1-800-992-9392

Website: www.stutteringhelp.orgFriends

8 South Oyster Bay Rd.

Syosset, NY 11791

Phone: 866-866-8335

Website: www.friendswhostutter.org

SAY: Stuttering Association of the Young

Website: www.say.org

American Board for Fluency and Fluency Disorders

www.stutteringspecialists.org

http://www.asha.org

http://www.stutteringspecialists.org

http://www.westutter.org/

http://www.stuttertalk.com

http://www.ifa.org

http://www.stutteringhomepage.com

http://www.stutteringhelp.org

http://www.friendswhostutter.org

http://www.say.org

http://www.stutteringspecialists.org

school age stuttering therapy · sig 4 (fluency and fluency disorders) specialty board of fluency...

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