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by Susan Hamilton
At an evaluation in February 1986, Bob Love presented with a moderate severity rating according to the Riley Stuttering Severity Scale (1972). His stuttering was characterized by sound prolongations, partial word repetitions, and blocks. Eye contact was poor and he exhibited facial grimaces. Bob stated that his speech was much worse than this sample when speaking to authority figures, strangers, groups or when introducing one person to another. In addition, he indicated that his speech was generally better in familiar social situations.
He indicated that he was seeking treatment because his job opportunities at Nordstrom, where he worked in the restaurant division, hinged on an improvement in his speaking skills. He was successful at using the fluency shaping techniques of easy onset and continuous phonation after a model during a trial therapy portion of the evaluation.
Two months later Bob began speech therapy, with treatment based on an intensive schedule of one-hour sessions four days per week. He accomplished a great deal during this period. He learned about how his speech mechanism worked and was able to identify and describe his stuttering moments. He began to explore his feelings about his stuttering and how his thoughts affected these feelings and his fluency. In addition, we explored the reasons for the lack of eye contact and its impact on his overall communicative effectiveness.
Simultaneously, he began to utilize the fluency shaping techniques of easy onset, continuous phonation, and light articulation in a hierarchical manner beginning with vowels and continuing through slow to a natural rate of connected speech. He learned how to use cancellations to modify stuttering moments and we emphasized speech naturalness, especially at the levels of connected speech. After four weeks, Bob was ready to begin the process of transferring his newly acquired speech skills and attitudes to his daily activities, especially in the workplace.
The next six to nine months of treatment were devoted to transfer and generalization work. Bob learned self-evaluation skills during the establishment phases of treatment, and utilized these skills as he began to collect samples of his speech during daily activities. First, we created a functional hierarchy of speaking situations he regularly encountered, and ones in which he wanted to participate. During this phase, for example, Bob told me that his dream was to become a public speaker, so we added this to the list. We began with the easiest situations, role-playing them, and rating his anxiety levels and use of techniques. Then Bob entered speaking situations. He carried his tape recorder and informed his listener that he was a person who stuttered and who was receiving treatment, and asked permission to record his half of the conversation. Afterward, he would analyze the recordings and bring them to his next appointment so that we could critique them and chart future progress. Transfer assignments included making appointments for his children, speaking with his bosses, making presentations at work, making phone calls and speaking to university classes. Eventually Bob developed the confidence to make cold calls to get on the speaking circuit for local organizations. During this period, much time was also spent on effective self-talk and maintaining positive attitudes. Bob and his employers at Nordstrom wanted him to work on his dialect, so we added that to our therapy targets. Bob also participated in a support/practice group at my private practice.
Bob's fluency improved so dramatically that his employers noticed, and he began to get requests for local speaking engagements. So, next, we worked to develop a speech to tell the story of his life.
A year after his first fluency evaluation, Bob's wish came true. He was invited to be the keynote speaker at the NIC-10 All-Sports Banquet in Rockford, IL. I accompanied him to this engagement, and we practiced the speech all day before the event. Two hours before the event, we went to the banquet hall where he delivered a practice speech to me and the set-up crew. Three hours later, at the end of the real speech to an audience of 600, he received a standing ovation, even though his fluency was far from perfect. There were few dry eyes in the house.
The next year, Bob sporadically attended speech therapy for refresher sessions and to practice for upcoming events. In 1988 he received an Individual Achievement Award from the National Council on Communicative Disorders at the Kennedy Center in Washington, DC. Former ABC-TV sports commentator Dick Shaap presented the award and soon Bob's story appeared in many magazines and on broadcast news shows. The Stuttering Foundation of America named him the chairman for its 1993 National Stuttering Awareness Campaign.
At the ASHA Convention last fall in Chicago, I saw Bob receive the Annie Glenn Award. It was the first speech that I had seen him give in nearly 10 years. His fluency wasn't perfect, but his message was. Bob Love isn't allowing stuttering to hold him back from his dreams, and I feel privileged to have helped him along the way.
Susan Hamilton is a speech-language pathologist in private practice in Seattle, WA, a lecturer and clinical supervisor at the University of Washington, and a regular presenter for the Stuttering Foundation of America. Contact her by e-mail at suzanh@earthlink.net.
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