Evaluation, Take Two

The early intervention speech therapist, whom I will call P., came this morning for L.'s informal speech evaluation. She happens to work with the woman who conducted the formal (expensive) evaluation, and she had gotten some basic information from her last week. After that, P. called me and said that from what the original evaluator said, L. probably would not qualify for early intervention services. She went on to tell me about normal speech disfluencies and how they are different from genuine stuttering. The call upset me, partly because I felt they thought I was crazy or stupid, and partly because it worried me to think that L. would be denied professional help when her father and I knew that her speech was not normal. Fortunately, P. has since changed her mind and believes L. will qualify after all.

When P. arrived today, she said she just this morning had spoken with the initial evaluator, who told her that she had (finally) viewed the speech sample tape I gave her. L.'s speech on the tape was "significantly different" from her speech in the clinical setting. I could've told her that, and in fact, I did when I gave it to her. Gee, I'm glad she finally decided to watch it. Anyway, after doing whatever fluency-counting test they do on the clinical sample and the video tape samples, she told P. that L.'s stuttering was mild in the clinical setting and moderate to severe on the videotape. Finally. Confirmation of what we already knew. P. listened to her speak some today and noted several disfluencies herself, including some occurring in the middles of sentences rather than just on the initial sounds. That, she says, concerned her. The secondary behaviors also were a "red flag," she said.

It sounds awful to say this, but I am so relieved -- relieved that someone else has seen the problem and can shoulder some of the responsibility with us. I knew L.'s disfluencies were significant. Now that we have that out of the way, we can get on with the business of helping her improve her speech and/or become comfortable enough with speaking the way she does that it does not interfere with her life.

Although I liked the initial evaluator pretty well, I like P. even better. She has a son who stutters and -- I didn't know this until our meeting this morning -- a father who stutters severely. When I answered the door this morning, she said, "I'm P. You must be M." It's the little things like that. The little things like gracefully taking away the pressure of introducing myself. She didn't do it in a condescending way, either, just in a natural way. The way someone would if she had lived with stutterers her whole life.

She also was able to detect L.'s disfluencies when she was across the room playing with her brother and P. and I were conversing. I was impressed that P. would stop what she was saying and listen attentively to the kids' conversation in order to pick up some of L.'s disfluencies. She has a good ear for this kind of thing. In the initial evaluation, I was repeatedly frustrated that I could hear L. stuttering while the evaluator was talking to me and seemed absolutely oblivious to the "evidence" right there before her. I hadn't wanted to interrupt her to say, "Listen! She's doing it now!" Today, with P., I didn't have to.

When P. left, she seemed absolutely sure that L. would qualify for early intervention. She seems to think that while L. is too young to start the Lidcombe program, there are aspects of it we could do. She didn't elaborate too much but will do so in our first meeting after the L.'s eligibility/IFSP meeting next week, I am sure.

Finally, one of the best things P. told me was a story about her son, who is in elementary school. He was in speech therapy for his stuttering for several years, and now that he is old enough to really express his opinions and talk about speech, he is saying that his stuttering, his blocks, don't bother him. He stutters fairly severely but doesn't let it get in his way. They eventually dropped the speech therapy because he just wasn't interested. She was afraid the story would be a downer for me since it didn't have a fluent happy ending. It was quite the opposite. Her son's story reminds me that even though blocks and severe stuttering episodes were very upsetting to me when I was young, they might not be to every person who experiences them. Her son has an attitude that I didn't begin to have until I was in my twenties. Perhaps the influence of a grandfather who stutters and a mother who respects and understands stutterers is part of what made his attitude so different from mine. I can't fix L.'s speech for her, but I think I can influence her attitude about it. And attitude is more important than fluency anyway.