Services
Evaluations | Individual Treatment | Pediatric Treatment | Consultations | Video Conference Calls | Workshops | Intensive Therapy | Refreshers | The New England Fluency Program
Evaluations
Ms. DiGrande provides evaluation services to preschool and school age children, teens and adults. Evaluations may be at the request of schools, parents, rehabilitation agencies or the individual adult.
Evaluations include the collection and analysis of video taped speech samples, attitudinal measures and gathering of pertinent case history information obtained from previous records and during an initial meeting with the client (and parent for children). A written report is generated outlining detailed findings and recommendations for treatment and is reviewed with the client or parent in a second meeting.
Individual Treatment
Ms. DiGrande provides individual fluency therapy for adults, teens, and children, including preschoolers, in her office in Lexington, MA. Therapy is typically scheduled once a week for 45 minutes to an hour.
Pediatric Treatment
Ms. DiGrande sees young children who may be at risk for developing stuttering. Intervention begins with a comprehensive fluency evaluation to determine the child's risk factors for developing stuttering and to make recommendations for the appropriate course of treatment. Ms. DiGrande has developed a pediatric program that includes both direct and indirect therapy approaches with a strong parent counseling component.
Consultations
Consultations may be provided to individuals and/or their families to address fluency concerns and determine the individual's readiness for treatment. Consultations are also offered to school systems and other professionals to address concerns related to stuttering.
Video Conference Calls and Treatment Sessions
For individuals from out of the region, where in-person meetings would not be possible, Adriana can arrange to meet for video consultations via SKYPE. This is particularly useful for individuals and families considering the intensive program who do not live in the United States or in the New England area. It is also useful for long distance follow-up sessions.
Workshops
Ms. DiGrande has extensive experience in conducting workshops, seminars, and in-service trainings for professional groups. She works with groups to tailor content and format to meet the specific needs of the requesting group.
Intensive Therapy
Ms. DiGrande has been conducting intensive fluency therapy since 1975. In 1982, she limited her practice to treating persons who stutter. In 2000 she developed The New England Fluency Program, an integrated intensive therapy program for children and adults who stutter. The program integrates both stuttering modification and fluency shaping strategies to address the complex nature of stuttering and human behavior.
Refresher Programs
Refresher programs are periodically offered to former intensive program clients to help re-establish fluency skills and maintain gains from previous therapy.
The New England Fluency Program
PROGRAM DESIGN
The New England Fluency Therapy program is an integrated approach for treating children adults who stutter. The program integrates both stuttering modification and fluency shaping strategies in order to address the complex nature of the stuttering and human behavior.
Treatment is multifaceted and helps clients develop an awareness of the physical, emotional, and cognitive components of their own stuttering. Participants first identify and become desensitized to moments of stuttering and listener reactions in order to begin the process of changing strongly held beliefs about themselves and their stuttering. Our clients are then taught to physically reconstruct the motor behaviors that facilitate fluent speech. And finally, participants are given numerous opportunities, both inside and outside the clinical setting, to transfer their newly established skills. For example, clients make well over 100 phone calls, ask questions of store clerks in shopping centers, and present a final speech to family, friends, and other invited guests.
The program design encourages the use of one's own internal resources, especially in challenging speaking situations, and incorporates the use of mindfulness meditation to foster and deepen self-awareness and self-acceptance. Individuals are assisted in making alterations in their attitudes and belief systems in order to support the physical changes (fluency) that occur as a result of therapy. Educational counseling sessions for parents are scheduled weekly to assist with the home program.
PROGRAM OUTCOMES
Individuals completing the program make significant improvements in their overall level of fluency with approximately 80% of our clients achieving fluency levels within normal limits. Clients also report positive changes in the following areas: managing stress, confidence, reduction of avoidance behaviors, and attitudes about themselves and those around them.
FOLLOW-UP
Weekly post-treatment sessions are provided for several months after the intensive phase of treatment to help maintain the important changes made in therapy. Consultation services and a workshop in the fall are offered, at no fee, to public school clinicians working with the children who have completed the summer intensive programs. E-mail and periodic phone check-in contact by clients and/or their parents is encouraged to maintain ongoing support.
PROGRAM STRUCTURE
The program is 15 days in length and meets five days a week from 8:30 a.m.– 3:30 p.m. Programs are conducted in Boston at local universities and are led by Ms. DiGrande with assistance from graduate level clinicians. Groups are typically comprised of six participants, ensuring a high staff to client ratio.