Patty Walton
and Mary Wallace have combined their extensive clinical
experiences to develop a step-by-step approach that combines
indirect and direct therapies and integrates fluency shaping
with stuttering modification.
Basic Components of our Stuttering Therapy Approach:
Our
treatment philosophy has evolved over many years, from what
once was relatively indirect to what is now a well-defined,
direct approach. As specialists in the area of stuttering,
it has not been uncommon for us to see children with resistive
stuttering behaviors or children who have had previous speech
therapy without success.
The Fun with
Fluency treatment paradigm incorporates the following: consistent
clinician modeling of speech strategies, positive reinforcement
of targeted speech behaviors, a therapy structure based
upon producing increasingly longer and more complex utterances,
procedures to maximize success in and out of the therapy
room, activities designed to improve the child’s self-esteem
and self-confidence, and family participation whenever possible.
All of our therapies contain these components, but the relative
emphasis varies from child to child. The strategies are
organized on a continuum ranging from a single focus on
building fluency skills to a single focus on modification
of stuttering.
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Modeling
Therapy Strategies
Clinician modeling
is provided throughout the therapy process. Providing a
continuous speech model of targeted behaviors facilitates
the learning process.
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Providing
Reinforcement
We reinforce
all productions initially, regardless of the child’s
accuracy in producing the targeted speech strategy. This
heavy reinforcement encourages further participation and
increases the child’s self-confidence early in therapy.
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Bolstering
Self-Esteem
It is not unusual
for children who stutter to feel different from their peers,
even at a young age. The experience of not being able to
speak easily or not being able to say what they want to
say can have serious, even devastating, effects upon the
child’s development of healthy self-esteem. Children
who stutter are often targets of teasing and ridicule, especially
from other children. The sense of self developed in childhood
often follows people into adulthood; therefore, it is critical
that children who stutter have every opportunity for positive
experiences, especially with respect to their speech.
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Following
a Hierarchical Therapy Structure
All therapy strategies
are taught within a hierarchical framework in which the
length and complexity of utterances are systematically increased.
The rationale for this approach is that children’s
disfluencies increase with the length and complexity of
their utterances.
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Maximizing
Success in the Therapy Room
Every activity
chosen is geared towards having the child experience as
much success as possible in the therapy room. In addition,
great care is taken to actively engage the child in the
activities by choosing games or toys that are of high interest
to the child.
For more specific information please read "Fun
with Fluency".
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What
are Speech Professionals?
The profession of speech-language pathology has been at
the forefront in researching, diagnosing, and treating stuttering
in children and adults for more than 75 years. In the past
decade new knowledge and advanced technology has created
the opportunity to understand and treat stuttering more
comprehensively than ever before.
Out of this process, a new group of highly trained and
skilled professionals has emerged: Board Recognized Specialists
in Fluency Disorders. These specialists hold the basic clinical
certification (CCC-SlP) awarded by the American Speech-language-Hearing
Association (ASHA) and, in addition, have received advanced
education and clinical training in fluency disorders. After
passing a comprehensive examination they are awarded a Certificate
of Specialty Recognition by the Specialty Board for Fluency
Disorders.
Fluency specialists work in many settings, including schools
systems, universities, hospitals, clinics and private practice.
They provide direct clinical services to people who stutter
as well as consulting services to other speech-language
pathologists (SLPs).
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Why should I consider using a Fluency Specialist?
Speech-language pathologists work with a vast array of
communication disorders. As in other professions, such as
medicine or law, it is extremely difficult to be an expert
in every area of practice. Many generalpractice SlPs are
proficient in the diagnosis and treatment of stuttering,
but at some point you or your current speech-language pathologist
may feel that seeking the expertise of a specialist is in
your (or your child's) best interest. Your SlP may consult
with a fluency specialist or refer you to a specialist for
evaluation or therapy.
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What should I expect from a Fluency Specialist?
The fluency specialist will begin with a formal interview
so that a complete history of you or your child's stuttering
as well as any past or current treatments can be obtained.
This will generally be followed by a formal evaluation/
assessment and analysis of the speech dys fluency and its
impact on your life. Following the evaluation the clinician
will go over the results and make recommendations for treatment.
You can expect that the interview and evaluation process
will take from 1-3 hours.
Fluency specialists use a variety of therapy methods and
usually tailor their approach to the needs of the individual.
Therapy is a partnership in which both the clinician and
the person who stutters (or the child and parent) should
participate actively in setting goals and working to achieve
them.
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Fee Schedule
I. DIAGNOSTIC
SERVICES
• Fluency
Consultations* (1 hour)……………………$100.00
• Fluency Evaluation* (1 ½ hours)……………………$200.00
• Articulation Evaluation*..…………………………......$100.00
• Complete Speech/Language Evaluation*..………..$150.00/hour
(*All include written reports. Payment is expected at time
of service)
II.
THERAPY SERVICES
• Individual
Therapy:
(effective March 1st, 2006)
30 minute session……………………………………...$45.00
45 minute session………………………………...........$67.50
60 minute session……………………………………..
$90.00
90 minute session……………………………………...$135.00
120 minute session…………………………………….$180.00
(Payments received
at the time of service or prior to the last day of the
month will reduce the fee to $85.00/hour. Payments received
after
the last day of the month will automatically be re-billed
at the full fee.)
III.
ADDITIONAL SERVICES
• Outside
Consultations*………………………………$100.00/hour
(With Social workers, Psychologists, School or Private Speech
Pathologists)
• Coordinating
Services Through the Schools……......$100.00/month
• Additional
Letter/Reports:
Insurance or Physician Letters…………………………$25.00
Progress Reports………………………………………..
$40.00
Final Reports……………………………………………...$40.00
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Stuttering
Therapy