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Hello! My name is Allison and my colleague Emma and I are attempting to gain more knowledge in the area of stuttering. We are both current graduate students in a speech-language pathology program. Throughout the course, we have learned various statistics, evaluation, and intervention techniques for stuttering. That being said, we are young professionals without a ton of knowledge or exposure to stuttering as a whole. That being said, our question for the ISAD panel concerns tips and tricks to ensure we practice at the top of our license post graduation. So how can we as young professionals ensure we are able to provide the best care for all stuttering clients? What are the best ways to utilize inter and intraprofesisonal collaboration in the speech therapy setting?
Hi Allison, it is great to see so much motivation and that is where it starts! Connect with other SLPs that are interested in stuttering. If you look on the internet you can find for example transcendingx.com and SperoStuttering who support SLPs that are interested in stuttering. Visit conferences (online), workshops and seminars. You will meet a lot of people here that are more than happy to exchange thoughts and help.
But the most important thing is: collaborate with and listen to your clients!
My clients helped me grow and helped me grow my knowledge. Keep this year’s theme of the ISAD in mind: One Size Does NOT Fit All! this means that you need to listen to what your client needs and tailor your goals to the needs of the client.
I wish the both of you good luck and lots of great opportunities.
Manon
Dear Allison,
I agree with everything Manon has written. Becoming an effective clinician means improving our skills in becoming a client-centered, community-oriented, and stereotype-sensitive therapist. At this point, I recommend a chapter written by Dr. Kurt Eggers, the president of the European Stuttering Specialization (www.stutteringspecialization.eu). The chapter’s title is Becoming an Effective Clinician Specialized in Fluency Disorders… (the entire publication is available online: https://fcl.org.pl/wp-content/uploads/2023/06/DIALOGUE_WITHOUT_BARRIES.pdf). In his chapter, Dr. Eggers stresses the importance of critical reasoning while applying the principles of evidence-based practices in stuttering. He also emphasizes building meaningful therapeutic relationships between the clinician and the client. We must be aware of how important it is for the clinician to establish an initial bond with the client before applying techniques (if any). You probably agree that stuttering therapy should be tailored to each person’s needs. As Manon mentioned, this year’s ISAD slogan was: One Size Does NOT Fit All! While setting therapy goals, we must remember that this can be done ONLY together with the client. After all, this is their therapy. For this purpose, it is worth considering the use of the World Health Organization’s ICF model, which stands for the International Classification of Functioning, Disability and Health. In my opinion, it is a great tool which can be used as a framework for decision-making in stuttering intervention. This model allows us to see a whole range of different goals that our clients may wish to pursue in therapy. The key message is that increasing fluency may or may not be their goal. The clients should decide what their therapy goals are. Our role is to encourage them to make informed and meaningful decisions.
I wish you all the best, Kasia.
Allison and Emma, I believe that learning from people who stutter is essential! Some of my favorite resources: 1) the Open Stutter YouTube channel which features lots of wonderful stories, 2) the many podcasts out there by and for people who stutter (e.g., StutterTalk, Transcending Stuttering, Women Who Stutter: Our Stories, Proud Stutter), and 3) the many books/memoirs available (e.g., Out With It, Life on Delay, Every Waking Moment, Stammering Pride & Prejudice: Difference not Defect, and more!).
Hi Allison and Emma!
I just want to add or highlight some aspects:
How we connect with other peopleI is essential. In some sense we still need to move away from a ‘paternalistic’ model where the speech therapist is the ‘expert’ and move towards a model which empower the person and where we in a friendly and respectful way may support and challenge the person so he is able to make his own decisions in his own daily life settings. We therefore have to recognize the persons’ expertise of themselves. If the person participates actively is involved in a joint decision making process, as well as in the evaluation, they then might feel that they are able to deal with stuttering in a longer term.
I very much support the feedback from my colleague above, including the aspect of regarding the persons’ own feedback as important information. In the study of Rodgers and Gerlach-Houck (2022, page 6), their reflexive thematic analysis contributed to a development of two global themes (one capturing the pros of making a positive change to stuttering, and one capturing the cons. This article is free of charge, and I think it is an important paper to be aware of. They have structured some of the information into a set of three processes: (a) noticing and adjusting physical behaviors involved in speaking to the extent that it is personally important to do so; (b) developing neutral or positive thoughts and feelings about stuttering; and (c) participating more fully in social and professional activities, even if the person stutters or thinks they might stutter.
A study of Neuman et al. (2019) was documenting awareness-based approaches (among others) as useful approaches. Research which is based on information from the PWS themselves is still lacking, and is highly needed. Since there still is a lack of information from the first person perspectives I think it is important not to rely your work on published studies which are regarded as ‘evidence based’ only, but also to relay on the PWS themselves, as well as your own clinical experiences, when considering therapy.
At last, don’t remember that there are two types of competence which need to be combined; clinical competence and relational competence. Then it is not enough to have only ‘technical skills’ but we need ‘soft skills’ as well, to be regarded as a valued speech-language therapist.
All the best wishes for your future!