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1. The MPC Approach: Under 7s Who Stammer
2. Psychological Approaches to Help Us Understand Stammering
3. Patmar Programme for Adults Who Stammer

1. The MPC Approach: Under 7s Who Stammer

Presenters: Frances Cook and Willie Boterill
Participants: SLPs
Date: 4th - 6th May 2007
Fee: € 200

About presenters:

Frances and Willie have been specialising in the assessment and treatment of Fluency disorders for more than 30 years. They manage the Michael Palin Centre for Stammering Children which provides specialist assessment and therapy for children of all ages and their families from all over the UK . They have presented at conferences across the world and published books, articles and research papers on a variety of topics related to fluency disorders.

About workshop:
Course Aims
This three day workshop will aim to increase speech and language therapists’ knowledge and skills in assessing and treating incipient stammering in children under 7 and in identifying those children who are at risk of more persistent problems. The course will also aim to develop participants’ confidence in the management of this age group. The course will be supported by video, discussion and skills practice, and a clinical resource pack.

Learning Outcomes
At the end of this course participants will:
  • be familiar with an assessment protocol for children under seven who stammer
  • be familiar with a tool to assess whether a child is at risk of persistent stammering
  • be familiar with the structure and content of Parent Child Interaction therapy
  • be familiar with the development of care pathways for children who stammer
  • be more confident about assessing and treating children under seven who stammer

Course Content
Day 1: Research and assessment
  • A Multifactorial Model of Stammering
  • Research update – current research into the factors contributing to stammering and risk factors for young children who stammer
  • Child Assessment - including fluency measurement
  • Parental Interview – including formulation of the child’s needs
  • A profile of vulnerability and discussion of level of risk
  • Discussion of management options

Day 2: Parent-Child Interaction Therapy (PCI)
  • Principles of PCI
  • Supporting a child’s fluency
  • PCI session structure
  • Behaviour management
  • Skills in working collaboratively with parents including parent packs
  • Outcome Measures for PCI

Day 3: Direct Fluency Management and other clinical issues
  • A discussion of other therapy options - including a programme for introducing young children to fluency management strategies (Tortoise Talking)
  • Supporting a child’s language and vocabulary
  • Clinical Decision Making for children under 7 using a Skills and Action Chart: PCI strategies, family strategies and direct strategies
  • Care Pathways – discussion of service delivery for children under seven who stammer
  • Action Planning – application to team settings

This workshop will combine theory with video-observation, skills practice, discussion and problem-solving. The timing given is approximate. It is recommended that participants attend all three days.

2. Psychological Approaches to Help Us Understand Stammering

Presenter: Trudy Stewart
Participants: SLPs and PWS
Date: 4th - 5th May 2007
Fee: € 120

About Presenter:
Dr Trudy Stewart has more than 20 years' clinical experience and is trained in the use of a number of psychological approaches. She has been involved in clinical training of speech & language therapists from the United Kingdom, America and Sri Lanka. She teaches under graduate and specialist post-graduate courses for speech and language therapist and has written numerous journal articles and several books on stammering. Trudy acts as a specialist advisor for the British Stammering Association and for the Royal College of Speech & Language Therapists in England. In addition, she serves on the editorial board for the Journal of Fluency Disorders.
She is also interested in the theatre, music and art and goes to the gym regularly.
She has 2 very tall sons!

About workshop:
In considering the content of this pre conference educational programme, Trudy has opted for the possibly more difficult task of offering workshops which will bring together therapists and individuals who stammer. She sees the conference in general and these 2 days in particular as an opportunity for these groups of people to collaborate and learn together in a non clinical context. She has chosen 2 psychological approaches which inform her clinical work with people who stammer and her personal life too as the focus of the workshops. She hopes that therapists and adults who stammer will regard these days as a chance not only to learn about psychology and the links with stammering but also to learn with and from each other.

The day will begin with a short overview of the theory and practice of PCP. We will also look at how it has been applied to stammering by referring to the literature and clinical practice.
Then therapists and individuals who stammer will explore their own constructions of stammering both as individuals and in separate groups using a series of practical exercises.
Next the groups will come together and share their findings. We will explore any similarities and differences and consider the implications of these separate meanings in a group discussion. Finally we will reflect on our personal meanings and those of the groups in the light of research, therapy and personal change.

Following a basic outline of the principles of SFBT, this day will concentrate on the basic techniques of SFBT including the following:
  • Problem free talk
  • The miracle question
  • Exceptions
  • Scaling
Each technique will be described and then individuals will have the opportunity to use each technique themselves in a number of practical exercises.
Participants will consider how these techniques might be useful in their own lives and therapists will be able to explore their use in a clinical context.

3. The Patmar Programme for Adults Who Stammer

Presenters: Patrick Kelly and John Sutton
Participants: PWS
Date: 5th May 2007
Fee: € 60

About Presenters:
Patrick formed the course in Ireland in 1998 and runs 2 courses each year with Maria McDonnell. Patrick is a PWS.
John Sutton is a PWS and attended the Patmar course in 1999 and assists as a helper on all Patmar courses.

Both Patrick and John are involved with the Irish Stammering Association and have done presentations in Europe in the past with ELSA, Patrick is the founder and Chairperson of the Irish Stammering Association. Both still stammer but manage to control it to a great degree.

About workshop:
The Patmar Programme has been in existence since 1998. It began in Dublin and is now run twice-yearly in a small hotel in the West of Ireland. The course is an 8 day residential intensive programme run by Patrick Kelly and Maria McDonnell, Senior Speech & Language Therapists with the Irish Health Service Executive along with John Sutton who attended the course in 1999.

This is a non-profit making programme which is currently funded by the Irish Health Service Executive. Up to 12 people attend each course with a follow up weekend about 6 weeks later. All former Patmar participants are invited to meet each other on a social basis every 6 months for a weekend get-together. A number of support groups have been organised throughout the country.

Patmar is a unique and progressive approach to adult stammering therapy involving underlying principles from Sheehan (1972) and Van Riper (1973) along with aspects of Personal Construct Therapy, Counselling Cognitive Therapy, Positive Thinking and Assertiveness training. The complex interplay of personality like experiences and family dynamics for each individual is a key consideration within the group. Family involvement is central to the therapy process, as individuals learn coping strategies for long term acceptance and their control of the stammer. The aim is to come to terms with the stammer, reduce sensitivity to it and then be able to control it. The intensive nature of the programme and group dynamics are essential to enable people to explore deep seated fears and emotions which can then result in controlling the stammer or avoidance behaviours. Friends and family members are encouraged to attend the first and last days of each course to enable lines of communication to be kept open in the future.

The residential course allows an intensive approach with ongoing therapy outside the "clinic" setting and members are actively encouraged to keep in telephone contact with friends, family members and even workplace colleagues during the course. The follow up weekend allows people to reflect on the inevitable relapse following the course but they have the "tools" to cope with the "real world" in the future.

Long term outcome measures are being collated using the W.A.S.S.P. (Wright/Ayre Stuttering Severity Profile) along with other assessments and results over the past 8 years have been very encouraging.