Vol. 18 •Issue 19 • Page 6
Fluency Consultants

When his family moved to Frisco, TX, 3-year-old Jack Kennedy was stuttering severely, with facial tics and other secondary behaviors. Today, his fluency is improving, and Jack does not lack for self-confidence as he looks forward to entering kindergarten in the fall.

Jack is one of the beneficiaries of an innovative program that has enabled the Frisco Independent School District to upgrade the ability of its clinicians to work with children who stutter with the help of a board-recognized specialist in fluency disorders (BRS-FD).

Frisco is a rapidly growing suburb of Dallas. "As in most school districts, stuttering therapy?made up a relatively small percentage of our speech-language pathology?caseload," said Judy Haven, MA, director of Special Education Services for the school district. "But it is an area that we felt?strongly needed strengthening."

Speech-language pathologists in the district saw an opportunity when Nina Reardon-Reeves, MS, CCC-SLP, BRS-FD, moved to the area and began working with the schools. The district hired her as a consultant in 2006 to guide its fluency program.

The speech-language pathologists had relatively little training and experience in working with children who stutter. That's not unusual. A recent survey found that school speech-language pathologists lack basic knowledge and skills in assessing and treating stuttering. Forty percent had not attended a workshop on stuttering since graduating from college, and nearly half were not comfortable working with children who stutter. The majority of those surveyed were unfamiliar with current stuttering treatment techniques and did not know how to contact a fluency specialist or stuttering support group.¹

Fluency is one of three clinical specialty recognition programs approved by the American Speech-Language-Hearing Association (ASHA). In addition to a Certificate of Clinical Competence (CCC), board-recognized specialists have advanced education and clinical training in fluency disorders. They must renew their qualifications every three years.

While a few school districts have fluency specialists on staff, the relatively small number of board-recognized specialists-fewer than 300 in the United States-makes this a rare occurrence. Consulting arrangements are an efficient way to make this expertise available to more school clinicians.

As a board-recognized specialist, Reardon-Reeves is a consultant to three school districts in the Dallas area. Her role in the Frisco schools is to help speech-language pathologists increase their knowledge of fluency and use new techniques for stuttering assessment and treatment. The district uses a multifaceted evaluation process that includes interviews with parents and teachers and multiple assessment tools. Reardon-Reeves participates in some evaluations, and school clinicians use video recordings of these sessions as a training tool to observe her assessment techniques.

She also compiled a fluency treatment toolkit that helps the Frisco speech-language pathologists expand their resources for parents and educators as well as their range of assessment and therapy techniques.

"In the past, people would grab onto one idea and use it for every fluency case," said Pam Graham, MLA, one of the lead speech pathologists in the Frisco district. "Now we have better material that reflects a global approach to stuttering and represents the best that's out there."

The Frisco district has strengthened its preschool program and outreach to parents. In addition to working individually with parents of children who stutter, the district sponsors parent night programs and family days for children and teens.

Jack Kennedy now goes to speech therapy twice a week in a group with other children who stutter, and the parent sessions have been an "awesome experience" for his mother.

"So much can be done at home," said Cheryl Kennedy. "The speech-language pathologists teach us how to make working on speech fun and to not put pressure on our kids. They model ways of speaking at home."

While Reardon-Reeves occasionally works directly with difficult cases, her primary focus is on building the skills of school speech-language pathologists. As the fluency resource person for the district, she conducts inservice training and facilitates a monthly fluency interest group for school clinicians.

In addition, the school district is sending more speech-language pathologists to continuing education workshops on stuttering.

As a result of Reardon-Reeves' involvement, speech-language pathologists in the Frisco Independent School District feel more confident in evaluating and treating fluency cases. One outcome is that clinicians are identifying and treating more children who stutter, especially in preschool.

From her perspective as director of Special Education Services, Haven stated, "Our therapists are gaining confidence and increased skill in their ability to evaluate and provide therapeutic support, resulting in unmeasured positive outcomes for these students. The parent factor is significant, too. The shared partnership of parents,?speech-language pathologists and educators all working together on behalf of a child has been a very positive outgrowth of Nina's efforts."

Reference

1. Tellis, G., Bressler, L., Emerick, K. (2008). An exploration of clinician views about assessment and treatment of stuttering. Perspectives on Fluency and Fluency Disorders, 18 (1): 16-23

For More Information

• Specialty Board on Fluency Disorders, online: www.stutteringspecialists.org

James McClure is the consumer representative of the Specialty Board on Fluency Disorders.