ACQ Vol 12 No 2 2010

already demanding schedules. If the situation is not discussed and monitored closely, some parents may end up feeling guilty and discouraged about the treatment process, or worse, conceal the reality of their circumstances. Rather than focusing on what the parent has not achieved, the SP should attempt to build on what the parent has already accomplished. For example, if a parent reports being able to complete treatment for only 5 minutes per day, the SP may suggest that an additional 2 minutes of treatment be applied each week, until the recommended dose of treatment is achieved. It is equally important to give parents the opportunity to suggest their own solutions to any scheduling problems. In doing so, parents may be more inclined to take ownership of their ideas and follow through with the solutions discussed. By setting parents up for success in this way, the completion of treatment tasks should become a more feasible part of their daily routine. Problem 7 The child’s siblings distract the parent or child during treatment. Possible solution When one child receives parental attention to the exclusion of siblings, as may occur during stuttering treatment, it is almost inevitable that siblings will attempt to disrupt the session. If not resolved, the situation could result in an overall reduction of treatment quality or duration. One potential solution to the problem is to allow all children to participate in treatment. In doing so, the parent can focus treatment on the child for whom it is intended while also attending to the demands of other siblings. Another solution may be to prepare, in advance, an alternate activity for siblings to complete while stuttering treatment is being delivered. For this to succeed, the activity must be appealing enough to keep the siblings interest for the entire treatment session. A reward system may need to be developed to ensure that the alternative activity is sufficiently engaging and motivating. In fact, if a reward system has already been developed for the child receiving stuttering treatment, it may be advantageous to apply a similar reward system to the alternative activity so as to minimise sibling dispute.

demonstrate great insight into the fluctuations of their child’s stuttering each day and require only minimal training in the task of collecting scores. Nevertheless, when initially instructing parents to use a severity rating scale it is important to calibrate readings between users, or risk the scale becoming potentially meaningless. To do so, a sample of the child’s speech within the clinic can be rated independently by both the clinician and parent. Severity scores can then be compared and discussed until they differ by no more than 1-scale point. During the calibration stage, it is important for clinicians to emphasise that the severity scale does not require parents to count the actual number or type of stutters present. Rather, scores should be a subjective reflection of the child’s typical level of stuttering each day. On the whole, provided that the clinician discusses severity rating scores regularly, it is likely that parents will continue collecting them consistently. Problem 5 The parent has difficulty identifying stutters. Possible solution Given that many preschool children exhibit normal disfluency as they acquire language, it can be difficult for parents to identify stuttered moments during the day. Accordingly, parents can be instructed to consider only unambiguous stuttering when attempting to assess severity in this age group. Unambiguous stuttering refers to speech behaviours that can be clearly and unequivocally categorised as either repeated movements or fixed postures (see Teesson, Packman, & Onslow, 2003). When uncertain, the general rule should be to overlook ambiguous disfluencies. Some parents, however, may need assistance in distinguishing stuttering from normal disfluency. To do so, a sample of the child’s speech within the clinic can be assessed by the clinician, reporting back to the parent when stuttering has occurred. With modelling and clear instruction, it is likely that parents will learn to identify stuttering quickly and accurately. Problem 6 Parents are unable to schedule regular treatment times. Possible solution It is common for parents to feel overwhelmed with the addition of treatment tasks to their

Would you like to contact more than 4,500 speech pathologists? Advertising in ACQ and Speak Out is a great way to spread your message to speech pathologists in Australia and overseas. We have different size advertising space available. If you book in every issue for the whole year you’ll receive a discount. See www.speechpathologyaustralia.org.au for further information about advertising

72

ACQ Volume 12, Number 2 2010

ACQ uiring knowledge in speech, language and hearing