Wednesday, October 07, 2009

ROPANA

I just read on the ISAD conference that someone was referring to techniques in golf coaching to change stuttering behaviours. I am not sure whether I have discussed the German treatment approach ROPANA by Roland Pauli on my blog. I had many Skype discussions with him, because I gave him feedback on his book project and I did ROPANA at the same time. Here is my view...

ROPANA is unique in my view in that it does not focus on stuttering at all. There are two main strands in treatment. First, fluency shaping teaches a new way of speaking, a more fluent way of speaking. So you are learning motor code that you use to smoothen your speech (gentle onset for example, and connecting your words) or put more rythm in your speech. Second, dysfluency shaping (I like to call it this way but it is known under stuttering modification) works on stuttered speech itself. You do not try to avoid stuttering, and you are working dilligently on trimming your stuttering. I like to picture this as the wild bush in your garden, you are trimming it, cutting it down as much as possible. The idea is simple: you might stutter but you don't have to stutter with tensions, with fillers, with secondary symptoms. And the end, ideally you just have easy blocks.



In both approaches the emphasis is on stuttering. It certainly is in dysfluency shaping, and in fluency shaping you are focussing on avoiding stuttered speech. The idea in ROPANA is the following. We have two modes of speaking: naturally and fluently, and stuttering. We stutter because our speech system is overloaded by stress, bad day, moods, liguistic complexity OR because the environment or inner thoughts are triggering associations. We cannot fix the neurobiological weakness but we can control the demands on the system and we can unlearn or avoid learning secondary stuttering behaviour.

The connection to sports comes as follows. Often in tennis we have learned motor code that produces a less than optimal hit, and tennis coaching is often about unlearning thoses bad habits and learning the right hit. Like in Golf, I guess. Though I never played golf after the age of 15. That might have to do with me playing a lot of mini-golf, and one day hitting my grand-father with the golf club accidently!! He needed a few stitches but I am happy to announce that he made it into his late 80s. Anyway... This unlearning bad habits and learning new ones is essential business of any tennis coach. Unlearning involves ignore the bad habits completely, avoiding the triggers that lead to the bad habit, and to learn the new motor code in small steps into more and more demanding situations.

Ignoring bad habits is important, because attaching any emotions to the habit strengthens the habit. That is a very important concept. Translated into stuttering treatment, the key is to ignore your stuttering moments while working on increasing the fluent periods. The second key is to avoid triggers of stuttering, and there are many: speed, self-imposed stress, wrong beliefs, bad past experiences. Here the new motor code kicks in. It is not about fluency shaping, a new way of speaking, but just of using your fluent mode more effectively. So there is no shaping on your natural speaking but rather simple rules of pauses, lower speed, think before you speak. Nothing that a good speech coach wouldn't tell you anyway. And the reason you do this is to reduce the demands on your speech system, even for fluent speakers. ROPANA starts out with very low demanding situations and works on this until fluency is established. So this could be just working on repeating single words for weeks. So the patient learns to associate words and situations to fluent speech. Also, a key of the treatment is post-paration instead of pre-paration. So after a stuttering event, the patient says the word until they can say it fluently without efforts. But to start with not in a speaking situation or using fluency shaping techniques, but by taking breaks and focusing on fluency. And every instance is picked up, which can be frustrated but essential. Of course, fears and beliefs play an important role to as they are also triggers to stuttering. And so on... don't have time to continue...

Of course, the big big issue as in ALL treatments is that it is a behavioural therapy and you need to work hard. But ROPANA seems to me like the most efficient way. Or maybe some are using this approach? I guess many elements are already used within the other two frameworks. I would call ROPANA fluency enhancing or dysfluency neglect as opposed to fluency and dysfluency shaping.

5 comments:

Karen said...

Super summary over ROPANA!
For some years I practice some elements of this method and can confirm that it really can work to "to ignore your stuttering moments while working on increasing the fluent periods" as you mentioned as the key of this method.

Dave Rowley said...

What happens when you get the "yips"?

Tom Weidig said...

What is the yips?

Pam said...

This is a very summary of an interesting method. Thanks for providing it. I read the ISAD paper, but didn't really get it. Your explanantion is much more thorough. Do you employ this method yourself for your stuttering?

Blanka Koffer said...

it s interesting to see so many people inventing the wheel again and again...

what s the new thing about ropana? that it s something to do with golf, maybe, no one has dared to link these two.

just to remind: van riper´s "treatment of stuttering" was released in 1973.