Fluency Friday Plus: A Journey with Children/Teens Who Stutter and Families!

games.jpeg About the presenter: Diane C. Games, M.A. is a licensed and certified Speech-Language Pathologist and co-owner of Tri-County Speech Associates, Inc., a private practice in the Cincinnati area. Professional activities have included the presidency of the Ohio Speech-Language-Hearing Association and honors of OSLHA in 1994. She currently serves on the ASHA Special Interest Group - Fluency. She has presented several workshops on the diagnosis and treatment of fluency disorders and has coordinated the Fluency Friday Plus project in the Cincinnati area for the last ten years.
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About the presenter Patricia Fisher, M.A., CCC-SLP, co-founder of Tri-County Speech Associates, Inc, is presently the Private Practice representative for the state of Ohio. She is actively working to complete a specialist degree in Orofacial Myology. Patty holds specialty training in the Australian based Lidcombe program for pre-school and school aged children that stutter. Patty has been adjunct faculty at Miami University.
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About the presenter, Rodney Gabel, Ph.D., CCC-SLP is a Board Recognized Specialist in Fluency and Fluency Disorders. He is an Associate Professor at the University of Toledo. Dr. Gabel conducts research, teaches courses, and provides therapy in the area of stuttering. He is the editor of the Perspectives on Fluency Disorders and an Associate Editor for the Journal of Fluency Disorders
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About the presenter: Ann Slone, M.A., CCC-SLP has been a speech-language pathologist (SLP) working in the schools for over 35 years. She has served students from birth to 21 with various disabilities and communication needs. She is currently a supervisor at the Hamilton County Educational Service Center and manages a program which includes over 85 SLPs. She has been involved with the Fluency Friday Plus program since it was founded in 2000.
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About the presenter: Irv Wollman, MA. CCC, BRFS is a clinical manager in the Division of Speech Pathology at Cincinnati Children's Hospital Medical Center where he manages speech pathology services at 8 neighborhood satellite locations and clinically, works exclusively with children who stutter. Irv is an adjunct assistant professor at the University of Cincinnati in the Communication Sciences and Disorders Department teaching Seminars in Stuttering. He has served as chairperson for the Fluency Team at CCHMC and is a Board Recognized Fluency Specialist. Irv has been a member of the Fluency Friday organizational team since its inception in 2003 and has presented lectures on Fluency Disorders at local and state conferences.

Fluency Friday Plus: A Journey with Children/Teens who Stutter and Families!

by Diane Games, Patty Fisher, Rod Gabel, Karen Rizzo, and Irv Wollman
Ohio, USA

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Diane Games - Introduction to Fluency Friday Plus

On the first Friday & Saturday morning in November, children and teens who stutter in the Greater Cincinnati area participate in an intensive treatment program called Fluency Friday Plus (FFP). Graduate clinicians from the University of Cincinnati and Bowling Green State University provide treatment under the supervision of experienced Speech Language Pathologists from the greater Cincinnati/Northern Kentucky area.

Each year the planning team picks a theme. One of my favorites, A Journey to Change, provided a framework for the FFP program. Each student in treatment had "Trip Tics" to talk about personal journeys with stuttering. They developed a "Guided Personal Plan" to plan various experiences at FFP and to discuss stuttering. During treatment activities, students were encouraged to develop a personal map for change. This map or journey included different people, places, feelings and experiences! They also learned that a "journey with stuttering" includes challenges, triumphs, and barriers! Feelings about stuttering were also validated as students worked through different speaking tasks and activities.

Parents of the students were invited to attend programs while their children/teens participated in various activities. Issues such as motivation, expectations from treatment and the impact of various responses to stuttering were discussed under the leadership of Donna Cooperman and Nina Reeves. Parents were able to ask questions of a teen panel on Friday led by Derek Daniels and an adult panel on Saturday led by Rod Gabel. In addition, speech language pathologists from the community answered various questions about treatment and qualifications for school treatment.

FFP is a collaborative program that relies on the support of many professionals. Professionals who attend and supervise include faculty from universities and speech language pathologists from the educational setting, hospital practices and private practice. All professionals and graduate clinicians at FFP receive a Diagnostic and Treatment manual developed by the FFP leadership team. The 2011 manual is freely available on the Fluency Friday Plus web site (www.fluencyfriday.org) and is also available HERE.

Finally, FFP has received support from the Ohio Speech Language Hearing Association's Affiliate Grant program and from SWOSHA, the Southwestern Speech Language and Hearing Association. The many children, teens, speech language pathologists, graduate clinicians and families thank OSHLA & SWOSHA for their financial support.

VIEW GAMES' PPT

Patricia Fisher - The parent perspective

Since FFP has an education track for the parents, there was an opportunity to obtain the parents feedback immediately following the program. 

VIEW FISHER'S PPT

Irv Wollman and Rod Gabel - Graduate Student Training

For many years, the prevailing sentiment among the vast majority of experienced and newly-graduated speech-language pathologists, is that there is a distinct level of discomfort surrounding working with people who stutter (1,2,3,8,12). Surveys have demonstrated that stuttering is one of the least favorite communication disorders to treat (10, 15). To a great extent, this view has been fundamentally grounded in a perceived lack of clinical competence, although there may be other potential factors that apply. In 1997 St Louis cited 6 recognizable problem areas that he suggested could be the sources of that fear and discomfort. One of the specific problem areas he cited, lack of academic training and clinical practicum experience, has received a great deal of attention. There have been numerous published reports that have drawn a direct link between training (academic and practical) and competency (1, 9). Thus, suggested recommendations to remediate such discomfort, especially in light of the change in ASHA pre-service requirements, have been to create more opportunities through specialized in-services and workshops coupled with hands-on experience following classroom training (1). From a training perspective, the "Fluency Friday Plus Workshop," which began 10 years ago, was established to help address those clinical needs as well as provide a unique opportunity for children who stutter. Yaruss, Quesal and Reeves (2007) characterize this type of self-help workshop as a, "Youth and Family Day" program.

VIEW GABEL'S PPT

Over the years, FFP has evolved and grown, and so have the instructional methods. Two of the target groups, speech-language pathology students and practicing community clinicians have found the experience both challenging and rewarding. Our surveys have indicated that the combination of academic coursework and the experience-based opportunities that the program provides, results in greater levels of self-confidence among graduate students. This was confirmed against the backdrop of St Louis's 6 problem areas as measured by a survey that probed the potential sources of clinician discomfort. Based on the responses obtained, the issue of competency was significantly mitigated for those students who participated as clinicians at FFP. Additionally, the second most significant problem area impacted by their experience was "responsibility." Graduate students' perceptions of their clinical responsibility when working with people who stutter change as a result of their presence. They appear to develop a broader view of the disorder as well as their role as clinicians. Clearly, this is a step in the right direction for future SLP's regardless of their eventual places of employment.

In short, Fluency Friday Plus has filled a unique space for a varied target audience. For children and teens who stutter, the day and a half program appears to yield benefit in terms of helping them feel better about themselves, improve their self-image and confidence. Similarly, the FFP experience appears to also impact levels of clinical competence and confidence for practicing speech/language pathologists and graduate students alike.

Wollman Bibliography

VIEW WOLLMAN'S PPT

Ann Slone - Summary/Conclusion

Speech-language pathologists who practice in the school setting play an important role on the Fluency Friday Plus team. FFP includes school-based professionals from the Hamilton County Educational Service Center, Cincinnati Public Schools and from other local school districts in the greater Cincinnati area. These professionals who work in the school setting identify and refer children and teens to the program. Many also participate as supervisors in the program. Feedback forms completed by the SLPs indicate that the children and teens who attend the FFP program benefit from being in an environment where the majority of speakers stutter! They especially enjoy the group interactions and the skits at the end of Friday. The Speech Language Pathologists also report benefitting from the activities, the manual and also from observing and interacting with the students who stutter, especially over the age range of Kindergarten to post high school. One of the ideas that evolved from the SLPs was to have the "older" students speak to and answer questions from the younger students! This is now a tradition at FFP. SLPs in the school setting have also carried over the benefits of the program into informal, group interactions such as "The Lunch Bunch". One issue that has occurred is obtaining "release time" from school to attend FFP. Fortunately, this has only impacted a few professionals. The outcomes of FFP are the opportunity to learn more about stuttering from lectures, from observing a variety of students who stutter and from the materials developed for the program.

VIEW SLONE'S PPT