Questions to Ponder

1. What is one goal that you have?
2. Why is that goal important to you?
3. What would be the best part of achieving that goal?
4. What would that really mean to you?
5. How long have you had that goal?
6. What would this goal ultimately help you achieve?
7. What steps have you taken to achieve that goal?
8. What challenges do you face when attempting to achieve that goal?
Can you give some examples?
9. What is the impact of these challenges?
10. What do you think it’s costing you, financially, emotionally, socially, etc?
11. How do these costs feel to you?
12. What does it mean to you to be hindered in achieving your goal?
13. If you could wave a magic wand, what would it be like for you to overcome
these challenges and achieve your goal?
14. Tell exactly what it would look like, what would happen, if you achieved your goal.
15. What would you do differently that you’re not doing now?
16. What would you start to do to move towards that goal if those challenges
were no longer stopping you?
17. If you achieved that goal, what would you do next?

Mental Re-Framing

Recently I started reading a fascinating book called Mind-Lines: Lines that Change Minds, by Hall & Bodenhamer. It’s a book based on the field of Neuro-Linguistic Programming (NLP). One of the first topics in the book is about the mind-body connection: that what you are thinking causes the internal state of your body to respond in certain ways. This brought to mind an example. If you were like me when you were little, you might have imagined monsters in your closet at night or maybe alligators under your bed. What frightful thoughts! With this imaginary fear in my head, my pulse was probably racing, my breathing shallow, maybe even some sweaty palms. My nervous system was on high alert, making it hard to fall asleep, all because of some thoughts in my head. Conversely, if my imaginary thoughts were more sedate, maybe about floating on a cloud, my whole nervous system might have been calm, allowing me to fall asleep.

Basically, our thoughts not only impact our physiology, but impact what we do or don’t do in life. That’s where ‘framing’ or ‘reframing’ comes in. How we think of things we do or that happen to us is important. If a negative experience leads to negative thoughts like “I’m a failure”, or “I’m dumb”, our bodies respond in a depressive, anxious way. This usually does not make things in our life better. If instead we think of a negative experience as “This is what I learned from this” or “Next time I will do it another way”, our physiology will respond in a more positive way, we’ll feel better about our self, and be encouraged to go forward in life.

So if you tend to put a negative mental ‘frame’ around experiences, try ‘reframing’ them and see if it makes any difference. Do an experiment: Catch yourself in a negative, self-defeating thought, and then see how you can think differently about the experience that brought about that thought. “Reframe” it.

Did I Cause My Child’s Stuttering?

The other day as I was ending a session with a young child and his mother, the mother looked at me and asked “Did I cause my child’s stuttering?’ I could see where she might get this idea. Parents of young children who have ‘bumpy speech’ and ‘sticky sounds’ are often counselled to slow down their own speech rate and simplify their language. These are just two of the many suggestions that they might be given. So I could understand why she worried that maybe the way she had been speaking to her child, with longer sentences and a faster speech rate, might have caused his speech dysfluencies in the first place.

This conversation stayed with me long after our session ended. I hoped that I had answered the mother’s question and helped reduce the guilt she seemed to be feeling. But I feared that that might not have been the case. Having been caught off-guard myself, I’m sure I didn’t give her a very good answer. Then it occurred to me that perhaps the best way of looking at this would be like looking at allergies.

I suppose one’s genetic makeup must predispose an individual to certain sensitivities (ex;  pollen, mold, dustmites, etc.). That predisposition certainly comes from somewhere in the family tree. Research studies have concluded that many types of stuttering have a genetic base. That tendency to stutter or to have an allergic reaction is pre-programmed in the individual. And just like an allergy, certain things make it worse or help to minimize it.

So, in my opinion, when a parent talks slower, simplifies their language, and helps reduce speech demands placed upon their young child, it is similar to a parent with a child who has allergies. That parent takes steps to reduce their child’s exposure to the irritant. So in both cases what the child experiences from his/her environment can have a huge impact on the severity. And in both cases there’s a hope that the child might out-grow the problem.

So the bottom line, do parents cause stuttering – or allergies in their children? Probably just gave them the genes. But what the parent does afterwards might make a big difference in how severe the problem manifests  itself.

Does this all make sense? Let me know what you think.

Telepractice

The past couple of years I have slowly been wading into providing some speech-language therapy services thru the internet – telepractice.  Granted, there are some limitations, and I don’t think this is the way to go for every client or disorder type.

Even though I have a super fast internet connection, I’ve had a couple of clients that didn’t. That was a problem. I’ve dealt with echos, sound delays, audio & visual freeze-ups, children who couldn’t keep their headsets on or their microphone by their mouth, and parents who were new to computers and the internet.

However, through the use of virtual classroom software, a webcam, and a document camera, I’ve been able to provide reading instruction and some speech therapy to people who would not have had the opportunity to receive such services. It also has challenged me and my brain to learn new technology and to provide creative ways of achieving therapy goals.

Self-Imposed Perfectionist

Another demand that I have observed is perfectionism.

I had spent some time interacting with a pre-schooler who stuttered and his mother. When it was time to clean up the blocks and the toys, I observed this pleasant little guy carefully stacking the blocks just so. He was making sure that  every edge was even and that none were leaning. I looked at Mom and asked if he was always so tidy. She assured me that this was the case, even though she and his father didn’t really emphasize this. She went on to say that he would independently clean up his toys, and wanted things ‘just so’ around the house.

In my many years of working with children who stutter, it is not unusual for their parents to report that the child is a perfectionist. Why? Perhaps someday they will find the ‘perfectionist’ gene. In the meantime, this trait can be a self-imposed demand, stressing  developing speech and language.

Turn Off the NOISE!!!

It never ceases to amaze me just how many toys are on the market that produce sounds – music, animal sounds, environmental sounds, stories, alphabet letters, etc. There are homes and daycares that I visit where there are numerous noise generating toys sitting out. Often there are several playing at one time. In addition to this onslaught of sound, the television might be playing in the background. No wonder so many children seem to have delayed or disordered speech and language skills! Many have early stuttering.

Children need to be able to hear a language spoken clearly in order to learn to speak it clearly. They need a quiet environment to be able to process what they are hearing and to be able to put their thoughts into language.

Every parent has experienced a situation where they are trying to talk to another person on the phone and have a crying, whining, fretful child at their feet. It’s very difficult carrying on a conversation with all of that distraction. So why do adults think a child can do it?

So if you want to help your child to develop good speech and language skills, please turn off the background noise and talk to them.

More On Demands

In my many years as a speech-language pathologist who works with people who stutter, I have learned a lot from my clients. Even the very little ones.

In a previous post I talked about demands/capacities model of early stuttering prevention. And one of the lessons that I have learned is that children have their own perception of what causes them stress and may place a demand on their emotional system.

The mother of one three-year-old began to notice that on some days her son’s speech was very fluent – no bumps or sticky sounds. On other days that was not the case. Using her great observational skills she discovered that her son had fluent speech on days where he wore sweat pants to daycare and had bumpy speech on days where he wore zippered pants. Can you guess what was causing him stress?

Well, he recently moved up to the three year-old class where the common procedure was for independent use of the small toilets. This little guy found that zippers were difficult for him. He silently worried about not making it in time as he struggled to get his pants zipper down. Mom saved the day by dressing him only in pants that he could pull up and down easily. Gradually his dysfluencies went away.

Another little fellow that I know was getting migraine headaches because he worried about getting paste on his finger at Sunday school. He didn’t like the feel of the paste on his finger, and stressed about it all week. Luckily this problem was solved by having a talk with the teacher and the use of a popsicle stick.

As adults, these issues might seem trite. But to our children they can be monumental. Sometimes we can just ask our child if something is making them sad or causing them to worry. Not all children can verbalize their concerns. In those cases parents have to act as scientists – making observations, making changes and observing what happens.

When Demands Exceed Capacities, Stuttering Can Result

I often see parents of young children who are beginning to stutter. For at least 10 years I have been successfully using with many families the Demands/Capacities Model for Stuttering Prevention (by Starkweather, Gottwald, and Halfond, developed at Temple University) as an intervention approach. The basic principle is “Stuttering results when demands exceed capacities.” 

First we look at what is meant by capacities for fluent speech. Since speech is a motor activity, it is affected by muscle strength, coordination, motor planning – all of the elements that might impact your golf, tennis or bowling game. Some of the other capacities include emotional maturity, intellectual or cognitive development, and language skill.

Demands on fluency include demands on the emotional system, demands on the language system and on the motor system, as well as a child’s uneven development.

Demands on the child’s motor system can include such things as fast-paced talking by the adults in the child’s environment and time pressure. Demands on the language system includes command performances, asking the child a lot of questions, lots of distractions while talking, and parents & adults in the child’s environment using long sentences.

Demands on the child’s emotional system can include confusion, volatile emotional atmosphere, instability in the child’s environment, parental fear of stuttering, and trying to pretend that the child’s speech difficulty doesn’t exist.

Intervention then involves trying to reduce demands while increasing the child’s capacities.

Speak Slowly – Setting an Example For Your Child

Think about it. When you are around someone who is talking fast, in a rush, we automatically feel we must rush. When you are around someone who is relaxed and calm, we begin to slow down.

When we slow down our speech rate while talking to our child they begin to automatically slow down their rate of talking. Talking at a slower pace allows our brain to process what we have heard and to formulate what we want to say. It also gives the muscles involved in speech production a little more time to coordinate their movement.

So how slow is slow? Mr. Rogers on television is a good model. Sometimes a parent just needs to try talking at different slow rates to see what rate is helpful to their child. You probably won’t be able to do this every time you are talking with your child. But find at least 10-15 minutes every day where you can interact with your child and focus on slowing your speech rate. It might be at bath time or riding in the car. Whatever works best for your daily routine. Put up a couple of signs to remind yourself to do this.

Remember: You are  never telling the child to slow down.  You are just slowing down yourself. Give it a try and see what happens.

Neuroscience: Building the Brain

When a young child is just learning to talk they need to practice a lot in order to learn to coordinate the movements of all of the body parts to achieve clear speech.  With practice  improvement should occur. When a person has learned to make sounds incorrectly they have already constructed neural pathways that have to be altered in order to improve.  Again  practicing the correct way creates new neural circuits and lets the old ones fade away.

If a client comes to me for help with their speech and they fail to do the necessary practice  they are setting themself up for failure and frustration. They are wasting time and money. So if you want speech therapy to help you or your child make it a priority and do the necessary work out of the clinic.

One of the things that I often tell clients and parents is that “Speech is a motor activity  like golf or tennis. ” What does this mean? Speech is only one method of communication. It is the physical process of taking a thought and coordinating the movement of many body parts to produce an outcome -in this case sounds. In sports our thought is to hit the ball in a certain way direction and intensity. Neuroscience is showing us that when we repeat an activity over and over we are actually strengthening neural connections in our brain. It’s like wearing a path across a yard.

WordPress Themes