The Change Process

Mind your Ps and Qs is an English language expression meaning "mind your manners", "mind your language", "be on your best behaviour", "watch what you're doing".

• To our self.
• To others.
• How we talk about children who stutter.
• How children who stutter hear us talk about stuttering generally.

Action: helpful self talk to counter stereotypes.

• Gather evidence in real-life situations will lead to generating more balanced thoughts on the basis of their findings.
• People can identify helpful self-talk that will positively influence their emotional reaction and behaviour in a situation.
• Helpful self-talk can also be generated by reflecting on previous experiences that have gone well and what the person was saying to himself or herself at the time.

<hr>

For the Speech and Language Therapist

• Be aware of own thoughts, feelings and expectations around stuttering and our role as an SLT.
• Communication trumps fluency.

Action: helpful self talk.

• Handouts for teachers.
• Powerpoint for school presentation.
• Advice leaflet for parents (Generate discussion about what works in therapy  and helpful versus unhelpful advice).

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics.

— The American Speech And Hearing Association (ASHA) (2007:1)

<hr>



Identity


• Etymological root refers to sameness but often seen as what makes me unique – who I am.
• Medical model/social model.
• Narrative Practice – viewed as “public and social achievement”.
• Co-constructed in “the trafficking of stories about our own and each other’s lives” White (2007, 182).

<hr>

The process of professional identity

• Individual process but co-constructed.
• Multiple identities.
• Fluid, dynamic.
• Therapeutic exchanges.
• Stories told and interpreted.
• Cultural Influences.

<hr>

How are identities constructed?

O’Dwyer and Leahy (2015)

• Postmodernist thinking – multiple identities are available to an individual at any given time.
• Narratives play a large role in how we construct and re-construct these identities for ourselves and for others.
• Narratives are how we make sense of our experiences and this meaning-making in turn leads to a sense of identity. Bruner (1986: 143) explained that ‘narrative structures organise and give meaning to experience’.  Riessman(2008: 8) states that ‘individuals and groups construct identities through storytelling’ and that these identities are fluid.

<hr>

SLTs – multiple identities*

• An individual speech and language therapist has multiple identities available to them at any time.
• More aware of some than others and how conscious/aware they are of any identity at a given time varies.
• Intrapersonal and interpersonal factors influence how these identities are negotiated and renegotiated.
• These identities are negotiated in their interaction with the people they see for therapy and their families/carers.
• “Through clinical interaction clients and clinicians negotiate who they are and the roles they play in the therapy story.” Simmons-Mackie and Damico (2011:44)
• If a particular identity gets validated through these interactions, it takes hold and is performed regularly, If not validated, gets renegotiated.

*O’Dwyer, M.  and Leahy, M.M. (2016). There is no cure for this:  An exploration of the professional identities of speech and language therapists’, Journal of Interactional Research in Communication Disorders, 2, 149-167.

<hr>

Who are speech and language therapists working with children and adults who stutter and their families?
 Possible identities:

My dilemma as an SLT

How best to support speech and language therapists who are working with children and adults who stutter so that they work as allies in the context of evidence which shows that stuttering therapy has an overall positive effect.  No one treatment approach for stuttering demonstrates significantly greater effects over another treatment approach. Herder, Howard, Nye, & Vanryckeghem (2006).

• Need to validate professional identities that support.
• Learning from people who stutter.
• Therapy which focuses on positive outcomes in terms of children and adults living the lives they want  to live and the development of therapy that focuses on education and resistance to normalising discourses.
• Resists focus on fluency and cure in therapy.
• Focus on confidence, fun and delight in finding and validating identities which fit with our dreams, hopes and ambitions.

We want to affirm, especially for the young people out there, that it is okay to stutter. We believe that not only is it okay to stutter, but people who stutter should be empowered to speak however is most comfortable for them – even if that speaking style contains pauses, repetitions, and blocks.

— NYC Stutters (2020)

<hr>

• Educators to integrate the diversity agenda into speech and language therapy training to enable future therapists to consider the philosophical underpinnings of their role and approach.
• Forums for therapists to examine their underlying values, role and scope of practice.
• Meaningful collaboration to rethink the scope, focus and role of future stammering therapy for CYP & adults.
• Open, public debate about social and ethical implications of research in the fields of neuroscience and genetics.
• Research into what matters for people who stammer.
• Balanced investment of funding.
• Accessible research findings & conferences.

<hr>

Still it appears to us that the answer will be forthcoming if we as a field are serious about engaging in a partnership between researchers and the population of people who stutter, for people who stutter can provide the most meaningful metric for determining whether a treatment is viable.

— Yaruss & Quesal (2004)

<hr>

It is critical for professionals to realise that people with lived experience are best situated to drive the effort for changing how our society thinks about stuttering. Professionals bring resources and credibility to the table which can be very important for public attitude change, and they can play a supportive role to improve social conditions. However, people who stammer themselves are best positioned to promote the agenda of their community in terms of actions and policies that effect their lives.

— Boyle (2019)