How Is Success Measured In Therapy?
This is perhaps one of the hardest questions of all for us to
answer.
Stammering has been recorded throughout history and the search
for a cause and a cure has been unrelenting. Whilst we now know
a great deal more about the factors that can make a child vulnerable,
and we are beginning to become more confident about overcoming the
problem when a child is still young, we still have to be cautious
about ideas to do with "success" or "cure".
Cure is a rather unhelpful word - it is a medical word associated
with illness - and stammering is not an illness.
Some people may always have a degree of stammering in their speech.
It is how the person deals with this and reacts to it that can be
part of the problem and part of the solution.
All we can say with any degree of confidence is that it is not
necessarily helpful to rate successful therapy by how many times
a child or adult stammers. It is also important to consider the
level of self confidence that the person has in his or her ability
to communicate.
Most people who have experienced a stammer will say that they
can be fluent under certain circumstances, Some therapy strategies
can produce "fluent", but highly controlled speech (i.e. not spontaneous),
and it would be wrong to say that a "cure" had been found under
these circumstances.
At the Michael Palin Centre, we are concerned not to make unrealistic
promises. We feel that there are a number of ways of measuring a
"successful" outcome, but one measure is not enough. The most important
outcome must be how the person feels about communicating.
We include in our measures:
- Child or parental concern
- The type of stammer - rather than the quantity
- The level of confidence expressed by the person who stammers
- The effect the stammering has on their daily lives
The trouble with these is that they can all vary - which makes
research very difficult to carry out.
Perhaps success is measured by the young person's reports that they
are able to say what they want, when they want.
A Final Thought
Stammering can come and go throughout life and may be affected by
stressful events such as exams or interviews. So, although things
can go well for a long time, we are not surprised when a family
comes back for a "top-up".
|
