About the Authors: Kristin Chmela, M.A. CCC-SLP BCS-F spends the majority of her time working with individuals of all ages with fluency disorders at the Chmela Fluency Center in the suburban Chicago area. She is co-founder and co-director of Camp Shout Out, a therapeutic program for school-age children who stutter and a hands-on training opportunity for professionals and graduate students.   Kristin was former Chair of the American Board of Fluency and Fluency Disorders, has supervised graduate students and provided training workshops across the globe, and collaborated extensively with the Stuttering Foundation on training videos, conferences, and publications.  She is co-author of two books focused on helping school-age children who stutter and is a certified yoga instructor and mindfulness teacher.  Kristin believes all can choose to continue evolving as communicators.  Scott Palisak is a person who can stutter. He is also an Associate Professor at the University Akron, Ohio, who teaches Stuttering, Counseling, and Voice disorders at the graduate level along with supervising future SLPs. Further, he runs the MASS Lab (Mindfulness ACT Social Cognition and Stuttering) at the University of Akron. He also is the co-host and co-creator for The Act To Live Podcast (along with Jaime Michise) and is a partner with the 3C Digital Media Network LLC. He is a novelist (under the pen name B.D. Scott) and a musician and songwriter since he was 12 years old. He practices mindfulness meditation everyday, values health, and appreciates the act of evolving as a person, speech language pathology and a fellow human in order to build a community and world of kindness and understanding. Lynne Shields, Ph.D. CCC-SLP, BCS-F is a board-certified specialist in fluency and fluency disorders. She taught for many years at Fontbonne University in St. Louis, MO, and is currently a professor emeritus there. Courses taught included undergraduate and graduate fluency disorders, language disorders, phonetics and counseling, as well as supervision of students in the on-campus clinic. She also served as the director of graduate studies in speech-language pathology. She had a small private practice working with children and adults who stutter. She served on the American Board on Fluency and Fluency Disorders, acting in various roles including certification coordinator and board chair. She serves as an assistant faculty at Camp Shout Out.

Camp Shout Out is a unique therapeutic opportunity for youth who stutter ages 8-18 and hands-on training for speech-language pathologists and graduate students.  It is held for approximately one week in Michigan and embedded within a traditional, recreational, residential summer camp experience.  Camp Shout Out is a 501(c) 3 non-profit organization co-founded and co-directed by Kristin Chmela, M.A. CCC-SLP BCS-F, and Julie Raynor, M.A. CCC-SLP.  The program strives to help participants choose and continue to evolve strong communication skills, defined across Five Areas of Focus (Byrd, Chmela, et. al, 2016) and experienced throughout camp in multiple ways. 

In the late spring of 2020, the difficulty accounting for the safety of our 140 registered participants became clear. A few days of frustration, disappointment, and disbelief led to the decision to move forward and provide a “virtual therapeutic-camp” experience.  After all, while quarantining, children who stutter were still communicating.  Additionally, online synchronous learning was likely imminent for many in the fall.  

Experiences related to the pandemic such as a lack of social interaction and reduction in both the frequency and manner in which communication occurred throughout the day were new challenges faced by youth.  For some of our clients who stutter, negative experiences related to stuttering over online platforms were reported.  There was no question it was essential for us to show our campers it was possible to continue to evolve as communicators during this difficult time.  We wanted to help them “grow inner strengths” by experiencing our three basic human needs (Hanson, 2018) throughout the week.  These needs, adapted to those who stutter, included providing a place where they felt:

1. Safety (A place where they are free to communicate without fear of negative consequences) 
2. Satisfaction (The opportunity to share ideas and say what they want to say)
3. Connection (With those they already knew and with new faces) 

We wanted to help our campers recognize they have the inner strengths to cope with difficulties related not only to stuttering, but also to the significant changes that had occurred in their daily lives.  We wanted to grow positivity within their own wellbeing and support them in moving forward, as individuals as well as communicators.  We wanted to show them that we, too, could bounce back, move forward, and create a novel experience within the midst of our world’s difficult crisis.  

The purpose of this paper is to review the goals and structure of the program, provide several strategies and activities utilized, and share preliminary outcomes of this virtual experience.     

What were the goals?   

The goals of this program were to provide campers’ multiple opportunities for positive communication experiences, increase their confidence in talking over the virtual space, and create a place for connection, joy, and support.  Due to the nature of this program, parent discussion groups were included, with goals discussed further in this paper.  Prior to the onset of the program, campers’ current records were reviewed and each camper and parent/caregiver participated in an interview with their team facilitator or assistant.  Parents/caregivers completed a survey identifying desired topics for discussion.

Who was involved?  

Given the novelty of creating and implementing CSO online and the desire to create small group interactions for campers, we sadly chose not to include registered trainees (graduate students from various universities as well as speech-language pathologists).  Along with its’ co-directors, this program consisted of faculty, assistant faculty, small group facilitators, and assistant facilitators.  All participants were either board-certified specialists in fluency or experienced in working with youth with persistent stuttering.  In total, there were twenty-four campers and twenty-two professionals, as well as two Zoom hosts.  Eight guests interacted within both small and large groups during one of the camp dates, as well as other guests on the last day of camp.  

How was it structured?  

This program was implemented across six days, ninety minutes each day.  The staff met for thirty minutes before and after each session.  Our structure included starting each day with a large group interaction, followed by small breakout groups and ending with the large group.  Small teams were created based upon age, consisting of two to four campers and two speech-language pathologists.  Parents/caregivers were included during the initial large group interaction on the first day of camp and had the opportunity to join four different topic-driven discussion groups led by professionals during the same time as the small speech team groups.  On the last day of camp, parents participated in a discussion with their camper’s team leaders. 

Several activities were routinely implemented to create positive energy and engagement.  These included but were not limited to, energetic music accompanied by dancing during all transitions into, within, and out of camp each day.  A camp song led by a guest (former camp counselors) was followed by a short mindfulness practice, followed by a choreographed dance practiced each day as a large group.  At the end of each session all engaged in a “Virtual Shout Out” whereby multiple opportunities for large group communication were provided.  Finally, to minimize delays across the virtual space and stay connected as communicators, three different hand signals were utilized:

1. One hand up in front of the face for “I would like to share something” 
2. One index finger up for “I need more time”
3. Two hands up with fingers moving for “I agree-awesome idea-that is great-thanks for sharing-way to go”             

A box was sent to all participants and opened together during the first small group team time.  Campers received items such as a t-shirt, colored team scarf, dry erase paddleboard with markers and eraser, cue cards for targeted general communication skills, and a tactile fidget.  All items were selected to provide team unity and assist campers in maintaining attention throughout the small group team time.  

What happened during the breakout groups?

During the small team breakouts, various strategies such as pausing, holding on to one person’s face on the screen when talking, moving forward, and answering oral questions by rephrasing the question at the start were reinforced.  Visual reinforcement was consistently utilized to provide positive feedback without interrupting or “slowing the energy” of the interactions.  Activities were planned carefully to provide multiple opportunities to talk spontaneously while having fun within the group interaction.  Meaningful topics were discussed, such as how campers’ lives (and communication) had been impacted by the pandemic.   “Comebacks” were also practiced related to starting school and experiencing unpleasant peer reactions to campers’ difficulty communicating. 

While campers met with facilitators and assistants, parents were provided the opportunity to participate in a series of four relevant topic discussions, facilitated by three camp staff members.  Overall, participation varied from 11 to 16 parents across the four sessions and they learned about the Five Areas of Focus of communication competence (the various ways one can strengthen their communication skills) typically focused upon at Camp Shout Out.  Additional discussion topics included: 

1. Parents/caregivers own feelings around their child’s communication difficulties.
2. Changes in their child’s communication since the beginning of the pandemic.
3. Talking with the child about speech/communication.
4. Their child as a communicator in daily routines and/or navigating life transitions.

What do our preliminary outcomes look like?

Campers and parents participated in post-camp virtual interviews with their team facilitator/assistant.  

Positive themes reported by campers included seeing friends, small groups, activities, guest speakers, and receiving the camp box.  Campers expressed learning the importance of “being myself” and how to talk in an online setting.  One camper stated, “I think instead of getting down on myself and talking less, I should keep on speaking up because I think that will help more than not talking at all.”  Campers expressed making eye contact with one person when talking was helpful.  One camper stated, “One of the biggest things I took away from this year was for (talking on-added for clarity) Zoom. So eye contact, I know it’s weird but before online, I was always looking all over the screen. But now I feel like it helps to hold onto eye contact with one or two people.”  Another theme shared by campers was the importance of moving forward if talking becomes difficult. One camper stated,  “I learned to just go for it during speaking opportunities and to put myself out there” while another shared, “I feel a lot more comfortable with talking online and sharing ideas.”  Themes for improvement included adding more campers in the groups, mixing up the groups, and having time to be together without adults, as well as more frequent meetings throughout the year.  When asked what this program should include if repeated, one camper stated, “There is not a lot I would change. It met all of my expectations. It was pretty perfect. “ 

Feedback about the parent discussion sessions obtained during parent post-camp interviews included that parents overwhelmingly believed the sessions were extremely beneficial, with one parent viewing them as more beneficial to those new to camp.  Themes included the importance of connecting with other parents, sharing struggles and perspectives about stuttering, and feeling a common bond.  Being able to hear from other parents was seen as helpful, and one parent stated, “It is helpful to hear other parents triumphs and challenges that we share.”  The discussions provided support and new ideas about parenting a child who stutters and gaining ideas about how to have more holistic and supportive conversations with their child. One parent stated it was helpful to learn “It is very normal to have lots of different emotions around your child who stutters (you are not alone).” 

Post interviews with parents/caregivers reported themes such as observations of increased confidence in their campers.  One parent shared, “The confidence alone is worth it and sense of comfort with himself and ease due to being with the other kids, the camaraderie. Confidence is what I want the most for him.  Confident enough to speak up.”  Another parent shared their son “has been more confident in general and happier. He got his spark back.”  Parents shared that the program met their camper’s expectations as well as their own, liked the convenience of being online, and hoped that future sessions might be scheduled in the evenings for greater access.  In addition to the in-person camp, a parent shared “I think it would be a great “boost” during the offseason.” For campers graduating high school, one parent noted, “I think it would be great for graduates as they step into a new chapter-maybe to address challenges they come across in college/adult life.”

One parent said, “I hope next year we are able to do this in person.”   We could not agree more.  In the meantime, perhaps this is another way that we can do more to help children who stutter, wherever they are.  

Byrd, Courtney & Chmela, Kristin & Coleman, Craig & Weidner, Mary & Kelly, Ellen & Reichhardt, Robert & Irani, Farzan. (2016). An Introduction to Camps for Children Who Stutter: What They Are and How They Can Help. Perspectives of the ASHA Special Interest Groups. 1. 55. 10.1044/persp1.SIG4.55.

Hanson, Rick with Forrest Hanson (2018).  Resilient:  How to grow an unshakable core of calm, strength, and happiness.  Harmony Books:  New York.

The author wishes to thank Lynne Shields and Scott Palasik for their contributions to this paper.

This program would not have been possible without the support of those involved.  Many thanks to Julie Raynor, Faculty June Campbell, Assistant Faculty Lynne Shields and Scott Palasik, Facilitators Derek Daniels, Sarah Penzell, Diane Morean, Natasha Gigliotti, Jaime Michise, Laura Johnson, Steven Moates, Robert Reichhardt, and Erik Raj, as well as Assistant Facilitators Kyle Pelkey, Nick Caruso, Laura Shepperd, Annick Tumolo, Cherish Thomas, and Caitlin Shanley.  

Finally, thanks to Erich Reiter and Lukas Latacz (sayitlabs.com) for being our Zoom hosts.