Activities & Ideas for Fluency Therapy in the School Aged Population Diane Games Tri-County Speech Associates ( part of a presentation with Irv Wollma...
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Activities & Ideas for Fluency Therapy in the School Aged Population Diane Games Tri-County Speech Associates ( part of a presentation with Irv Wollman, Cincinnati Children’s Hospital Medical Center)
SYNERGISTIC APPROACH Multi-dimensional Treatment Mix z
Fluency Shaping Speech Targets/Modifying Moments of Stuttering – Integration of Strategies
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Attitudes & Emotions are an important component of treatment
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Environmental /Situational Hierarchies
Concept: Focus on the message not on the stuttering z
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The child/student is reinforced for communicating regardless of the fluency levels. Fluency shaping tools are given as options for modifying the message. The various aspects of good communication are emphasized with focus on content rather than on the actual motor responses. The child/student evaluates his/her own message with respect to clarity of thought and content as well as fluency.
Ideas: z
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Use a variety of play or action figures to simulate potential conversations: doll house, animals, superhero figures, etc. Engage in simulated interactions that explore feelings. Empower the CWS to “handle” these situations. Act out familiar plays using puppets. Encourage the child/student to assume various roles in these interactions. Evaluate feelings and build in gradual reinforcement for fluency levels.
Concept: Symbolize treatment goals with objects or visual activities z z
Visual reminders of ideas help children transfer skills and remember concepts. Visualization often generates a mutual language for the clinician and the child/student to discuss ideas and events in the child’s life.
IDEAS z z z z
The House that Jack Built (Bennett & Westbrook) Fluency Cock Pit / Fluency Meter/ Charts to Measure progress The Fluency Tool Kit (younger children) Paint a Picture of your Stuttering/Draw your stuttering/Monster Balloons
Concept: Attitudes about communication need to be discussed in every session
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CWS often have poor self esteem with regard to a variety of speaking situations or with communication in general. Positive self-talk exercises provide the child with productive comments about the communication process. CWS need to know that they are not alone in dealing with this disorder.
Ideas z z z z
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Positive self talk cards. Internet resources. Establish meetings with other students who have stuttering problems. Educate those in the environment. Have the student/child practice a short speech about stuttering treatment. Deliver the speech to those in the child’s environment. Journal writing – summarizing/evaluating interactions
Concept: Treatment goals & tasks need to be relevant to the cws z z z
Motivation for change often depends on feeling that treatment is relevant to needs. Goals should be written together; evaluation is an important part of the process. Hierarchies of difficult situations need to be established and problem solved as part of the treatment process.
Ideas: z z
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Use vocabulary of high interest – names; relevant vocabulary; expressions Practice organizational frameworks to facilitate difficult discourse tasks..explaining, story telling relating events. Simulate academic talking tasks