Are you curious about how you could support clients who stutter using neuroaffirming goals and a tool to track support needs on those goals? This first-author graduate student was and WHOA check out what she developed! This WISSH-CHAT Adaptation* framework is an innovative approach that combines coursework from Dr. Kerry Mandulak’s stuttering class at Pacific University and the leveled framework proposed by Duthie and Robbins (2013), which is now being researched by Drs. Duthie and Reece. The co-authors on this poster are incredibly proud of this graduate student for her recognition of the need for such a tool and for her scholarly integration of clinical approaches.

*Duthie & Robbins (2013)

Abstract

“WISSH-CHAT Adaption by authors: Autumn Anglin, B.A., B.A., B.S., Mary Mitchell, Ph.D., CCC-SLP, Jill Duthie, Ph.D., CCC-SLP, Benjamin Reece, Ed.D., Kerry Mandulak, Ph.D., CCC-SLP

Stuttering is a multifaceted communication difference involving observable speech characteristics and less visible experiences such as cognitive load, emotional responses, and social participation (Mandulak, 2025). Traditional stuttering scoring and surface-level measures often fail to capture these complexities. Grounded in the “under the surface iceberg” framework (Wright, 2021), this poster presents a neuro-affirming adaptation of the Clinician’s Hierarchy for Advancing Treatment (CHAT; Duthie & Robbins, 2013), to support nuanced, evidence-based stuttering intervention and progress monitoring.

The WISSH-CHAT framework, developed by Autumn Anglin, organizes therapy across five levels of acquisition from initial exposure to functional generalization within a social-interactionist model of intervention. Each of the five levels of Client Ability incorporates Education, Ease, and Empowerment(Gora, 2022),recognizing that the client is the expert on their stutter while the clinician contributes expertise in speech science and intervention. Each of the five levels of Direct Clinician Supports describes direct supports provided during therapy (e.g., modeling, cueing, feedback, and scaffolded task complexity), while Indirect Clinician Supports outline indirect supports such as caregiver, teacher, and communication-partner education and counseling. This anti-abelist chart embeds evidence-based practices by addressing both overt stuttering strategies and self-monitoring like desensitization to increase joy and reduce mental effort around communication (Gerlach-Houk, 2022). The WISSH framework includes three separate versions to encompass the lifespan, including language acquisition and onset (ages 2-5), school-aged children, and adults.

Designed for clinicians with limited formal training in stuttering as well as experienced practitioners seeking structured treatment strategies, the WISSH provides a flexible framework for goal development, measurable outcomes derived from qualitative observation, and progress monitoring beyond tally data. Non-relevant elements may be adapted or removed for individual goals. “

Poster

WISSH-CHAT Adaptation_OSHA Sp26

For the full resource packet for this poster, including the leveled tools for prek, school-age, and adults, go here:

https://docs.google.com/document/d/1_MJI9OVwhXftLK0o0UAnYm1jsenw-Veg2MQH4fCOK8M/template/preview