The following poster was presented by Courtney Luckman, MSc, CCC-SLP and Katie Gore, MA, CCC-SLP at the 2021 Oxford Dysfluency Conference on January 7-8, 2021. Additional reading and therapy resources are included in this blog post.
Here we are at the end of 2020, friends. As the kids say, That happened.
This has been a year of downs and ups and downs and downs and (ups?) and downs. We have changed so much from where we were, and who we are, at the beginning of the year. We also haven’t changed, thanks to the way that 2020 has reminded us of what really matters, and how we’ve intentionally recommitted to the most important things in our lives during a year of turmoil.
We’re the same, and not the same. We’ve stretched, yet are finding stability. We’ve learned, but every new learning is a reminder of how little we really understand.
What have we taken away from 2020? Here’s our slice, from speech IRL.
Read moreby Alexander Whelan, MA, CCC-SLP
Each year, the stuttering community celebrates International Stuttering Awareness Day on October 22nd. People who stutter (PWS) all over the world take this opportunity to raise awareness and educate others about stuttering and to shine light on some of the “blind spots” and misconceptions that people have about stuttering.
As PWS know, stuttering is so much more than what casual listeners can observe during mundane, everyday interactions. As an example, PWS could experience twenty minutes of mounting anxiety while sitting at a restaurant waiting to order an entrée. If their order happens to come out fluently or mostly fluently, the server and everybody else at the table are completely unaware of the stressful moments that were just endured. Even when stuttering is directly observable, listeners only see a snapshot of the stuttering moment. All of the mental gymnastics that led up to that moment aren’t outwardly visible to listeners. Neither are the embarrassment, awkwardness, guilt at having caused awkwardness for the listener, frustration, and shame that sometimes follow stuttering moments.
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In our previous posts on education and empowerment goals for speech therapy, we discussed activities to work on as alternatives to speech goals. You may expect this post will finally get to some new activities that actually focus on fluency—but alas, not quite. Ease, our final E in our 3Es model actually has little to do with fluency of speech. Aspects of ease include spontaneous speech, stuttering easier with less tension, and awareness of the speech mechanism.
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In our previous blog on education goals for speech therapy, we outlined some education-focused goals and activities for IEP students who are “over” speech therapy. Some students just don’t want to work on speech goals, and that’s perfectly fine! Empowerment is the second E in our 3Es model of stuttering therapy, and it’s another goal area you can work on to make IEP minutes that doesn’t involve speech goals.
It follows that while the student makes progress with empowerment, it might not look like progress on the outside: I had a parent come to me once, concerned that her 12 year old was stuttering more after coming to speech therapy for a few weeks.
“Great!” I said to mom. That is exactly where we want to be.
Uncomfortable and confused, mom wanted answers. I asked her,
Mom answered yes to all of these questions.
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Congratulations on graduating, CF-SLP! Welcome to the CFY job search, the first gauntlet of your new career. The good news is, getting that CFY job is something you only have to do once.
...well, hopefully once. Unfortunately, there are a lot of people out there who take CFY jobs that turn out to be miserable, to the point that they decide to quit and find another CFY job to finish out the fellowship period. You know how much the CFY hunt sucks, so it really says something when a person decides to jump ship and put themselves through the wringer again.
New clinicians often struggle to determine if a job offer is reasonable, and if an employer seems decent. In many cases, the CFY is your first experience ever with a professional-class job, where the expectations and standards are different from positions like retail, hospitality service, or working at summer camps.
I will say this as politely and professionally as I can: a lot of SLP employers are crap. The quality of clinical service delivery may be outstanding, the practice may be decades-old and have multiple locations, and the clients may report high satisfaction. Sadly, when it comes to what is good for the practice, what is good for the clients, and what is good for the clinicians...the clinicians are prioritized dead last (if even considered at all). Clinics can get away with this because there is a constant supply of naive, eager, and debt-ridden CFs who graduate every year that can be reliably recruited and discarded as needed.
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On Thursday night, I shared joy with so many others around the country. We watched and listened to Brayden Harrington as he spoke openly about stuttering at the Democractic National Convention. He exuded confidence, eloquence, and charisma while showcasing his powerful voice. The next day, #BraydenHarrington was trending on Twitter.
It is difficult to describe in words how emotional and impactful this moment was for the stuttering community. Stuttering is one of the oldest-known human experiences, dating back to Greek philosophers and Old Testament figures. Despite this history, stuttering continues to be misunderstood and miscategorized, with discrimination faced daily by people who stutter.
Brayden was a sign that maybe now, in 2020, things are finally different. Members of the stuttering community and professional community have joined forces for decades to educate the public, dispel harmful myths, and advocate for the rights and dignity of people who stutter. Could a Presidential candidate, and his 13-year-old friend, be a sign that this has finally paid off?
We all thought so, but the New York Times proved otherwise.
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I received an email from a graduate student this week, asking for advice about a fluency client in an upcoming school placement. The student described a very, very common scenario that school-based SLPs encounter with stuttering students who have IEPs. If you’re a school-based SLP diving back into IEPs after summer break, there’s a good chance you’ll encounter one or two students like this:
"The student does not describe his disfluency in any specific way. His current goals include working on breathing techniques and easy onsets. He is unaware of his difficulty with coordinating speech with breath, and talking too fast through each breath. My supervisor noted that he is very unmotivated to participate in therapy. She expressed that this became even more difficult with the transition to remote therapy in the spring, and that is how we will be delivering his services this fall as well. He is entering 4th grade, and apparently is very 'over' going to speech therapy."
Sound familiar?
This post is for anyone who gets overwhelmed by headlines, Instagram stories, and tweets that use all kinds of social terms you aren't familiar with. You want to ask questions, but are afraid of saying something wrong in the process. Here's what you should know before you download "Social Justice" on Duolingo.
“Katie, you know what makes me so angry?” My passionate teenage client had just arrived, the conversation ready to explode out of him before he had even sloughed off his backpack.
“What?”
“People using the wrong pronouns! Like, I have a bunch of friends who have updated their pronouns, and it’s like, cool. I use their new pronouns. And my other friends, they all use the new pronouns too. You know what I’ve noticed, it’s adults who don’t use the right pronouns. And they make all these excuses, like ‘Oh I’m trying,’ ‘Oh it’s hard to change habits’, whatever. Like, bullshit. It’s not that hard. Just be a decent person, shit!”
“That’s a pretty interesting observation.” I paused. “I have that same problem, too. I am trying, but I mess up a lot.”
He blinked, confused. “Wait, what? You?”
“Yeah. I think you’re spot on about adults versus younger people. It is a lot harder to change those verbal patterns when you’re older. I’ve noticed the difference in my brain now, back from when I was a teenager. Even with the work that we do at speech IRL now, I am really clumsy with pronouns. You’re still right, of course—it is no excuse, it’s a reminder that I need to dedicate more time to practice. But adult brains...we’re very slow at changing patterns like this.”
His body language softened. “Hmph. I guess. But it’s still wrong.”
“Yes, that’s absolutely true,” I agreed. “It’s not fair or right to those on the receiving end. So, support your friends who are dealing with people like me. And make sure you enjoy your adaptable brain while you have it.”
In the era of memes, tweets, angry acronyms and eponymous insults, the words we use mean more in 2020 than ever before. As this client pointed out, we’re all making changes to the way we talk about certain things—especially this year—because our society as a whole is changing. It was easy for me to empathize with his frustrations because I’ve had my own moments of disbelief and impatience with others who aren’t adjusting as quickly as I’d like them to.
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If communication topics were songs, Small Talk would be in our Top 5 Greatest Hits at speech IRL. We hear all kinds of complaints about how pointless small talk is and that it’s a waste of time. So, some of our most chagrined clients are surprised to find out that small talk is actually a means to an end—and understanding that purpose is often what solves the small talk problem. Ironically, while it is one of the most universally-loathed forms of communication, it is one of the most straightforward skills to teach.
Take this client for example:
“Any plans this weekend?”
“Yeah.” He sighed. “I’m going to California. My girlfriend’s cousin is getting married. I’ve met a bunch of her family, they’re fine…it’s just the whole conversation thing is so exhausting. Like even though I’ve met them, we just have to be together for all those hours, and I never know what to say. It’s so awkward.”
We had already finished the session, but I wanted to assuage his stress. “Oh yeah, that’s a thing. You know there’s a formula for that, though, right?”
He bolted upright. “What?”
“Yeah, here.” I grabbed a piece of paper and sketched out a few words. “Here you go.”
He stared at it, in a blend of relief and anger.
“Holy shit. Why the f--- did no one teach me this in middle school???”
Conversation is an art, but there is an awful lot of science, or method, behind it. Small talk is in fact the most methodical form of conversation. I’ve written previously about the high-level principles of successful conversation, where small talk is a critical element. In this post, I’ll outline exactly what small talk is, how to do it, and how it relates to the introvert’s saving grace: Medium Talk.
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