This is such a key part of each session. Most parents are uncomfortable to start with but the clinician should provide a safe and supportive environment where trial and error, failure and giving it a go are encouraged.
I always ask parents to bring in three things to each session:
1. The severity rating chart (see post on 29 July 2020).
2. Some show and tell to help get a conversation going for the in-session rating (see post from 7 August 2020).
3. An activity (book, toys, cards, game) that worked well at home. It’s important to keep treatment real by using materials that are in the home. Many times, I can chime in and we make adaptations and extensions with the tasks that are demonstrated.Seeing the parent do the therapy is an eye opener.
At first, they require a lot of support. Most parents gradually become incredibly skilled at doing talking practice and I often find they are better at it than me after several sessions. Parents know their child best and engaging with parents through home practice demonstration is a great way to connect with them and their child.
Sometimes I use video-playback to help teach key points. Mostly, it’s easier to offer comments in real time. While I am observing the parent and child, I tend to keep a tally of utterances that the child says:
l = stutter-free
_ = stuttered
Any parental verbal contingencies (PVCs) are noted below the tally mark e.g. P = Praise; A = Acknowledgment etc.
I also note what scaffolding strategies the parent uses, what language level the child is at (e.g. single word level, sentences, spontaneous chat) and what severity rating they maintain during the practice session. All of this information helps provide clear feedback to the parent about their dose of PVCs and how accurately they are using the PVCs.
I would encourage all clinicians to spend time building capacity with the parent by having the parent show you what home practice looks like. It’s a clinical game changer…
