Question
I just began to work with an adult with a very strong stuttering (sometimes till 30 seconds before saying a word, with totally no eye contact and very contracted muscles). He was a short time with a speech therapist when he was a teenager but till now he
Answer
Many times, the challenge of working with adults who stutter is to help them overcome years of negative reactions to stuttering. In this case, you have several hurdles:
I would start by focusing on the reactions rather than the fluency. Teaching this man all the techniques in the world will not make him perfectly fluent. So, the first step has to be learning to deal with his stuttering. Maybe help him find a support group for adults who stutter. Also, have him confront his fears about speaking situations, if this is an issue.
It is important to understand that personality does not cause stuttering. Stuttering is a multi-factorial disorder, meaning it is "caused" by a number of variables. You can help him understand that, while is personality didn't cause him to begin stuttering, it can help make it better or worse. You describe him as being out of control. I'm not sure exactly what you mean by that, but stuttering is, essentially, a loss of control on many levels.
I would really ensure that this man and his family learn all they can about stuttering. If he is 60, and just seeking help now, my guess is that there has been a pretty fair amount of avoidance on his part. You'll have to work through that with him and help him face situations and face the fact that he is a person who stutters.
I would make sure he understands that even when he uses the speech modification (e.g. reduced speaking rate, easy onsets) and stuttering modification (e.g. cancellations, pull-outs) techniques, he is still going to stutter. Using these strategies can be very hard. He should view them as tools that he can use if he wants to, rather than tools that he has to use all the time.
Craig E. Coleman is a Clinical Coordinator at Children's Hospital of Pittsburgh and Co-Director of the Stuttering Center of Western Pennsylvania. He received his Bachelor's and Master's degrees at the University of Pittsburgh. Craig is a member of the National Insurance Advocacy Initiative and Chair of the National Stuttering Association's Insurance Advocacy Committee. In addition, Craig is an elected member of the ASHA Legislative Council.
Craig Coleman
Related Courses
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'It was well written and gave over a lot of good information, but I would have preferred if there had bee a video or auditory version as well'Read Reviews
AG Bell - LSLS/1.0 Domain 3; ASHA/0.1 Intermediate, Professional; Calif SLPAB/1.0; IACET/0.1; Kansas LTS-S1370/1.0; SAC/1.0
The key issues in the treatment of early childhood stuttering, with a focus on less-direct and more-direct treatment approaches are addressed in this course. Ways that clinicians can draw upon various approaches to develop individualized treatment so that each child’s and family’s individual needs are addressed are discussed.
