Robert W. Quesal. J. Scott Yaruss. Bill Murphy. Purdue. Western Illinois. University of Pittsburgh. University. University

Transcription

1 Bill Murphy Purdue University Robert W. Quesal Western Illinois University J. Scott Yaruss University of Pittsburgh

2 Required Disclaimer Forgive us, ASHA, for we have sinned The presenters have financial or nonfinancial relationships relevant to the content of this presentation with: Stuttering Therapy Resources, Inc. Publishers of Minimizing Bullying for Children who Stutter: A Practical Guide for SLPs (Murphy, Quesal, Reeves, & Yaruss, 2012) and School-Age Stuttering Therapy-A Practical Guide (Reeves & Yaruss, 2012) [formerly The Source for Stuttering Ages 7-18] NCS Pearson, Inc. Publishers of the Overall Assessment of the Speaker s Experience of Stuttering (Yaruss & Quesal, 2008; 2010). StutterTalk Podcast and their book Stuttering: Inspiring Stories and Professional Wisdom We have also slept with our hair dryers

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4 A new resource for helping SLPs help children who are being bullied. Minimizing Bullying for Children Who Stutter: A Practical Guide for SLPs Murphy, Quesal, Reardon-Reeves, & Yaruss Available for pre-order from With workbooks specifically written for Students Parents Teachers and School Administrators

5 Stuttering Therapy Resources, Inc.

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7 Bullying vs. Teasing Teasing harmless ribbing or joking from family and friends we have all experienced and enjoyed this often a way to show love or good feelings toward others having fun, not meant to control or harm anyone try to get everyone to laugh everybody enjoys the interchange Ends when one of the participants begins to feel upset or hurt

8 Bullying vs. Teasing Bullying inappropriate teasing not the same as teasing conscious effort to hurt someone or cause harm bullies seem to want to create more power for themselves by trying to make the person they are bullying feel afraid, rejected, or hurt never acceptable, regardless of the situation or the individuals involved bullying is something we want to prevent for all children, not just for children who stutter

9 Some Facts Anywhere from 30% to 60% of children are bullied at some time Between 6% and 15% of children are bullied on a regular basis Estimates of bullying for children who stutter vary but may be 80% or more Children often don t report bullying because they are embarrassed or feel they deserve it We need to be aware (more about this later)

10 Effects of Bullying guilt shame embarrassment frustration loss of self-confidence low self-esteem withdrawal depression difficulty making friends negative impact on school-work increased stuttering avoidance

11 The Players Bully Bullied Bystanders (Combination of roles)

12 Four principles to understand (about treating stuttering and dealing with bullying) Stuttering is not the child s fault it s nobody s fault Stuttering varies perhaps the most critical aspect of stuttering Changing stuttering is hard work changing how you talk is hard for anybody Stuttering is not fun no one chooses to stutter

13 A Five-Step Intervention Model for Helping Children Who Stutter Deal with Bullying

14 The five steps Step 1: Help children understand stuttering Step 2: Help children understand bullying Step 3: Help children think differently about stuttering Step 4: Help children develop assertive responses Step 5: Help children educate peers

15 1. Help children understand stuttering Stuttering is not due to: Laziness Psychological problems Brain damage etc. Stuttering can make you feel bad and make it hard to communicate You can learn to overcome these problems and become a good communicator

16 2. Help children understand bullying Bullying involves the bully, bystanders, and the child Bullying is never appropriate

17 3. Help children think differently about stuttering Many children have negative thoughts and feelings about themselves and stuttering These can exacerbate the problem Reducing negative thoughts and feelings is accomplished through Desensitization Cognitive Restructuring

18 Desensitization Reducing negative feelings about stuttering (or anything else that bothers someone) Experiencing what the child fears in a controlled, supportive environment Deawfulizing and having fun with stuttering

19 Some activities for desensitization Teaching adults and others how to stutter Making representations of stuttering (e.g., clay models, pictures, water balloons) and destroying them Games involving longest, loudest, funniest, etc., stutter Introducing child to other people who stutter or self-help groups

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22 Cognitive Restructuring Learning to think differently about stuttering and about bullying Based on a process of identifying unrealistic, maladaptive, or unhelpful thoughts by: (a) examining the evidence (or lack of evidence) supporting those thoughts, and (b) replacing those thoughts with more realistic thoughts that enable children to deal with the challenges they face

23 Cognitive Restructuring How we feel comes from how we think When something happens to us, we can have different thoughts, and those different thoughts will affect the way we feel Some of our thoughts can make us feel more worried than others When we are scared, it is because we are thinking thoughts that make us feel worried. We can call these thoughts our worried thoughts Other thoughts do not make us feel as bad. We can call those calm thoughts If we can change worried thoughts to calm thoughts, we will feel less scared

24 Changing from worried to calm thoughts identifying the thoughts behind the negative emotions gathering evidence about the thought evaluating the thought based on the evidence examining the consequences of the feared event

25 Example of Cognitive Restructuring Worried thought : I am going to stutter on all the words I read out loud in Mrs. Jones class and all the kids will laugh at me. The process (identifying the thought, gathering evidence, evaluating the thought, examining the consequences) Calm thought : I should do okay. I might stutter a little but I am getting better at using my speech tools. I also know I have a lot of friends in class and they would not try to make me feel bad on purpose.

26 4. Help children develop assertive responses A critical part of the bullying management plan is helping children who stutter respond to bullies in assertive but non-aggressive ways Assertiveness training in general can be helpful for many children who stutter, because they may have difficulty sticking up for themselves verbally

27 Responding to bullies Typically, responses would be short: I statements Mighty Might Broken record technique etc. (Be careful what the child says may make the bully more aggressive) Disappearing act Accomplished through role-playing

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29 5. Help children educate peers As children grow older, they spend more and more time with their peers, and they begin to take more and more of their cues for how to respond to life situations from their peers Therefore, it is critical that the peers of children who stutter understand what it means to be a child who stutters

30 The Classroom Presentation Help children become more open about their stuttering Help classmates understand what stuttering is As a result bullying behavior may be decreased, particularly among bystanders When children who stutter experience success in talking openly about their speech in the classroom, it helps to reduce their fear and embarrassment Stuttering continues to be deawfulized and normalized in the classroom Help the child improve generalization and maintenance

31 Preparing the child for the classroom presentation Ask: What do you want others to know about your stuttering? What would it be like if other people knew these things? Child vs. SLP s role in presentation Age of child Severity of stuttering Degree of anxiety etc.

32 Possible outline for a classroom presentation Introduction Classroom participation Definition Stuttering is no one s fault! Facts and Myths Famous (and not-so-famous) people who stutter How does it feel to stutter? Speech Management Tools This is not easy! What is bullying? Who has been bullied and how should we respond? Helpful responses to stuttering Questions and Answers

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34 Parents: Six things they can do to help Identify bullying Understand the situation Listen and provide support Validate their child s feelings Develop a support network Bully-proof their child ALL OF THESE THINGS APPLY TO US, AS WELL

35 Identify Bullying How do parents know when it happens? Some children will tell them! Others may not; parents can watch for signs Shift in attitude Reluctance to go to school Desire to spend time with younger children Sudden drop in grades or school performance Lack of interest in interacting with pears Dramatic changes in health (stomach aches) Changes in SPEECH (increased stuttering severity, increased avoidance)

36 Understand the Situation Rule 1: THINK before you ACT (this is for us, too) Many parents may want to jump right in and try to solve the situation Their kids don t necessarily want them to do that! Why wouldn t we take action? All is not necessarily as it seems (different viewpoints / different opinions about what is actually going on) Children can benefit from learning strategies for managing bullying more independently Of course, if the child is in physical danger, then immediate action is certainly warranted

37 Listen and Provide Support We are experts at listening Others? Not so much Parents want to listen, but they may be caught up in their own feelings about the situation Parents can benefit from learning some of the same skills we have developed Active / Empathetic Listening (Egan, 2012) Reflecting Letting the child know that he s not alone in facing the situation

38 Validate their Child s Feelings Children need to hear that their concerns about being bullied are valid They also need to hear NOBODY deserves to be bullied IT IS NORMAL to feel upset and scared THERE IS HOPE for changing the situation Parents (and SLPs) can reinforce this message, while allowing the child to express his concerns

39 Develop a Support Network When we are bullied, we may feel alone The more we know that there are other people who understand us, the easier it is to face Part of the support network involves school personnel Parents (and SLPs) can connect children with self-help/support groups (NSA, Friends) Parents (and SLPs) need this support too!

40 Bully-Proof Their Child Bullying is less likely to affect children who have: Well-developed self-esteem A strong sense of personal power (The ability to act in a way that supports self-esteem; Kaufmann et al., 1999) A safe place to go, where they can be themselves The firm knowledge that they are okay even though they stutter Parents and SLPs play a key role in teaching children these all important lessons

41 Teachers: They can help, too! Get the Facts about the situation Get Involved once they understand the situation Help Children Learn to Solve Problems using common problem-solving strategies Remember Their Unique Perspective as a person at the center of the child s life Work to Prevent Bullying by creating a safe place for everyone in the class Prepare Children to handle difficult situations Involve the SLP, their best ally in reducing bullying

42 Some quick thoughts Getting involved does not necessarily mean punishing the bully Again, children benefit when they learn problem-solving skills they need for working through these issues. This does not mean that we leave them to work it out on their own; but we do want them involved in the solution Teachers are unique and they have a unique role to play for all children

43 Problem-Solving IDEAL problem-solver (Bransford & Stein, 1993) Identify the Problem Define the Problem Explore Possible Strategies Adopt and Implement a Plan Look Back and Evaluate the Effects Every child can learn to work through these steps to figure out new ways of facing challenges in their lives

44 Preventing Bullying Educate everybody about: What bullying is Who is involved (bully, bullied, bystander) How it if affects people Create an atmosphere of: NO tolerance for bullying Acceptance, respect, and support for all people

45 Working Together In partnership with teachers, parents, and children who stutter, we can provide an environment that helps our students overcome the problem of bullying None of us needs to face this alone together, we are stronger than any bully

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47 Contact us Bill Murphy Bob Quesal Scott Yaruss

48 Selected References Beck, A. (1979). Cognitive therapy and emotional disorders. NY, NY: New American Library. Beilby, J. M., & Byrnes, M. L. (2012). Acceptance and commitment therapy for people who stutter. Perspectives on Fluency and Fluency Disorders, 22, Bernstein Ratner, N., & Sisskin, V. (2002). Intervention strategies for children who stutter. Rockville, MD: American Speech-Language-Hearing Association. Blood, G.W. & Blood, I.M. (2004). Bullying in adolescents who stutter: Communicative competence and self-esteem. Contemporary Issues in Communication Science and Disorders, 31, Blood, G. W. & Blood, I. M. (2007) Preliminary Study of Self-Reported Experience of Physical Aggression and Bullying of Boys who Stutter: Relation to Increased Anxiety. Perceptual and Motor Skills, 104, Bloodstein, O., & Bernstein Ratner, N. (2008). A handbook of stuttering. (6th ed.). New York: Thomson Delmar Learning. Callaghan, S. & Joseph, S. (1995). Self-concept and peer victimization among school children. Personality & Individual Differences, 18(1), Charach, A., Pepler, D., & Ziegler, S. (1995). Bullying at school: A Canadian perspective. Education Canada (Spring, 1995). Chmela, K., & Reardon, N. (2001). The school-aged child who stutters: working effectively with attitudes and emotions. Memphis, TN: The Stuttering Foundation. Coloroso, B. (2003). The bully, the bullied, and the bystander. New York, NY: HarperCollins Publishers Inc.

49 Selected References (cont.) Egan, G. (2010). The skilled helper (9 th ed.). Pacific Grove, CA: Brooks/Cole Publishers. Faber, A., & Mazlish, E. (2012). How to talk so kids will listen and listen so kids will talk. (30 th anniversary edition.) New York: HarperCollins. Freedman, J. S., (2004). Easing the teasing: Helping your child cope with name-calling, ridicule, and verbal bullying. New York: McGraw Hill. Kaufman, G. Raphael, L. & Espeland, P. (1999). Stick up for yourself! Every kid s guide to personal power and positive self-esteem. Minneapolis, MN: Free Spirit Publishing. Kim, Y. S., & Leventhal, B. (2008) Bullying and suicide. A review. Journal of Adolescent Medicine and Health 20(2), Kuster, J. Stuttering Home Page. Minnesota State University, Mankato. [website] Langevin, M. (2000). Teasing and bullying: unacceptable behavior. The TAB program. Edmonton, Alberta: Institute for Stuttering Treatment and Research. Langevin, M., Bortnick, K., Hammer, T., & Wiebe, E. (1998). Teasing/bullying experienced by children who stutter: Toward development of a questionnaire. Contemporary Issues in Communication Science and Disorders, 25, Langevin, M., Kleitman, S., Packman, A., & Onslow, M.. (2009 The Peer Attitudes Toward Children who Stutter (PATCS) Scale: An evaluation of validity, reliability, and the negativity of attitudes. International Journal of Language & Communication Disorders, 44, Langevin, M. & Narasimha Prasad, N. G. (2012). A stuttering education and bullying awareness and prevention resource: A feasibility study. Language, Speech, and Hearing Services in Schools, 43,

50 Selected References (cont.) Logan, K.J., & Yaruss, J.S. (1999). Helping parents address attitudinal and emotional factors with young children who stutter. Contemporary Issues in Communication Science and Disorders, 26, Murphy, W. P. (1998). The school-age child who stutters: Dealing effectively with shame and guilt. Videotape No. 86. Memphis, TN: Speech Foundation of America. Murphy, W.P. (1999). A preliminary look at shame, guilt, and stuttering. In N. Bernstein-Ratner and C. Healy (Eds.) Stuttering Research and Practice: Bridging the Gap. (pp ). Mahwah, NJ: Lawrence Erlbaum Associates. Murphy, W.P. (2000). Speech pathologists can help children who are teased because they stutter. [website] Murphy, W.P., & Reeves, N.A. (2010). A Classroom Presentation: Stuttering. New York: National Stuttering Association. Murphy, W.P. & Quesal, R. (2002). Strategies for addressing bullying with the school-age child who stutters. Seminars in Speech & Language, 23, Murphy, W.P., Yaruss, J.S., & Quesal, R.W. (2007a). Enhancing treatment for school-age children who stutter I: reducing negative reactions through desensitization and cognitive restructuring. Journal of Fluency Disorders, 32, Murphy, W.P., Yaruss, J.S., & Quesal, R.W. (2007b). Enhancing treatment for school-age children who stutter II: reducing bullying through role-playing and self-disclosure. Journal of Fluency Disorders, 32,

51 Selected References (cont.) Reardon-Reeves, N., & Yaruss, J.S. (2012). School-age stuttering therapy: A practical guide. McKinney, TX: Stuttering Therapy Resources, Inc.Yaruss, J.S., & Quesal, R.W. (2003). Success in the schools: Bringing it all together. Seminars in Speech and Language, 24, Yaruss, J.S., & Quesal, R.W. (2004). Stuttering and the International Classification of Function-ing, Disability, and Health (ICF): An update. Journal of Communication Disorders, 37, Yaruss, J.S., & Reardon, N. (2002). Successful communication for children who stutter: Finding the balance. Seminars in Speech and Language, 23, Yaruss, J.S., & Reardon, N., (2003). Fostering generalization and maintenance in school settings. Seminars in Speech & Language, 24, Yaruss, J.S., & Quesal, R.W. (2006). Overall Assessment of the Speaker s Experience of Stuttering (OASES): Documenting multiple outcomes in stuttering treatment. Journal of Fluency Disorders, 31, Yaruss, J.S., & Quesal, R.W. (2010). Overall Assessment of the Speaker's Experience of Stuttering (OASES). Bloomington, MN: Pearson Assessments. Yaruss, J.S., Coleman, C.E., & Quesal, R.W. (2012). Stuttering in School-Age Children: A Comprehensive Approach to Treatment. [Letter to the Editor]. Language, Speech, and Hearing Services in Schools, 43, Yaruss, J.S., Pelczarski, K.M., & Quesal, R.W. (2010). Comprehensive treatment for school-age children who stutter: Treating the entire disorder. In B. Guitar & R. McCauley, Treatment of stuttering: Conventional and controversial interventions (pp ). Baltimore, MD: Lippincott Williams & Wilkins.