Presented by Carmen LeFevre
A key component of stuttering therapy is changing the behaviours that result in disfluency. In this one-hour presentation, Carmen LeFevre, Ph.D., of the Centre for Behaviour Change, University College, London introduces the principles and the science of behaviour change and relates it to therapy for stuttering. She discusses a methodology to understand behaviours, conduct behaviour analysis, engage in systematic intervention design, evaluate intervention effectiveness, and refine interventions for maximum effectiveness.
Presented by Joseph Donaher
In this 54-minute film, Joseph Donaher, Ph.D., CCC-SLP, of The Children's Hospital of Philadelphia, introduces the clinical characteristics of ADHD, the literature on stuttering and ADHD, and clinical management accommodations that may improve therapeutic outcomes for children who stutter who present with coexisting attention and focusing concerns.
Presented by Ellen Kelly
The psychosocial consequences of stuttering including anxiety, stigma, social isolation, negative listener reactions, and bullying are well-documented. The degree to which children who stutter experience these “slings and arrows,” and the ways in which they respond, vary. In this presentation, Dr. Ellen Kelly, CCC-SLP, of Vanderbilt University explores resiliency theory and research to motivate a strengths-based model of resilience. She discusses assessment and treatment of stuttering in school-age children in familial, social, and academic contexts. She presents practical strategies for providing children who stutter and their families with the armor needed to build healthy adaptation to stuttering and to thrive in communicative interactions.
In this hour and forty minute presentation, Ellen Kelly, Ph.D., CCC-SLP, BCS-F, of The Stuttering Foundation discusses how the complexity of stuttering development necessitates a multifaceted approach to assessment of preschoolers. She provides the rationale for and specific elements of screening and discusses comprehensive assessment protocols for use with preschoolers suspected of stuttering and their caregivers. Case examples illustrate prioritization of assessment measures and formulation of recommendations to caregivers.
Presented by Vivian Sisskin
There has been increased interest in understanding the variety of speech disfluency patterns among those with autism spectrum disorders.
Case studies that describe types of disfluencies have added to our knowledge base. While both stuttering and "atypical" disfluencies (final part-word repetition) have been documented, many questions remain unanswered. What treatment methods are effective? What are the priorities for improved communication? What should we expect for positive functional outcomes?
In this 2 hour presentation, Vivian Sisskin, M.S., CCC-SLP, from the University of Maryland, summarizes the literature pertaining to disfluency in autism, and provides basic principles to aid in differential diagnosis and treatment planning. A case study, demonstrating effective treatment for final part-word repetitions, highlights a problem-solving approach to clinical management, using both learning style in autism and strategies from traditional fluency therapies. Filmed at The Children's Hospital of Philadelphia during the Stuttering Foundation Mid-Atlantic Workshop, Philadelphia, PA, July 2012. Filmed and edited by Bob O'Brien, Video Design Productions, Inc., Lake Zurich, IL.
Presented by Vivian Sisskin
Vivian Sisskin, M.S., CCC-SLP, University of Maryland, walks clinicians through methods of group therapy while providing the nuts and bolts of Avoidance Reduction Therapy.
Presented by Barry Guitar, Peter Ramig, et al.
Description: This 2+ hour video course demonstrates speech management strategies to help you work effectively with children and adults who stutter.
Chapters include: Exploring Talking and Stuttering (identification, exploring stuttering, exploring change); Tools for Change (specific speech management techniques) and Making change durable (transfer and disclosure).
The video shows dynamic demonstrations of stuttering therapy techniques by experts from around the world:
Barry Guitar, Ph.D., University of Vermont; Peter Ramig, Ph.D., University of Colorado-Boulder;Patricia Zebrowski, Ph.D.,University of Iowa; and June Campbell, M.A.,private practice. From the Michael Palin Centre in London Ali Biggart, BA (Hons), MSc,Jane Fry, MSc (Hons), MRCSLT,; Willie Botterill, MSc, MRCSLT,; Frances Cook, MSc,MRCSLT (Hons), Cert CT (Oxford);and Alison Nicolas, MSc, MRCSLT.
Presented by Courtney Byrd
In this 1 hour presentation, Courtney Byrd, Ph.D., CCC-SLP, of the University of Texas at Austin, sheds light on differential diagnosis of stuttering particularly when clinicians may be misled by similarities in the speech behaviors produced. Participants will learn key differentiating characteristics and areas of overlap, along with other critical assessment considerations that will enhance their competence and confidence in their evaluation of speakers for whom there may be an increased risk for misidentification of stuttering, with an emphasis on assessment of speakers of more than one language.
In this one-hour presentation, Sarah Caughter, MSc, MRCSLT of the Michael Palin Centre in London explores the potential negative impact of stuttering on children and young people and discusses ways to support them and their parents to build their confidence and resilience in therapy. The presentation includes clinical examples and videos to demonstrate therapy ideas.
Presented by Julia Hollister
In this one hour, twenty minute presentation, Julia Hollister, Ph.D., of Loma Linda University discusses the importance of designing holistic stuttering interventions that include resiliency-building practices. Activities that build emotional regulation skills within the framework of stuttering will be discussed.
Presented by Florence Myers and Kenneth St. Louis
This 42 minute program, written and narrated by Florence Myers, Ph.D., and Kenneth O. St. Louis, Ph.D., features people who clutter and clearly illustrates the essence of cluttering as well as the problems that often accompany it.
Strategies and suggestions for diagnosis and treatment of cluttering are provided for speech-language pathologists.
Presented by Kathleen Scaler Scott
In recent years, many advances have been made in understanding the communication disorder, cluttering. Kathleen Scaler Scott, Ph.D., of Monmouth University helps to clarify prior myths and explain recent research findings about cluttering. She presents the current lowest common denominator definition of cluttering and demonstrates how to apply this definition to assessment, differential diagnosis, and treatment.
For clinicians who have been confused about how to identify, assess and treat cluttering, this 76-minute video provides practical strategies for understanding and managing complex clients.
Presented by Vivian Sisskin
Many people who stutter who can "pass" as fluent in daily life are desperate to do so despite the emotional cost: anxiety, dread, and fear of potential stuttering; exhausting "mental gymnastics" to avoid words or remain silent; and poor self-confidence as a communicator. Adults with a covert profile of stuttering share their experiences and provide insight into their personal journey toward self-acceptance. Vivian Sisskin, M.S., CCC-SLP, BCS-F,
Clinical Professor, University of Maryland, College Park presents the basics of a treatment plan that supports stutterers with a covert profile to embrace their identity and confidently say all they want, when they want.
Presented by Elaine Kelman and Ali Berquez
Desensitisation has long been recognized as an important component of therapy for children who stutter. In this 1-hour presentation, Elaine Kelman, MSc, Cert MRCSLT and Ali Berquez, MSc, Cert MRCSLT, of the Michael Palin Centre for Stammering in London explore the process of desensitisation and its potential benefits for parents and their children who stutter. The construct of desensitisation is defined and a description given of how traditionally it has been incorporated into therapy with adults and children who stutter. They discuss the rationale of desensitisation and the benefit of including parents of children who stutter of all ages in the therapy process. They present research evidence about the impact of a child’s stuttering on parents. The presentation focuses on clinical methods for desensitising parents of children who stutter using examples of activities conducted in group and individual therapy with parents at the Michael Palin Centre in London.
This audio version of the Stuttering Foundation book Effective Counseling in Stuttering Therapy presents how counseling principles and methods are used to help those who stutter and their families explore and address their emotions, thoughts, and behaviors in therapy for stuttering across the lifespan.
Presented by Kurt Eggers
Research in the area of children’s temperament has demonstrated that many children who stutter are prone to react emotionally and have lower emotion/attention regulation skills than children who do not stutter. This can play a role in exacerbating stuttering and the impact that stuttering has on day-to-day functioning. In this one-hour presentation, Kurt Eggers, Ph.D., Thomas More University College, University of Turku, discusses the relevant literature and provides several tools and strategies clinicians and parents can use to help improve children’s emotional regulation.
Presented by Cara Singer
In this 1 hour 15 minute presentation, Cara M. Singer, Ph.D., CCC-SLP of Grand Valley State University presents the latest research in which children who stutter were evaluated and followed to help identify ways to differentiate children who eventually recover from those who persist. She presents a review of the current literature and findings from a recent study based on evaluation practices of speech-language pathologists in order to identify where we are in our current understanding of stuttering persistence and recovery. She then discusses important implications for caregivers of children who stutter and for speech-language pathologists.
Presented by Nan Ratner
Discussions about evidence-based practice often culminate in claims that there is one best approach to treatment of a particular type of client, or that we lack appropriate evidence or that clinicians lack access to what evidence we have.
In this presentation, in an effort to frame these claims more positively, Nan Bernstein Ratner, Ed.D., argues that there is both research and common-sense evidence that these claims are wrong. She also suggests that in the debate about best practices in fluency treatment, there is indeed a need to search out and integrate many sources of evidence that either support our approach to a case or suggest a need for reconsideration, adjustment, or change.
Many options exist to find and use this evidence, and many more await implementation either in the clinic or in our research undertakings.
This 55 minute talk provides a range of options for both clinical researchers and practicing clinicians who want to find, use and integrate evidence of treatment effectiveness.
Dr. Ratner suggests some fruitful ways to frame further discussions on the topics of evidence-based practice and practice-based evidence to answer commonly posed questions about the effectiveness of what clinicians do.
Filmed at the 9th Oxford Dysfluency Conference, St. Catherine's College, Oxford, UK, September 2011. Filmed and edited by Bob O'Brien, Video Design Productions, Inc., Lake Zurich, IL.
Managing fluency disorders can be further complicated by concomitant diagnoses. In this one-hour presentation, Kathleen Scaler Scott, PhD, CCC-SLP, Associate Professor at Monmouth University discusses a host of combinations and offers strategies for managing them. Dr. Scaler Scott uses a case-based approach to discuss the intersection of fluency disorders with concomitant diagnoses; stuttering, cluttering and atypical disfluency in Autism Spectrum Disorder; stuttering in selective mutism; and stuttering and cluttering in intellectual disability.
Presented by Vivian Sisskin
For many children who stutter, successfully managing communication involves more than just changing speech. In this 2-hour, 55 minute video, renowned clinician Vivian Siskin, M.S., CCC-SLP, of the University of Maryland, presents a multidimensional approach as a foundation to help children address thoughts and feelings that sometimes co-exist with stuttering. She offers concrete strategies to help children become more mindful about communication, to answer others' questions about what stuttering is and why they talk the way they do, and to recognize how feelings influence their behavior.
Presented by Ellen Kelly
In this one-hour video, Ellen M. Kelly, PhD, CCC-SLP, BCS-F, of Vanderbilt University Medical Center, discusses the healthy development of self-regulation (i.e., the ability to manage thoughts, feelings and behaviors) in the context of caregiver-child interactions and its positive impact on educational, emotional, physical, social, and communication outcomes. Kelly discusses how therapists can enhance intervention by helping parents understand the development of self-regulation, i.e. how children respond emotionally, cognitively, and behaviorally to their stuttering. She also uses case examples to illustrate recommendations for coaching parents in fostering self-regulation skills with their children who stutter.
Presented by Kristin Chmela
In this one hour video, Kristin Chmela, M.A., CCC-SLP, BCS-F, discusses a framework for helping children who stutter evolve their skills as communicators. This treatment framework for children who stutter ages 8-18, is based upon the multidimensional nature of stuttering and the importance of varied treatment outcomes over the course of development. It encompasses five areas of focus, broadens a child's perspective (beyond stuttering-fluency), and emphasizes the positive mindset of choosing to grow as a communicator. Each of the five areas of focus (Attentive, Assertive, Confident, Effective, Proactive) include actions one may engage in and are derived from evidence with our field, as well as the fields of psychology and neuroscience. This presentation defines and applies this framework across a case study.
Presented by Lisa Scott
Cognitive-behavioral therapy is one approach for helping children change their thoughts and feelings about stuttering. These changes can lead to better therapy outcomes as children develop coping strategies, test their beliefs about listener reactions, and take risks like using speech tools in front of others.
In this 1 hour, 40 minute program, clinicians learn why unhelpful thoughts and feelings can interfere with stuttering therapy and then how to help children begin to make changes. Extending the information presented in the Stuttering Foundation's DVD 9900, A Cognitive Behavior Therapy Taster, Lisa Scott, Ph.D., of The Florida State University presents concrete therapy activities for helping children learn to cope with difficult speaking situations, identify unhelpful thoughts, and strategies for trying out new thoughts and behaviors. Reproducible worksheets and slides included!
Special thanks to the University of Iowa, The Florida State University, Stuttering Foundation workshop participants, and Patricia Zebrowski, Ph.D.
Presented by Ellen Kelly
Listen while parents share their stories and answer questions about their experiences as parents of children who stutter. Parents talk about their first memories of their children stuttering and how they responded (their thoughts, feelings, and behaviors), as well as what they learned over time, and provide helpful advice to other parents and speech-language pathologists who work with children who stutter. The webinar is hosted by Ellen M. Kelly, PhD, CCC-SLP, BCS-F, Vanderbilt University Medical Center.
Presented by Heather Grossman
In this one-hour presentation, Heather Grossman, Ph. D., CCC-SLP, of The American Institute for Stuttering, discusses how Rational Emotive Behavioral Therapy provides a powerful framework for helping clients identify and restructure the self-destructive core beliefs that contribute to tense, avoidant stuttering behaviors. As people who stutter come to replace these cognitions with more helpful constructs through individualized action assignments, stuttering tension and avoidance are reduced. Over time, this work brings individuals who stutter closer to how their speech flows in situations where they are most comfortable and unconcerned about stuttering. This workshop provides an overview of applications of REBT for stuttering in older teens and adults.
Presented by Diane Parris
Many methods have been developed to count speech disfluencies and in this 1-hour program clinicians are trained to differentiate between various types of disfluencies, code them, and analyze the data accordingly. While this is just one aspect of a comprehensive fluency assessment, it is important to obtain reliable frequency measures for assessment purposes as well as to determine treatment effectiveness.
After being trained in several methods, including Northwestern University's Systematic Disfluency Analysis (Campbell and Hill, 1987) and Vanderbilt University's disfluency counting method (Conture, 2001), Diane Parris, M.S., CCC-SLP, BRS-FD of Boston University demonstrates a pragmatic approach to scoring disfluencies using two case examples for practice.
Reproducible counting forms and slides are included.
Presented by David Luterman
This exciting 3 hour video program features renowned audiologist and expert counselor, David M. Luterman, D.Ed. Luterman's philosophy of counseling centers around deep listening and silent witnessing of our clients' stories and concerns as we refrain from providing immediate advice, information, or solutions.
In this seventy-five minute presentation, Selma Saad Merouwe, SLP, ECSF, of Saint Joseph University, Beirut, discusses new research in bilingual people who stutter. Our insight into the frequency and types of the disfluencies of bilingual children who do, and do not stutter, is limited because research has primarily focused on monolinguals. Recently, many studies have been conducted that include children with different language profiles to better understand the interlinguistic characteristics that can distinguish bilingual children who do and do not stutter from their monolingual peers. Results inform the accurate clinical identification of stuttering in bilinguals. This presentation includes the theoretical background related to this specific topic, and some preliminary findings of a research project carried out in Lebanon.
Presented by Barry Guitar
Barry Guitar, Ph.D., of the University of Vermont describes the differences between the two primary approaches to speech modification: fluency shaping and stuttering modification. He describes the goals of each approach, the speech strategies used in each, and the appropriate hierarchies for application.
Presented by Christopher Constantino
Stuttering as an adult can be difficult. Although therapy is often helpful, after having been in therapy throughout our school careers, it may not be very enticing. Access to a specialist, time, and the expense can be additional barriers to therapy. Self-help, another oft-suggested activity, may also be problematic. In this presentation, Christopher Constantino, Ph.D., CCC-SLP, of The Florida State University presents an orientation towards stuttering that offers opportunities for growth. He discusses how to become more comfortable stuttering and how to speak with greater ease and spontaneity.
Presented by Joseph Donaher
In this engaging 77 minute lecture, Dr. Joseph Donaher of the Children’s Hospital of Philadelphia provides a framework for clinicians to view childhood stuttering from an evidence-based perspective. He presents the latest research in stuttering onset and development, genetics, neurophysiology, and speech motor control. He then helps clinicians understand how to apply this information to the children on their caseloads through the use of several case examples, emphasizing the importance of viewing each child as an individual and creating a strong therapeutic alliance.
Written by Barry Guitar
This 4th edition by Barry Guitar, Ph.D., explains how speech-language pathologists can combine the different but most commonly used treatment procedures to get more effective results in working with those of all ages.
In this one-hour presentation, Sarah Delpeche, MSc, BSc(Hons), RegMRCSLT, RegHCPC of the Michael Palin Center for Stammering Children in London, begins with a summary of the current evidence base related to temperament, stuttering frequency and stuttering impact in preschool children who stutter. She presents the findings of her recent research, The Role of Temperament in Stuttering Frequency and Impact in Children Under 7 (Delpeche, Millard & Kelman, 2022*), and goes on to discuss clinical implications and provides practical examples of how to support young children with their emotional reactions as part of therapy.
Presented by Courtney Byrd
In this 90 minute presentation, Courtney Byrd, Ph. D., CCC-SLP, of the University of Texas at Austin discusses the positive impact of self-disclosure and voluntary stuttering in positively altering listener perceptions. Dr. Byrd presents a review of a series of recently published studies that demonstrate that voluntary stuttering and self-disclosure are among the most beneficial therapy strategies, not strictly from the perspective of clinicians, but more importantly from the perspective of persons who stutter. She discusses and demonstrates that these strategies are only effective when used in distinct ways.
In this one hour presentation, Bridget Walsh, Ph.D., CCC-SLP presents highlights from 15 years of large-scale research projects examining risk factors related to persistence and recovery in early childhood stuttering initiated at Purdue University and continuing at Michigan State University. She discusses new findings concerning the neurophysiological, behavioral, and clinical factors that differentiate children who persist or recover from stuttering. The findings reveal distinctly different patterns of brain activity during speech and language tasks in children who persist in stuttering and contribute to multivariable risk models used to predict the probability of stuttering persistence in preschoolers.
Presented by Courtney Byrd
Research has demonstrated that through acceptance and commitment therapy persons who stutter can learn a range of skills that mitigate negative thoughts and feelings about stuttering and make meaningful progress towards valued communication goals. In this 1 hour presentation, Courtney Byrd, Ph. D., CCC-SLP, of the University of Texas at Austin facilitates a panel of adults who have completed treatment that incorporated principles of acceptance, commitment and mindfulness. They discuss how their participation lead to reduced avoidance behaviors, increased acceptance of self and stuttering, and effective management of difficult thoughts and feelings through mindfulness skills. Participants provide valuable insight for clinicians and other persons who stutter regarding how use of this approach helped them to move forward in their lives in ways that their thoughts and feelings about their stuttering previously prevented.
Presented by Jane Harley
In this one-hour presentation, Jane Harley, MSc, Dip.CT (Oxford), Cert/MRCSLT, HCPC, of The Michael Palin Centre for Stammering in London, explores two aspects of attention in relation to young people who stutter and their parents: what we pay attention to as human beings, and how we attend.
Harley first explores some key concepts related to attention, including: selective or broad focus of attention, ‘bottom-up’ and ‘top-down’ attention, and attention bias. She then presents examples of clinical interventions which help clients to shift their focus of attention in relation to children and also parents. The concepts of mindfulness, of stepping back from thoughts (defusion), and of self-compassion are discussed.
Written by Kristin Chmela, Nina Reardon, and Lisa Scott
You can earn ASHA CEUs for The School-Age Child Who Stutters: Working Effectively with Attitudes and Emotions Workbook. The workbook offers you a powerful tool for stuttering diagnostics and therapy, focusing exclusively on assessing and treating feelings and beliefs in school-age children.
Presented by Frances Cook and Willie Botterill
This course presents highlights from a workshop featuring Frances Cook, MBE, MSC, MRCSLT (Hons) Cert. CT (Oxford) and Willie Botterill, MSc, (Psych. Couns.), MRCSLT.
The 4 hour video taster intoduces participants to cognitive behavior therapy and explores the interaction of thoughts, feelings, physical reactions and behaviors from the perspectives of children, parents, and therapists. The presenters discuss and demonstrate ways to use the cognitive model.
Presented by Willie Botterill and Frances Cook
This course presents highlights from a workshop featuring Willie Botterill, MSc, (Psych. Couns.), MRCSLT, and Frances Cook, MSc, MRCSLT (Hons)Cert. CT (Oxford), where they provide insights into working with Solution-Focused Brief Therapy(SFBT) and stuttering.
This taster introduces viewers to the principles and practice of SFBT, providing examples of children, parents, and teenagers describing their "best hopes" for the future, using scales to determine the skills and resources they already have to attain that future and identifying the small signs of change along the way.
Produced by the Stuttering Foundation, the new 3 hour 30 minute DVD features Willie Botterill, MSc, (Psych. Couns.), MRCSLT, and Frances Cook, MSc, MRCSLT (Hons)Cert. CT(Oxford).
Additional Therapy Footage includes Willie Botterill MSc, (Psych. Couns.), MRCSLT of the Michael Palin Centre for Stammering Children, London, England.
Special thanks to Boston University and Diane Fillion Parris, M.S., CCC-SLP, Boston University and the 20 Stuttering Foundation Workshop Attendees.
Written by Carl Dell
This outstanding self-directed program based on the book by Carl Dell, Ph.D., describes how speech-language pathologists can work effectively with school-age children who stutter.
This course is offered for 0.4 ASHA CEUs (Intermediate level, Professional area).
Presented by Michael Boyle
In this 90 minute presentation, Michael Boyle, PhD, CCC-SLP of Montclair State University, discusses how communicative participation and quality of life can be impaired by the stigma associated with stuttering. He presents research about how public and private stigma can act as barriers to the achievement of life goals. This presentation will provide attendees with a deeper understanding of stigma as it pertains to stuttering, with an emphasis on evidence-based approaches to stigma reduction for individuals who stutter.
Presented by Dennis Drayna
In this 72-minute video course, Dennis Drayna, Ph.D., of the National Institute on Deafness and Other Communication Disorders, provides an update on recent research findings in the genetics of stuttering.
This video describes the evidence for genetic factors in stuttering and the genes discovered to date. It discusses the function of these genes and what they tell us about the underlying causes of stuttering. It also discusses efforts to create an animal model for stuttering by putting human stuttering mutations into mice and analyzing their ultrasonic vocalizations.
Presented by Joseph Donaher
School-age children who stutter often rate themselves as poor communicators and are more likely to experience negative social interactions because of their stuttering. Additionally, the general public sometimes harbors negative views of people who stutter and may underestimate what they can accomplish. Fortunately, the impact of negative stereotyping can be diminished with the use of voluntary stuttering. In this presentation, Dr. Joseph Donaher, CCC-SLP, BCS-F, of Center for Childhood Communication at the Children's Hospital of Philadelphia, explores ways in which voluntary stuttering can be used to empower school-age children who stutter in therapy.
Presented by Patricia Zebrowski
Increase your confidence and flexibility in teaching students to modify their speech behavior! In this 153-minute video, filmed at the Stuttering Foundation’s 2014 two-day conference on working with the school-aged child, Dr. Patricia Zebrowski describes how to teach children to make speech change using Dean Williams’ Normal Talking Approach as a foundation. Then, Dr. Zebrowski reviews the various speech modification strategies clinicians can use with children who stutter, including what each technique is designed to change within the speech system and how to apply the technique in therapy.
In this one-hour video, Ali Berquez, MSc, MRCSLT, of the Michael Palin Centre in London explores how to help school-aged children who stutter and their parents think about what they want from therapy by drawing on Solution Focused Brief Therapy (SFBT). The presentation includes ways to talk about progress by drawing attention to a client’s strengths and resources, and what they notice over time. Themes of difference, being unique, becoming more open, and developing self-advocacy skills are discussed. The presentation includes discussion of one client’s journey with video examples.
Presented by Ali Berquez
In this one-hour presentation, Ali Berquez, BRIEF Cert. SF Practice, RegRCSLT, RegHCPC, of the Michael Palin Centre for Stammering in London, begins with a short overview of the principles of Solution Focused Brief Therapy and then explores how SFBT may be used in therapy with parents of children who stutter.
Shared goal setting using SFBT methods helps clinicians to establish what parents want from therapy and fosters a respectful partnership. SFBT also enables parents to focus on the resources and strengths in the family; to notice what’s going well and build optimism and hope. It fosters a progressive narrative, recognizing that one change in the system will have a ripple effect and lead to wider changes.
This presentation describes how therapists can use the principles of SFBT to explore parents’ expectations from therapy, agree on shared goals and support a process of change through solution focused conversations.
Presented by Kristin Chmela
Improve your ability to treat stuttering in preschoolers. This one hour and 45 minute program with corresponding handout offers comprehensive and practical strategies for working with young children. Featuring Kristin Chmela, M.A., speech-language pathologist and Board Recognized Specialist in Fluency Disorders.