Each week we will put a spotlight on one of the people the SpeechRight speech and language therapists have been working with. This will give an insight into the types of difficulties we support and what goes on in a speech therapy session.
Difficulties: Jack has a stammer. His stammer first appeared when he was 4 years old. Jack’s stammer involves repetition of the initial sounds of words, blocks (where his mouth is in position to say a word but no noise comes out) and prolongations (where a sound is made longer). Jack has never received any speech and language therapy support until he came for a detailed initial assessment 2 weeks ago with SpeechRight. This identified that Jack would benefit from therapy which:
- gives him some direct speech strategies he can use to support his fluency
- focuses on his general communication skills e.g. volume, eye-contact, talking speed, posture, facial expression
- considers his thoughts and feelings around his stammer and its impact on his daily life
Hearing: No concerns
Session: Therapy Session Two with Emma
We started the session with a re-cap of how things had gone during the week. Jack reported that he had been able to try some of the activities we had suggested at the last session and he was pleased with how this had gone. Jack said he felt that his stammer had increased this week in his spontaneous conversations but when we discussed this in more detail, we realised that potentially the stammer had not increased but Jack’s awareness of it had. This is important because if Jack is to have strategies to use to support his fluency, he needs to be aware of what his talking and stammer are like now.
We had three key areas we were targeting today:
Abdominal Breathing: Breathing is important to consider when looking at our fluency. The breath coming out of the lungs ‘powers’ our voices. Therefore, if we do not complete regular, relaxed breaths we are going to be unable to maintain a steady, calm flow of talking. Together, Jack and I practised this breathing and began to use it as we slowly increased the length of our utterances from single sounds to short words, longer words, phrases and sentences.
Tallying: Tallying was used to help Jack accurately identify when he stammered. He needs to know this in order to use the direct strategies he will be taught. Jack and I held a conversation about our favourite holiday destinations. As we were talking, every time Jack felt he stammered he held his finger up. In the same way, every time I thought I saw or heard a stammer, I held my finger up. The idea is for Jack to ‘catch’ as many stammers as he could. Following practice last week, Jack achieved a near 100% record in this session. When Jack ‘caught’ his stammer, he was also able to learn more about what happens when he does stammer; he realised that in a stammering moment when he is repeating the initial sound of a word, there is a lot of tension in the top part of his throat.
Talking Speed: Jack uses a fast talking speed and this puts lots of pressure on his language system to: quickly workout what he wants to say, to formulate the utterance he needs to produce and to quickly move his mouth and tongue into all the correct places to make the speech sounds. This can encourage him to stammer. A fast talking speed also puts lots of pressure on the listener to keep up with and follow what Jack is saying. If Jack does stammer, combined with his fast talking rate this can have a negative impact on Jack’s ability to clearly communicate his ideas. We encouraged Jack to use a ‘good talking speed’ by using more pauses in his speech (rather than saying each word more slowly). By pausing, it also gave Jack chance to use his ‘relaxed breathing.’ Jack practised reading aloud a range of different reading passages with a special ‘syllable ball’ that gave him the pace he needed to follow.
Jack was given a number of different activities to practice linked to the exercises we had done today. Jack has a lot of work on at the minute with his business so he felt that he needed a longer time before the next session in order to complete enough practice. Jack felt a session in 3 weeks would be best.
In the Spotlight next week will be a group of six 5 years olds who are completing a Narrative Group at school. Narrative works on developing a child’s attention and listening, understanding, talking and social communication skills.