Future for PWS and SLPs
Hello! My name is Alicia Barragan and I am a senior at CSUF. My question to professionals is what do you think is in store for the future of therapeutic techniques for PWS? Is there any new research being done that will improve outcomes? For a class I had to voluntary stutter, which can be used in therapy, but I feel there must be other ways to achieve the same results. Thank you!
Hi Alicia-
Thanks for joining the conference! You pose a really interesting question. I cannot comment on any upcoming research – though I’m sure that many of my colleagues will be able to jump in here.
However, I wanted to share a few of my thoughts on ‘techniques.’ I think one thing that can be helpful to remember is that the modifications that exist within stuttering therapy are not one size fits all. It’s not so much about learning them and then going through the list with a client to teach them the techniques. Instead, as clinicians, we really want to understand our client’s stuttering – as each person stutters in a unique and different way. We then want to take the time to really ask them about their goals for therapy. Based on this information, we may move forward in helping them to play around with modifications to reduce to struggle when speaking.
To give you an example, let’s say we are working with a client who speaks with a comfortable rate and uses a lot of really natural pauses. Would it make sense to teach that client pausing/phrasing? Probably not – as she already does this. What could be really powerful in this case, is to reinforce all the amazing things that the client is already doing to support her own communication (especially connected to the goals she’s identified). Does that make sense?
I think we also want to keep in mind just how exhausting it can be to make changes to one’s speech all day, every day. Have you ever tried it? If not, I would totally encourage you to do so. Even tasking yourself with stuttering for entire day can be incredibly eye-opening. I bring this up because if a client has a goal of speaking in an easier way or even lessening the amount of stuttering – it can be helpful to probe further and find out in which speaking situations specifically the client may want to focus on this goal. Perhaps, when ordering at a restaurant or when giving a presentation in front of the class. Now we have a real-life speaking situation in which we can guide the client in practicing modifications to his speech. Do you see the difference here – between making modifications in a given speaking situation if the client chooses to in that moment versus feeling the pressure to modify speech all day, every day?
I’m not sure if this really answers your question – so please feel free to ask any additional questions you might have. I know others will chime in as well.
Best of luck,
~Jaime
Hi Alicia…
Thank you for your question!
I feel rather than looking for new techniques or strategies, the key to good outcomes lies in using what we already know to best suit the needs of the PWS. Like Jaime wrote, using pausing/ phrasing with someone who really rushes to finish their sentence, breathing- voicing co ordination with someone who tends to complete freeze during a block, adequate jaw opening for someone who tends to use very tense and closed jaw postures while speaking- our skill lies in utilising what we know, in the right places.
As you mentioned specifically about voluntary stuttering, as I’m sure you’ve realised, it could work well as a desensitization exercise, or something that helps the PWS feel that it’s ok to stutter. Another way to achieve this could be disclosure of one’s stuttering. Although this can help reduce the stress caused by an impending block, it could be difficult for many PWS. Discussing it’s pros and cons, and helping the PWS gradually approach the idea of disclosing about their stuttering to a complete stranger can take several steps. You must remember though that listener reactions to disclosure could vary from culture to culture. So do read up literature about it before you introduce the idea to a PWS you’re working with.
Hope this helps!
Pallavi