Palin PCI Therapy: Follow-Up & Child Strategies

Therapy Follow-Up

  • Typical Therapy Duration: For most families, the initial block of therapy sessions is sufficient.

    • Follow-up reviews are suggested at six weeks, six months, and one year from the therapy's start.

  • Rationale for Follow-Up: Regular follow-ups are important due to stammering and its impact fluctuating over time.

Additional Support

  • Need for Further Support: Some families require more support, which may include:

    • Revisiting family strategies.

    • Introducing additional family strategies.

    • More work on special times and interaction strategies.

  • Child Strategies: In certain cases, child strategies may be appropriate.

  • Typical Approach: The usual approach involves six sessions, followed by reviews throughout the year, with the family having the option to contact the therapist.

  • Value of Contact: Knowing they can contact the therapist, even if they don't often do so, provides a safety net for families.

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Palin PCI Feedback

  • Positive Feedback: Palin PCI generally receives positive feedback from families.

  • Personal Experience: The presenter has had a positive experience implementing Palin PCI with families.

  • Real Family Quotes: Positive feedback and experiences from families are highlighted, demonstrating the therapy's benefits.

Parent's Perspective

  • Video Testimonial: A video featuring a mother discussing her experience with the therapy process is shared.

    • The therapy has helped the family deal with stammering as a whole, making it a natural part of their home life.

    • Specific praise and allowing the child time to talk at their own pace have been beneficial.

    • The approach has been non-invasive, preventing negative feelings about stammering.

  • Common Feedback: The feedback aligns with typical experiences reported by parents who have undergone the therapy.

Child Strategies

  • Limited Use: Child strategies are only used in a small percentage of cases which won't be appropriate for all children under seven.

  • Holistic Approach: Child strategies now have a stronger emphasis on being holistic.

  • Focus Areas: The child's thoughts and feelings about stammering, along with desensitization, are key focus areas.

  • Desensitization: Is a big part of child strategies.

  • Clinical Decision-Making: Determination of whether to apply child strategies involves parental expectations, open approach and should not raise expectations of "fixing stammering".

  • Appropriate Scenarios: Child strategies may be considered when the child shows awareness, insight, and outward struggle in relation to their stammer.

Key Topics in Child Strategies

  • Openness:

    • Encouraging open conversations about stammering.

    • Determining how the child wants to refer to their stammering.

    • Helping children respond to questions or comments about their stammering from others.

  • Neutral Language: Modeling neural language instead of "better or worse" language when talking about stammering.

    • Ensuring the child has the language to explain stimmering.

    • Using words such as "stammering", "stuttering", "words getting stuck"

  • Additional resources

    • "Perfectly normal" is a book about a boy hiding his wings and applies to the concepts of stimmering.

    • "Do animals stammer?" positive and playful book.

  • Desensitization: Aims to reduce sensitivity towards stammering through a stepped approach:

    • Learning about talking: Educating the child on how speech is produced, including the parts of the body involved. One way of teaching this is big paper where the child lies to create a silhouette and then draw the parts of the body involved in talking.

      • Books about the brain can be integrated to show how the brain is involved in talking.

      • Use of balloons to help children understand the lungs and talking.

    • Learning about stammering: Educating the child on the different stammering behaviors people display. Watching videos of other children stammering. It is important to monitor how comfortable the child feels.

      • Videos "Wait wait I'm not finished yet" to watch other children stammer and "Sam's Poem".

    • Voluntary stammering: encourages a child to practice stammering on purpose through different long, short, hard, soft stammering to increase desensitization.

Confidence Building

  • Integrating Confidence Building: Discussing what has been going well and identifying strengths.

  • Activities: Draw around hands activity and write things they like about themselves on each finger.

Thoughts and Emotions

  • Emotional Literacy: Allowing the space to explore emotions and intensity of emotions related to stammering in order to provide support.

  • Resource: "Sitting still like a frog" and other mindfulness activities.
    *Note: Children with significant emotional health needs can be referred to psychology and CAMS.

Speech Modification

  • Direct Speech: Can be appropriate, but is in a very small cohort.

  • Parent Conversation: During direct speech, talking through advantages and disadvantages are important.

  • Direct speech involves: Slowing down and pausing when speaking.