|About the authors: Elaine Kelman is a consultant speech and language therapist and the head of the Michael Palin Centre for Stammering Children in London. She has contributed to the development of the various therapy programmes for children who stutter, particularly the management of early childhood stuttering and has published a number of papers, chapters and books, having co-authored the Palin Parent-Child Interaction Therapy manual. She participates in the Centre’s international training programme and the research programme and has been invited to present at many international conferences. Elaine is President of the International Fluency Association, on the board of the European Fluency Specialists and is an affiliate of the American Speech and Hearing Association.|
|About the authors: Ali Berquez has a Clinical Lead role at the Michael Palin Centre for Stammering in London, UK. She qualified as a speech and language therapist from City University in 1993. She completed a foundation course in Personal Construct Psychology in 1994 and an MSc thesis comparing the View of Self in adults and adolescents who stammer from a Personal Construct Psychology perspective in 1996. She has worked at the Michael Palin Centre since 2000 and obtained a Post Graduate Diploma in Cognitive Therapy at the Oxford Cognitive Therapy Centre in 2005. Ali was Joint Project Lead for the Stammering Information Programme, to develop awareness and skills about stammering in the education workforce in the UK, which completed in 2010. Her current role involves clinical work with all ages including adults, teaching nationally and internationally, writing, clinical supervision and contributing to research projects. She is currently collaborating with Dr Patricia Zebrowski and her team in Iowa, USA, to explore the expectations of older children and their parents from therapy and whether their hopes are met. Ali presents regularly at conferences. She has managed and developed the Michael Palin Centre’s Teaching Programme since 2004. She manages new referrals for children and young people to the Centre and marketing what the Centre provides to local SLT teams and commissioners.|
|About the authors: Jane Harley is a Clinical Lead Speech and Language Therapist at the Michael Palin Centre, London. Jane has a Post-graduate Diploma in Cognitive Therapy from the Oxford Cognitive Therapy Centre and an MSc in Psychological Counselling. She has an interest in Acceptance and Commitment Therapy (ACT) and Mindfulness Based Cognitive Therapy. Jane has authored, and co-authored peer and non-peer reviewed clinical and research publications. Her research interests include the effectiveness of therapy with adolescents and school aged children who stutter. Jane regularly contributes to the Michael Palin Centre teaching programme.|
At the Michael Palin Centre we have a long history of working with children, young people and adults who stutter and our focus has always been on becoming a confident and effective communicator, rather than a fluent speaker. Way back in the 1970s and 80s Lena Rustin ran group therapy courses which incorporated social communication skills and confidence-building, alongside fluency strategies (Rustin, Purser, Rowley 1987). ‘Minding less’ about stuttering was our earlier (and possibly watered-down) version of ‘it’s OK to stutter’. So this message is by no means new to us – but we need to be thoughtful about whether we are consistently conveying it in our work with the youngest children and their families, through to the young people and adults.
Anxious parents of a three year old may be aware of the ‘window of opportunity’ (which is open for longer than we first thought) and seek help to ‘fix’ the stutter before it becomes established. They may not wish to consider the possibility that it’s going to be OK for the child to stutter, especially if a parent is a person who stutters who has had negative experiences. At this stage we cannot be sure about what the outcome will be – the stuttering may resolve, with or without therapy, and clinical experience and common sense tell us that parental anxiety may have a role in this outcome. So we have the delicate task of providing hope without creating unrealistic expectations, by developing the parents’ understanding about stuttering and what causes it and how they can respond to and support their child.
Our work with school-aged children continues along the same lines: we do not know what the long term outcome of therapy will be for the child, so we offer a combination of fluency building skills, social communication skills and confidence building, working with families to find the balance that is right for their child and for them. When families come to us their focus may be on how to help the child to stop stuttering. From the first session, we use Solution Focused Brief Therapy (de Shazer, 1985) to help them all to explore what confident happy and effective communication looks like, rather than focusing on fluency alone. Some of these children become more fluent, some continue to stutter and we consider either to be a successful outcome if the child is also confident in himself, a good communicator, resilient to deal with setbacks and comfortable with the notion that being an individual, being yourself and saying what you want to say is more important than being fluent.
De Shazer, S. (1985) Keys to solution in Brief Therapy. New York: Norton
Rustin, L., Purser, H., & Rowley, D (1987) Progress in the treatment of fluency disorders London: Taylor and Francis.
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