Question
From: Patricia and
Amanda
Date: 01 Oct 2009
Comments
This is a
great idea and we believe this technique will work with almost anyone. But what
if the parent or caregiver does not have two weeks to prepare the individual?
Will a shorter time span work as well?
From: Vanessa
Sacchi
A shorter time will work
too! Two weeks or ten days was used with the advent of school, but three to
five days will also work. The thing that makes this strategy so successful is
the open, ongoing, conversation that occurs paired with the visual reminder.
Additionally, many of my parents that used this strategy this year also found
themselves preparing their children for transition in other ways. For example,
starting the school schedule early so that the kids could get used to getting
up earlier, and bringing the kids to play at their new playground.
From: Karen
Kumar
Date: 02 Oct 2009
Hi Vanessa! I like how you
applied a simple activity to helping young kids who stutter with transitions. I
appreciate your specific instructions as to how parents are to converse with
their child. There is a young child in my practice who will be moving into a
new home and this will be a helpful activity for both he and his mom.
From: Vanessa
Sacchi
Date: 05 Oct 2009
So glad it can help! It is
amazing to think such a simple activity can have such a big impact on our
kiddo's lives. With a move, I would also recommend that they continue the paper
chain maybe a week into the move, so that the daily conversation can continue
to discuss some of the unforeseen feelings or fears that can be associated with
a new living environment. With this type of preparation I have found that
fluency remains more stable, and if a down cycle occurs it is characterized as
only a change in an increase in frequency of the predominant pattern, and is
typically much shorter in duration. Additionally, in many cases the next
up-cycle is much stronger and this propels the child to a higher level of
fluency.
From: Britta
Larson
Date: 02 Oct 2009
I love this activity! It is
such a simple way to prepare a child for future change. I am wondering if there
should be a balance of changes the child fears and looks forward to in the
paper chain? Have you seen any children become more anxious or afraid due to
constant reminders of the event they fear?
From: Vanessa
Sacchi
Date: 05 Oct 2009
I have not seen any children
become more anxious because of doing this activity. I think that the reason why
it is so effective is because kids can work through and process the range of
emotions associated with transition. Always it is important to validate the
child's feelings. However, in my experience with using this strategy- most
fears that the children express have to do with them worrying about doing
things wrong. For example: a kiddo was happy about hot lunch, but he was very
anxious about not knowing what to do, and if he did not get his ticket for hot
lunch, would that result in him not having lunch? Parents in this situation
were able to go over the lunch time process, and also quell fears that if
something happened he should talk to this person, and the situation would not
result in him not getting lunch. If a child fears introducing themselves, or if
they are worried about their peer's making fun of them, this process provides a
wonderful opportunity to discuss ways to deal with these types of situations
repeatedly. Child and parent (or speech therapist) can practice what to say if
people make fun of their speech by role playing. Also, discussing what the
child should do if they feel like the situation is becoming too much. Having
them identify who (what teacher or trusted adult) they will talk to in a
specific amount of time after an incident occurs. In my experiences with using
this strategy thus far, the result has only been positive, and children who
stutter feel more capable and empowered to deal with the unexpected events that
can come up during any transition.
From: Pam
Date: 04 Oct 2009
Comments
I am a PWS, and not a SLP. I
try to visit local schools a couple of times a year, to teach kids about
teasing and bullying prevention strategies. I use my stuttering story as an
example, as I was teased quite a bit as a kid when I did dare to stutter
openly. I use hands-on activities for the kids to teach about stuttering. Even
kids who don't stutter love activities like this, and learning is much more apt
to occur as they experience the feeling or concept. Great idea! And I know all
about covert stuttering. I did it for more than 30 years, until I finally found
the courage to just be me.
Re: Hands-On Activities Always
Good Idea
From: Vanessa Sacchi
Date: 05 Oct 2009
That is great, Pam! I hid my stuttering for many years as
well because in my family it was just not something that was okay to talk
about. It must be so empowering for you to go into the schools and discuss
stuttering so openly. I know that I feel empowered every day when I help kids
discuss and feel good about their stuttering because that was not what I
experienced growing up. I also do school presentations, and have used the paper
chain idea to list things that peers can do when their friend is stuttering
(keep good eye contact, no interrupting etc.). I have also used paper chains to
show how much we have learned, put all of the important factiods
on rings and debrief at the end... put them together and have kids hold it up,
and out stretched that is how much they now know about stuttering! It's
powerful, and I thank you personally for all the lives that you positively
effect because with knowledge there is a decreased desire to tease.
From: Lourdes
Ramos-Heirnichs
Date: 06 Oct 2009
Comments
Will suggest this activity
to the mother of my second grade student who has fluency relapses over the
weekend. This venue should guide discussion about school concerns. Thanks for
the idea.
Transition Difficulties
From: Shayna Baker (MSU)
Date: 07 Oct 2009
Comments
Your strategy
is very interesting. It sounds like it would be a lot of fun for the child who
stutters as well as the parents. It allows for more bonding time between the
two. One thing I was wondering, Is the child anxious about the upcoming event
because of their tendency to stutter? For example: Is the child thinking,
"I don't want to start a new school year because I stutter"? Thank
you!
From: Vanessa
Sacchi
Date: 13 Oct 2009
The anxiety associated with the
advent of a new school year is not because they stutter, but more has to do
with the personality profile that accompanies a person who stutters. It is not
that we do not want to start the new school because we stutter, it is more of
all of the unknowns that come along with the advent of a new school year, new
teacher, new classmates and a new set of expectations. People who stutter find
a great deal of comfort in routine, and knowing what to expect. The more
predictable we can make the transition for them, the more that they will feel
comfortable with the upcoming transition. That is why the routine of the
goodnight procedure with visual reminder; paired with discussing the variations
of the same transition each night is so successful. Additionally, with the
repetition, kids get the opportunity to discuss the range of emotions, and
problem solve situations that they might be worried about before they occur.
From: Irina
Ponomarenko
Date: 07 Oct 2009
Comments
Hello Vanessa, like your
idea very much. It is a great way to reduced tension and anxiety as well as for
parents to communicate with their children. From your experience, what is the
optimal amount of days should this technique be started before an event?
From: Vanessa
Sacchi
Date: 13 Oct 2009
From my experience... it all
depends on the kid. However, I like to start the transition about ten days
before the anticipated event and continue it through the transition four to
seven days after. Continuing this procedure after school has started, or the
move to the new house has happened allows for this procedure to be a permanent
venue to discuss anything that the child is feeling. And for parents it is one
of the few times of the day that they are not multi-tasking and can truly give
their child their full, and undivided attention. I have also had great success
with seven days before and seven days after the anticipated event. Hope that
helps, and thank you for your question.
From: Katherine
Thayer
Date: 08 Oct 2009
I think this is such a great
idea! Not only is this helping to relieve anxiety for the child which helps the
stuttering, it seems that it would help the parent and child bond and build
upon their communication and openness with one another about feelings. Do many
parents report that they feel closer to their child during and after this
experience? Also, do you see general reduction of anxiety and tension in these
children?
From: Vanessa
Sacchi
Date: 13 Oct 2009
The results have been astounding! Especially from the parents. All parents
reported that they felt much closer with their child, and some parents were
astounded about the information that was discussed during this time. One parent
said that she thought that she knew her son so well, his likes, dislikes, his
fears and the things that he enjoys. From this experience she was shocked to
learn that the things that she thought her son feared about the advent of
school- he was fine with, and the things that he was worried about included
things that she would have never thought of! Insight into the mind of a third
grader is a beautiful thing. Additionally, parents reported that through this
process they became better listeners. Parents also reported that because of
this activity, they thought of different ways to support and ease the
transition. For example, one family did school morning schedule practice, where
they actually got up, got dressed, and then drove to school before school
started. Other parents brought their kids to play on their new playground, or
let their child participate in the meeting with the teacher before school
started. I collaborated with mom and the child to prepare them to discuss their
stuttering. We make it really fun and take the angle of, "you get to teach
your teacher about stuttering... how cool is that?" During this meeting
with the new teacher the child and mom talk about their stuttering. What helps,
what does not help (like interrupting), and ways that the teacher can support
the student. It is amazing process that let's the child advocate for themselves
and feel really empowered, and great about their talking. All in all, it has
been extremely positive.
From: Maria
H.
Date: 08 Oct 2009
Great idea! One question,
however, would be when to fade this reinforcement? It seems like this idea
would only work with smaller children; what other things would work with the
older child that isn't quite as reinforced using paper chains?
From: Vanessa
Sacchi
Date: 13 Oct 2009
I have used the paper chain
activity with kids up to the third grade with positive response. For older
kids, I like to take the angle of "celebrating their growth".
Especially for kids that are entering middle school. Celebrating that this this a new beginning, with new people, new teachers, and
new expectations. That they are getting older, and more responsible is a great
thing, and that the parent believes that they can handle all of the new
challenges that will come their way during this new school year. Additionally,
it provides the parents with repeated opportunities to tell their child that
they are always there to talk to... because pre-teens and teens new to hear
that a lot!
Paper Chains
From: Amber Martin
Date: 10 Oct 2009
Comments
I really enjoy
your idea and love how visual it is. In my fluency disorders class we discussed
how parents should model the gentle, easy natural speech for their children. We
also discussed how hard this is to accomplish in our fast paced lives. Often a
solution to this was to set aside a certain amount of time to use that model of
speech. This activity is a great way to do this as well as discuss and validate
any thoughts and feelings they may have. I was actually just wondering, did you
have a range of ages in mind for this activity?
From: Vanessa
Sacchi
Date: 13 Oct 2009
I use this activity for pre-K to third grade mostly, and their are some
variations that you can do up to fifth grade. I also encourage parents to do
easy talk with their children in the morning, because the mornings are
inherently stressful... multi-tasking, and rushing about.
From: Monica
(MSU)
Date: 10 Oct 2009
What an excellent idea! This
is such a great way to spark communication between a child who stutters and a
parent or family member. It is so great because the emotional side of
stuttering is so huge so having this opportunity to express themselves could be
extremely beneficial. You talk about starting this chain 2 weeks before the
event occurs (i.e. school starting). What kind of other events have you seen
clients use this chain for? Thank you for sharing this with us!
From: Vanessa
Sacchi
Date: 13 Oct 2009
Depending on the event, like moving to a new house, we would do the paper chain
at least a week or two before the move and a week or so after the move. This is
important because feelings can develop while the child gets used to their new
surroundings. I have also used this activity for vacations to Disney World.
Other scenarios have included: Traveling to see a sick family member- where the
person they are visiting was going to look different (as a result of chemo)
than the last time that they saw that person. Another time that I used this
activity was when Mom and Dad were going out of the country, and Grandma and
Grandpa were going to stay with the child. In that case the grandparents were
thrilled with the activity because they learned so much about their Grandchild
in a matter of two weeks, and never did the child ask, "when are Mom and
Dad coming home" because they counted the rings until they came back each
night before bed.
From: Jen
S.
Date: 12 Oct 2009
I am a graduate student who
just found out about ISAD this semester. I really like the idea of the paper
chain as a therapy tool for open communication and confidence building. I can
imagine how beneficial it would be for a child to have something tangible that
provides a visual support leading up to an anticipated event. It seems like an
effective and easy way to prompt the types of conversations that provide children
with strategies helpful for preparing for big events.
From: Dave
Williams
Date: 14 Oct 2009
Another good clinical
technique in the therapist's armamentarium! This should be a useful procedure
for lessening the young stutterer's anxiety about a prospective change in the
child's environment or in the 'significant others' with whom he interacts. Good
article!
From: Ruthann,
San Gabriel, Ca-USA
Date: 18 Oct 2009
Dear Vanessa: This is a
great bonding project for home and well as school. Seems with the older middle
school students, this could incorporate changing emotions regarding social
issues and the likes. There is lots of opportunity to learn and grow here.
Thanks!
From: Lori
Garscia
Date: 19 Oct 2009
Hi Vanessa. I really think
that using paper chains as a tool for fluency could be very effective, yet so
simple. I like how it does two things at once with helping to ease stress about
the upcoming event and also promote the easy talk technique, not to mention the
quality time it supplies for the parent and child as many posts have mentioned.
I would think that modeling other techniques could be incorporated as well. Perhaps
audio taping these talks be
beneficial to the therapist for future sessions. The therapist could possibly
do a follow up after the event takes place and explore the childŐs current
feelings about what occurred.
From: Kathy
Sexton
Date: 21 Oct 2009
One of the reasons I like
this idea so much is because it provides a tangible reminder for a child, of
the time they will have to share their feelings with a loved one each night. I
also think that allowing the child to choose the colors, create the chain, and
then voluntarily dismantle it, would give them a greater feeling of control
over the way they will deal with the upcoming event. This would be a nice
activity for any child, whether they stutter or not, to help them through
significant transitions. I will definitely be adding this to my resources!
From: Jaime
Date: 22 Oct 2009
I think this idea of making
a paper chain prior to major events is a great twist on simple count downs or
schedules. This could be used in various situations with many different types
of clients. I really liked this concept.