Camp Shout Out Training and Treatment Program

	About the presenter: Kristin Chmela, Board Recognized Fluency Specialist and mostly recovered person who stutters, has diagnosed and treated individuals with fluency disorders for almost 25 years. She is an adjunct faculty member at Northwestern University, served on the Task Force on Fluency Services in the Schools, and trains clinicians nationally and internationally.
	About the presenter June Haerle Campbell, M.A.,CCC-SLP, member of the initial cadre of Board Recognized Specialists, Fluency Disorders, has been influential in developing differential evaluation and treatment procedures and training students and professionals in working with individuals who stutter and their families. She has provided services in the public schools, was on the faculty of Northwestern University for twenty-three years, and currently is in private practice in Carmel, California.
	About the presenter Julie Raynor, CCC/SLP Muskegon, MI, works as an SLP at Reeths-Puffer Public Schools in Muskegon, MI. Julie has spent the past several years focused on bringing high quality fluency training and treatment to the West Michigan area and as such volunteers her time as the Camp Shout Out Coordinator.

Camp Shout Out Training and Treatment Program

by Kristin Chmela, Julie Raynor, and June Campbell
from Illinois, Michigan, and California, USA

Camp Shout Out is an overnight, recreational therapy experience for school-age children and teens and a clinical training program for professionals and graduate students in the field of speech and language pathology.

It was created in order to provide specialized clinical training for both speech-language pathologists and graduate students in the area of fluency disorders and a dynamic, individualized therapy experience focused on improving communicative competence in youth ages 8 through 16.

Camp Shout Out was co-founded by Julie Raynor, a local school-based speech-language pathologist and parent of a child who stuttered and fluency specialist Kristin Chmela. The purpose of this paper is to provide an overview of Camp Shout Out and discuss future considerations for the program.

The first session of Camp Shout Out was held in August of 2011 at Pioneer Trails Camp on Big Blue Lake in Holton, Michigan. This unique learning environment included participants from nine different states across America, as well as Guatemala. Twenty-three campers, fourteen speech-language pathologists, and twelve graduate students joined founders and coordinators, and co- directors, and volunteer support and resided at the camp in cabins for the entire experience. The overarching goal for campers and caregivers was to develop a better understanding of their unique perceptions, feelings, and experiences related to stuttering and how to support future progress across three areas of communicative competence, including confidence, assertiveness, and effectiveness.

At Camp Shout Out, individual communication goals of campers were facilitated in one on one, small group, and large group activities, as well during other dynamic interactions such as hiking, eating meals, and boating. The unique experiences and profile of each camper were carefully considered, and individual relevant and functional goals while at Camp Shout Out were implemented for each camper. Campers were provided consistent, ongoing verbal and tangible reinforcement for various aspects of communicative competence by professionals, graduate students, and even by each other, throughout the entire experience.

Caregivers and campers supplied information prior to and during initial intake meetings including previous evaluations, current Individual Education Plans, and completed informal questionnaires. In addition, they collaborated with their assigned speech-language pathologist and graduate student "speech team" upon arrival at Camp Shout Out, in order to develop personal camp goals. Caregivers and campers also engaged in final meetings with their speech teams in order to review observations, progress, and the proposed exit plan from camp. The therapy program for campers began the moment they arrived and was completed when they exited camp.

The Camp Shout Out Clinical Training Program initiated one and one half days before campers arrived, and focused on increasing knowledge, confidence, and skills of both professionals and graduate students in the area of school-age stuttering assessment and treatment.  Participants were from various settings of service delivery and university programs. Training was led by Kristin Chmela and her mentor, June Campbell, speech-language pathologist, fluency specialist.

Throughout the week, training and collaborating continued daily as participants applied Basic Principle Problem Solving, a way of "clinical thinking" that assists both speech-language pathologists and graduate students in the ongoing application of evidenced based practices in the area of fluency disorders in school-age children. Special emphasis was placed on understanding campers' unique temperaments, experiences, features, and other contributing factors associated with their fluency problems.

Speech-language pathologists and graduate students reviewed records for one or two assigned campers, planned and executed the initial intake meeting, developing goals based on the desires of all parties involved. In addition, they planned and executed activities daily to complete therapy objectives, provided feedback to each other and the group, and problem solved within small and large group settings with other professionals and students.

Activities such as the climbing wall, high ropes, and zip line were optional for adult participants.

Observations of clinical trainers interacting with campers and conducting small and large group activities were provided, and participants engaged campers and caregivers in exit meetings focused on experiences at camp, progress, and future recommendations. Data collection methods included questionnaires developed in collaboration with Dr. Steven Tasko, Western Michigan University, Department of Speech Pathology and Audiology. These questionnaires were administered to all participants prior to the camp experience, and will be re-administered approximately four to six weeks, as well as eight months, following Camp Shout Out.

While follow-up data is not yet available, many informal observations and comments from participants support our perceptions and observations of Camp Shout Out, 2011. For example, a teen camper who had participated in several years of stuttering therapy indicated his desire was to be "challenged" during camp. Therefore, goals and objectives for him throughout the week provided opportunities to increase his leadership abilities and competence as a communicator in front of small and large group activities. During camp, he was able to successfully accomplish many assignments, even planning and executing the final ceremony with caregivers in attendance! After camp, his mother was quoted as saying "I am delighted with the tremendous improvement in self confidence our son has had since Camp Shout Out. He says it was absolutely the best part of his summer and can't wait to be back next year."

Another parent noted her middle school son had opened up about his stuttering after the camp experience, and shortly thereafter, they met and educated his teachers about his speech and ways to make the school year more successful for him. During interactions on the final camp day, an elementary-aged camper assertively and confidently expressed a verbal opinion. His mother, overcome with emotion, shared it was "the first time she had seen him advocate for himself." Finally, another camper who had participated in extensive speech therapy shared she learned additional ways to improve the effectiveness of her speech.

Speech-language pathologists completed a survey directly after camp ended, although several noted it was difficult to process the various components and depth of the experiences they each encountered. Overall, ratings of the training experience were highly favorable, although some shared they needed more practice themselves modeling and teaching skills and counseling children within this age range. Training participants also shared positive verbal feedback about the experience. One speech-language pathologist recently provided a presentation for her local colleagues regarding her attendance at Camp Shout Out, noting "it was such a powerful experience for me." Another professional shared he had attended many helpful fluency training workshops, but the "opportunity to interact with children as the training ensued was remarkable." Professionals and graduate students alike shared "surprise" at how quickly campers' communicative competence improved overall, with one stating it was "the best week of his life as a learning graduate student."

Many future considerations have been discussed as data collection and review of all training and therapy procedures continue. For example, an additional day of clinical training has been added to the program, in order to provide professionals and students with more specific guidance regarding modeling and teaching fluency shaping and modification skills, as well as ways to deal with negative attitudes and feelings of children within this age group.

In response to the desire of teens to improve leadership skills, an additional program, Counselor in Training, will be included for high school students ages 15-18. Ways to increase participation of caregivers and families are being considered.

In addition to on-going internet communication methods with previous campers and families throughout the school year which are currently in place, other avenues for providing continued support are being discussed, as well as a more structured approach for assisting campers with modification of speech patterns. Upon review, improved methods of data collection will be explored.

Founders and directors of Camp Shout Out wish to acknowledge collaborators in this endeavor including Stuttering Foundation, Western Michigan University Department of Speech Pathology and Audiology, Reeths-Puffer Public Schools, Muskegon Area Intermediate School District, Pioneer Resources, Camp Pendalouan, and the local Camp Shout Out committee.