Michael F. Shaughnessy
Robin A. Wells
Eastern New Mexico University
Portales, New Mexico

1) You have recently developed an Educational DVD to help speech - language pathologists working with fluency problems. Why do you feel it is important that students who stutter receive counseling?

The video is intended to help speech-language pathologists become better able to relate to their clients who stutter as well as their parents and teachers. Focusing on the quality of these relationships and how to help clients make the changes they wish to make is what I mean when I say "counseling". We may refer some clients out for "counseling" in addition to stuttering therapy, if we feel their issues are beyond the scope of our expertise. Otherwise, we use the term "counseling" here to talk about the problems that may arise that are related to the stuttering. Speech/language pathologists are not trained counselors per se, but we do have knowledge of the disorder of stuttering, and we should be able to address attitudes and feelings as they arise related to the stuttering problem. "Counseling" is what we all do when we are in a helping profession. That is, focusing on listening and relating to the people with whom we are working.

2) Does it differ for elementary vs. secondary students?

The issues related to the stuttering are different for each individual child. The way we relate to children and deal with these issues depends on where the child is in terms of their cognitive, social, and emotional development.

3) Do you involve parents?

Parents are a critical part of a "therapy team" when working with any child who stutters. We teach parents to listen and validate the feelings their child has about the stuttering. We also teach them to encourage the child to implement the changes they are trying to make in how they communicate. In addition, we educate them about stuttering and the complexities of the therapy process.

4) What led you to do this DVD?

I have worked with children who stutter for the past 18 years of my career. I grew up with a stuttering problem and did not share the feelings I had about it. I was scared to stutter and tried to hide it in any way I could, like by not talking or saying "I didn't know" in school. My passion has been to help children who stutter, their parents, and speech-language pathologists understand how attitudes and feelings may play a central role in the development and maintenance of a stuttering disorder.

5) Do teachers and parents understand stuttering problems?

Many teachers and parents have had little experience with individuals who stutter. Stuttering is a very complex, multidimensional problem. Organizations such as the Stuttering Foundation of America have created wonderful videos to educate parents and teachers about stuttering. Speech-language pathologists need to spend a lot of time educating parents and teachers about stuttering, therapy, and appropriate outcomes for therapy.

6) What exactly is a fluency disorder?

A fluency disorder deals with the rate and continuity by which one speaks. Some children have fluency disorders in addition to receptive (understanding language) and expressive (retrieval and formulation) language difficulties. Other children, however, do not. Therefore, children may have "language-based fluency issues" and may often demonstrate more "typical" types of disfluency such as revisions, interjections, and repetition of whole words and phrases. Other children may have a "motor based" fluency disorder, which may include "less typical" stutter-like disfluencies such as repetition of sounds, prolongation of sounds, or blocking of sounds. Children who stutter may exhibit various types of these behaviors, or they may "cover" it up by talking "around a word" or substituting one word for another. These "covert" features of the problem are of significant concern to the child's overall development of self-esteem.

7) What do all of those initials behind your name represent?

My initials: CCC-SLP means Certificate of Clinical Competence-Speech/Language Pathologist (achieved with a 4 year B.A. and then a two year M.A. in Communicative Disorders and Sciences, and a 1 year Clinical Fellowship under a practicing colleague); BRS-FD means Board Recognized Specialist-Fluency and Fluency Disorders (I was in the initial cadre of specialists recognized by the American Speech-Language-Hearing Association Special Interest Division 4 on Fluency and Fluency Disorders. Requirements can be found under the SID 4 on the American Speech Hearing Association website.) 

8) What do you see as the main issues in "counseling children who stutter"?

a. Developing the skills to talk with a child about the problem at different times when needed

b. Developing the skills to create an environment that is conducive to change

c. Developing skills to help parents communicate and cope with feelings they have regarding their child's stuttering problem

d. Knowing how to help a child work through "speaking fears" if they arise, or deal with issues related to teasing

e.
Knowing how to help children and parents develop healthier attitudes and feelings about the stuttering problem

9) What does therapy for children who stutter involve?

It involves many different things. It is important to understand what the child thinks and feels about what is happening with their speech; in addition to understanding what they are "doing" (motorically) when they stutter. Therapy may include developing healthier attitudes towards speaking, learning skills to become more fluent, or learning skills to change the tension when they stutter. Most importantly, the therapy should be motivating to the child, the parents should be involved, and progress should be evidenced each step of the way. Successful stuttering therapy considers all aspects of the problem.

10) How can parents and teachers best work together?

I think the best thing to do for teachers is to meet with them and discuss their questions, concerns, and observations of the child who stutters in their classroom. Many times we have children meet with us and they teach their teacher about the tools they are learning in therapy. That often helps the child have courage to try and use these skills in the classroom. Parents and teachers can best work together by becoming educated about stuttering, about their child/student's stuttering, and ways they can best help.

11) How and where can parents get help?

Parents can get help and information by contacting the Stuttering Foundation of America ( stutteringhelp.org ). There are two self-help organizations that provide information and support for families of children who stutter. Their names are the National Stuttering Association and Friends. They can also get information about stuttering on the stutteringhomepage.com .

Counseling Kids in Fluency Therapy: Issues & Strategies
Kristin A. Chmela, M.A., CCC-SLP, BRFS .3 CEU Seminar - Intermediate Level

The answer to many speech-language pathologists' concerns regarding how best to support speakers with disfluency might be found in an ASHA approved .3 CEU Intermediate Level Seminar, Counseling Kids in Fluency Therapy: Issues & Strategies, by Kristin A. Chmela, M.A., CCC-SLP, BRFS. While SLP's often have the training in working with individuals on improving fluency, they often express being less confident in supporting the emotional challenges speakers have towards their disfluent speech patterns. This seminar, available through Super Duper Publications, offers an actual workshop given by Ms. Chmela addressing such issues as attitudes and feelings, self-reflection, acceptance and accountability, and self-confirmation.

The seminar's DVD and accompanying workbook provide speech-language pathologists with the opportunity to "attend" a full-day workshop without really being there. The DVD provides the viewer an entire workshop and the video clips shown during the seminar demonstrate the strategies Ms. Chmela uses in therapy sessions, including: (1) Balanced Therapy with school-aged children, (2) counseling techniques, and (3) actual therapy strategies. The accompanying workbook (with note-taking areas available) follows the workshop's PowerPoint presentation. During the seminar, Ms. Chmela shares personal insights of her own stuttering challenges as well as those experienced by her students. Interactive therapy sessions, individual student and family reactions, and workshop participant questions and answer sections are viewed during the presentation.

Pre-service training in speech-language pathology has taught various program approaches for achieving fluent speech, but training has been remiss in teaching a holistic approach in supporting the individual with non-fluent speech patterns. A holistic approach toward the challenge of disfluency encompasses not only teaching the individual strategies to address non-fluent speech patterns, but it also focuses on the individual's attitudes, emotions, and behaviors associated with having disfluent speech. Ms. Chmela helps to broaden the knowledge base of SLP's towards this facet of "balanced therapy." She provides insight into the art of counseling, interacting, listening, valuing, validating, and seizing opportunities for creating new attitudes and beliefs towards disfluency.

Ms. Chmela's on-going support of pre-service SLP's, as well as to those SLP's currently in practice, fills a lingering gap in fluency training. After viewing this DVD, and completing the accompanying workbook, speech-language pathologists should feel more confident in using fluency programs to "guide and support" individuals through therapy sessions. Teaching fluency strategies as well as teaching individuals how to be self-advocates in a communicative world should be a goal for all speech - language pathologists.

You may contact Super Duper Publications at 1-800-277-8737 to order this ASHA approved .3 CEU Intermediate Level Seminar, Counseling Kids in Fluency Therapy: Issues & Strategies, by Kristin A. Chmela, M.A., CCC-SLP, BRFS. The cost is $89.00.

Reviewed by

Robin A. Wells, Ph.D., CCC-SLP/L
Assistant Professor - Special Education
Eastern New Mexico University Station 25
Portales, NM 88130
505-562-2264
[email protected]