A process of mutual learning: a speech and language therapist at the McGuire Institute course - British Stammering Association
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David McGuire Course

A Process of Mutual Learning: a speech and language therapist at the McGuire Institute course
by Dr Trudy Stewart

Day 1

Thursday morning began with introductions and video recording of the 16 participants. It was clear from this that the participants had a range of difficulties; at least two did not stammer overtly during the recording, while another two stammered very severely (i.e. over 80%).

It was noted that the age range was very wide. The youngest was ten years old and the eldest over 50 years old. However, the vast majority were between 20 and 30 years of age. This average seems to be typical of the clients referred for speech and language therapy. David McGuire confirmed this was typical for the McGuire programme, although the numbers of older participants were increasing.

We reflected that individuals need to have the financial and emotional independence to be able to present themselves for four days (two working days, two weekend days) and minimal responsibilities to be able to attend the first and several follow-up courses. (We understand that scholarships and offered by the programme, and old graduates receive financial assistance to attend courses where necessary).

We did note the high levels of motivation of most, if not all of the participants and an obvious desire to change. We thought that the programme was NOT designed for the 10-year old. There is an opportunity here to develop the programme for the younger age group, with activities to meet their needs. While this 10-year old enjoyed his interaction in the group, some of the discussion (e.g. on the covert aspects of stammering) went over his head. His mother had no opportunity to take an active part. We were also concerned about the physical effect of some of the breathing and voice work on this child?s developing vocal mechanism.

David McGuire felt the child?s inclusion in the programme was justified because the parents had pressed for it. He believed that the child benefited from aspects of the course and made good progress. However, he stated he would not include a child of this age in the programme again. He is investigating the possibility of collaboration with speech therapy in the development of a programme for children.

David McGuire's introduction

David introduced himself to the "new graduates" and told of his experiences, including the development of his ideas and his personal battle with stammering and relapse. This was a very open and honest presentation, with David stressing the need for hard work and commitment, and support for maintenance.

David had separate session with the "old graduates" where he reviewed their maintenance and asked for ideas on how to make the current programme more effective. He was willing to learn from these old graduates and incorporate their ideas where possible. He was also supportive of their difficulties and encouraged them to move forward and recognise how far they had progressed.

The Teaching Process

The principles of the breathing technique (and other aspects of the programme) were taught with old clients facing new clients in rows. The "old graduates" acted as mentors and models for the techniques, clarifying and correcting techniques in the new graduates. The old graduates rotated along the rows until they indicated to David McGuire that an appropriate standard had been reached. This was an intensive teaching method, which maximised the feedback to the new graduates.

A very structured approach to speech was used, with new graduates moving from no speech to talking with old graduates only through to outside assignment, it was felt that more use could have been made of spontaneous speech, particularly gradual length of utterances and/or increasing linguistic complexity.

An immediate impression on that first day was of high energy levels combined with a great deal of support and empathy for individuals. The support was primarily directed at the new graduates but there were specific instances where David McGuire and their peers helped old graduates through difficult times.

Day 2

This day began with the new graduates phoning David and each other from 6.00am, having been up until about midnight the day before. We were amazed by the energy levels of the participants who often seemed to go without refreshments and frequently filled breaks with assignments.

In the morning, the new graduates had a chance to look at the videos made on the first day to see the changes they had made. This was obviously quite an emotional time for many who both confronted the reality of their stammering behaviour but also appreciated the gains they were beginning to make.

The rest of the day was spent with the inner (old graduates) and outer (new graduates) circles. There was a great deal of repetition or "drilling" using the two rows as in Day 1, with old graduates presenting topics from a check list - voluntary stammering, breathing, deep voice and so on. Lunchtime was spent in old and new graduate pairs, with old graduates completing 50 assignments - asking for the time, directions and so on. Some lucky ones managed to grab a quick sandwich too!

We did not observe the evening session, although we understand that the new graduates reported on how well the old graduates did with their afternoon assignments. Anyone finding this speaking exercise difficult was given support and encouragement.

Day 3

Some time was allocated on Day 3 for the old graduates to consider Harrison's stuttering hexagon. This model was reviewed and they were asked to think about a current maintenance problem in terms of the hexagon. This was then shared in pairs and explained again when the pairs moved on to a third person. Thus the participants were encouraged to make some sense of difficulties in terms of a holistic model of the self.

Also on the third day, old and new graduates presented a theme (e.g. eye contact, voice projection, claiming your space) and then other individuals volunteered to give a presentation to the group and received feedback on the "theme". The themes were rotated around the groups. Once again, this was intensive and participants got a lot of positive feedback. This exercise also acted as a desensitisation for the street assignments, which followed in the afternoon.

Old and new graduates paired off and both carried out contacts with the new graduates aiming to complete 50 in an hour. These contacts involved introducing themselves to a variety of individuals on the streets of Bradford. Having shadowed a pair, we felt this task was tackled with enthusiasm and apparently without the trepidation often seen in such a task.

The new graduates we observed (a severe stammerer) with his enthusiastic coach/mentor, introduced himself to ethnic minorities, a bench full of adolescents, and finally to a café of 20-30 people. This direct approach to assignment work can border on the aggressive. Some of the speech and language therapy clients with whom we have discussed this feel this can be viewed as socially inappropriate. They prefer to integrate their "contacts" into more routine interactions, which they have as a matter of course.

The afternoon ended with the famous "Speaker?s Corner" event in the centre of Bradford. All graduates took up the challenge, performed well and appeared to enjoy the experience, albeit in hindsight. The evening session was devoted to work on positive thinking.

Day 4

By the final day, participants were weary but mostly still quite elated. Several of the new graduates mentioned that they had lost their original "high" at their new found fluency because some of their problems had returned, but they were all confident that this was something they could work on successfully.

There was more circle work on this day, and also farewell speeches, firstly from old graduates or those who had to leave early and then from the new graduates. The message which was repeated was that it was hard work but worth it and it goes on being hard work for a long time.

The course had a feeling of passion and intensity about it, which is understandable considering the emotional level of the participants. We did note, however, that it was hard for participants to be negative in the group setting, although some expressed some reservations to us in private. Others mentioned that they would have been less able to benefit from this course if they had not received previous speech and language therapy.

In all, we were very impressed with the course. We feel that David has taken note of criticisms made over the years and rather than becoming defensive he has used the criticisms to refine the programme and make positive changes.

The aggressive approach which some people found unacceptable in the past is no longer a real feature and although David still enjoys occasional use of militaristic analogies these came across as quite appropriate (evidently he is a bit of a military history buff). A previous concern was that people would feel guilty about failure - this too seems less likely now.

The support and back up offered by this course is second to none and speech and language therapists have a lot to learn. We hope to continue a dialogue with David McGuire and have invited him to see some of our work. We feel this continuing interchange of ideas will be to the benefit to us both and more especially to our clients.

From the Autumn '97 issue of Speaking Out

See also:
Costal Breathing - for more on the McGuire course.

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