Speech restructuring or prolonged speech treatments, like the Camperdown Program can help adults who stutter to speak more fluently. Often, after working with a speech pathologist, clients are able to speak with little or no stuttering in the clinic. But using the technique out in the real world is not as easy.
What does it feel like?
Cream and her colleagues asked 10 adults who stutter what it feels like trying to use prolonged speech to control their stuttering. This is the ingenious metaphor they came up with:
Those of you who are as lucky as me and grew up in regional Australia will recognise a collection of playground rockers when they see them.
Playground rockers come in three basic designs – the one way (also known as the “horse”), the two-way, and the four way.
Riding a horse: when using prolonged speech alone, there are no others to consider and riders can move up and down as fast as they want. They feel completely in control.
Riding a two-way rocker: using prolonged speech with a supportive partner, like a family member, good friend or speech pathologist is a bit harder than alone. But both riders share a commitment to make the ride as smooth and predictable as possible – straight up and down – to maximise the chance of an easy-ride.
Riding a four-way rocker: using prolonged speech in groups and/or with people who are not aware of the person’s stuttering or treatment is harder. The person feels less in control, and the ride is unpredictable – they might be bounced all over the place – up and down, and side to side. The person needs to spend more energy anticipating and processing what others are doing. In the worst case, the person may panic, stutter, abandon the ride and refuse to get back on.
What we should take from the playground rocker idea
For people who stutter, practising alone and with sympathetic people (like a speech pathologist, family member or good friend) is important. But it’s not enough to prepare for rough rides out in the real world. People need to find ways of enhancing their sense of control on that four-way rocker. People may find it helpful to:
- plan more (though this has its limits);
- improve their social and conversation skills;
- reduce social anxiety (if any), through such evidence-based treatments such as cognitive behaviour therapy; or
- otherwise learn to accept themselves to reduce feelings of being different.
Specific skill development ideas might include training in making introductions, handling difficult people, working with difficult people, managing conflict, providing feedback to others, being interviewed and interviewing.
Of course, this is all much easier said than done!
For speech pathologists, we need to know that helping clients become fluent in the clinic is good, but not good enough. We need to help clients tackle real world challenges – to work with clients to troubleshoot, experiment, encourage, and, when appropriate, refer on to others who can help with specific training needs or goals. Working with a speech pathologist who understands or – better yet – has first-hand experience with some of the client’s real world challenges can help.
Source: Cream., A., Packman, A., and Llewellyn, G. (2004). The playground rocker: A metaphor for communication after treatment for adults who stutter. Advances in Speech-Language Pathology. 6(3), 182-187.
Images: http://tinyurl.com/p8gperr, http://tinyurl.com/nh8n9bj, http://tinyurl.com/nptdlkb