Lori Melnitsky couldn't say her own name. Not fluently, not without a fight. She became an accountant for five years because it felt safer than being heard.
Then she decided she didn't want to hide anymore.
Twenty-eight years into her career as a speech pathologist, Lori runs All Island Speech and Stuttering Therapy out of Plainview, New York. She sees around 60 clients a week, six days a week, and she's done it solo since 2001. When COVID forced her practice online, she didn't just adapt. She got licensed in five states and found that her clients actually preferred virtual sessions.
Lori's path into speech therapy started with a personal reckoning. She stuttered severely as a child and through young adulthood. Her first career, accounting, was comfortable but unfulfilling. She felt like she was hiding.
"I had this great desire to be heard and to help others," she says. "I felt like I had lived the life. I had gone from barely being able to say my name to public speaking and being an adjunct professor."
That lived experience became the foundation of everything she's built. Her clients know she's walked the same road. The teenagers trust her because she gets it. The adults come back because she's proof that progress is real.
She started with a single client in 2001, kept doing contract work and early intervention during the day, and marketed her private practice at night. Each year, the caseload grew.
Lori accepts one insurance plan, Blue Cross Blue Shield, and runs the rest of her practice on private pay. It's a deliberate choice.
"Stuttering therapy is not covered by most insurances," she explains. "A lot of the insurances do not consider things medical. Even if an adult is 39, they still consider it developmental."
She tried to make the insurance model work with her approach and realized it couldn't. Her programs are intensive, often several sessions per week, with heavy parent involvement for younger kids and direct access to her between appointments. That kind of availability doesn't fit into insurance-approved session limits.
"The value that I offer cannot be offered under many of these insurance plans," she says. And she's invested thousands in her own training to back that up, from PROMPT certification to years of specialized stuttering coursework.
When COVID hit in March 2020, Lori had already been seeing teens and adults online. But the shift to fully virtual sessions opened doors she hadn't expected.
She got licensed in New York, New Jersey, Florida, Connecticut, and Maine. Teenagers who used to spend 45 minutes in the car could log on from their bedroom. Adults could fit a session between work meetings. Parents of younger children found they were more relaxed at home.
"It wasn't something we wanted happening, but it turned into a positive thing," she says. "I found a lot of people were more comfortable working from home."
Her caseload has grown since the shift. She's now weighing whether to stay solo or bring someone on, a decision every practice owner eventually faces. For now, she's choosing to keep it personal. People come to her because of who she is and what she's been through.
Lori describes herself as "a very, very, probably unusually involved therapist." That's not marketing language. It's how she operates.
For kids under eight or nine, parents are deeply embedded in the process. She teaches them not just about stuttering but about the power of language and voice. For teens and adults, she provides intensive sessions multiple times per week and stays accessible between appointments via call or text.
She also connects her adult clients with each other so they can practice fluency strategies together, build confidence through mock interviews, and simply feel less alone. Since COVID pushed so many people into isolation, that peer connection has become even more valuable.
"I don't like people waiting," she says. "They can just call or text."
Her advice on early childhood stuttering pushes back on the standard "wait four to six months" guidance. If a two-year-old is saying "Mom, I'm stuck, I can't get my words out," Lori doesn't wait. She brings parents in within two to three months, sometimes just to coach them on what to do at home.
"If someone calls and the parents are nervous and I say, 'Wait a couple of months,' they hang up with extreme anxiety," she says. "The parents need help. The biggest gift we can say to a parent is, 'You didn't do anything wrong.'"
Lori's marketing strategy is simple: show up, teach, and let the work speak for itself.
She's spoken at state and local conferences, served as a consultant on the PBS show Arthur for a stuttering episode, and led support groups for the National Stuttering Association. When the movie The King's Speech came out, she was featured in Newsday. She runs a Facebook group called SLP's Stuttering Demystified where speech therapists can learn more about working with people who stutter.
None of that happened overnight. It took years of writing articles, giving talks, and building credibility one referral at a time. But now, nearly three decades in, word of mouth carries her practice.
Her advice for other practice owners is direct: "Give people a reason to come to you. Why would they choose you? What skills do you have? Establish yourself as an expert because people have to have a reason to come."
And to the adults who stutter and haven't found results from past therapy, Lori has a message: "There really is hope. I could not say my name. So hang in there."
Running a solo practice means wearing every hat. ClinicNote is a HIPAA-compliant EMR built for private practices and university clinics, handling documentation, scheduling, and billing in one place so you can focus on the clients who need you most. See how ClinicNote works.
Kadie: You are listening to Clinic Chats, the speech therapist's private practice podcast. A podcast full of personal journeys where we not only talk about success stories, but also real life struggles of small business startups. Clinic Chats is sponsored by ClinicNote, a HIPAA compliant, cloud-based EMR platform used specifically by private practice owners and university clinics. I'm your host, Kadie Jackstadt, and thank you for joining me today.
Kadie: Today I have Lori Melnitsky, and she is the owner of All Island Speech and Stuttering Therapy. Hi, Lori. Thanks for joining me today.
Lori: Hi. Thank you so much for having me on.
Kadie: I'm excited to hear about your journey. So I'm assuming that you are on the East Coast. Where is your business located?
Lori: Yes. So, well, that's interesting. So I am on the East Coast. I am in Plainview, New York, and that was how it was until March. And then COVID hit, and I am actually virtual. And so now I am licensed actually in five states: New York, New Jersey, Florida, Connecticut, and Maine.
Kadie: Wow. So was going virtual and expanding states something that was in your plan, or is this something that COVID might've nudged you to do?
Lori: Well, it's kind of interesting. I specialize in stuttering therapy, and I also do a lot of coaching to help parents out and people with ADHD also. So I had always seen a lot of the teenagers and adults online anyway, but once COVID hit, I mean, we sort of had no options, so we went completely online and I started to see a lot of the younger ones also. And to be quite honest, it started to work really well. I found a lot of people were more comfortable working from home. I found especially the teenagers who didn't have to spend so much time in a car, and the adults, and they could concentrate on work and on homework. So it wasn't something that we wanted happening, but it kind of turns into a positive thing in terms of online therapy.
Kadie: How cool. So you got the ball rolling and got licensed in other states. Are you going to continue to get licensed in as many states as you can, or just kind of wait to see what clientele you get where?
Lori: So I was licensed in most of them. The process from the United States is very hard because you have to be licensed in each individual state. So it's a big process. We're kind of hoping that ASHA, our governing board, is going to work on this. During COVID, there are some states that have actually waived it. So in certain states, you can practice even if you're not licensed. My goal and my passion is stuttering therapy, so especially the teens and adults who don't have as much access, I would love to reach them all over and internationally also.
Kadie: Absolutely. So let's backtrack a little bit and tell me, when did you start your private practice in New York?
Lori: Oh, so my private practice in New York, I've been a speech pathologist for 28 years. I would say my private practice started almost 20 years ago, around 2001.
Kadie: Wow. And what was your experience prior to going into business for yourself?
Lori: So prior to that, my kids, honestly, were younger. I was doing a lot of contract work. I did a lot with the early intervention population because I'm certified in PROMPT therapy also, which is a lot of hands-on and moving their mouth. So it was more contract work, and I worked in a few preschools also.
Kadie: And then you decided, for what reason, that you were ready to open your own practice?
Lori: I'll be honest, I think it started out small. I always wanted to have my own practice. I always wanted to have the freedom. I always had to, because I stuttered severely when I was younger.
Kadie: Oh, you did?
Lori: Yeah. Yes, I stuttered severely, and I became an accountant, honestly, for five years.
Kadie: Oh.
Lori: Yeah. And after five years, I kind of felt like I didn't want to hide. I almost felt like I was hiding, and I had this great desire to be heard and to help others. So I really wanted to be known for stuttering. I felt like I had lived the life. I had gone from barely, honestly, being able to say my name to public speaking and being an adjunct professor. So I really wanted to.
Lori: So it started out, at the time in 2001, it was like one, and I had one client. I stayed doing a lot of what I was doing, and at night, I started to kind of market my private practice more. Each year, I sort of added more and more.
Kadie: Amazing. That is so inspirational, and I bet your clients feel that compassion from you and fully trust your experience. So you began your business. You said you started pretty small. So were you going to family's homes? Did you get an office location right away?
Lori: Right. Well, my office location was always in a part of my house. It worked for me, especially when my kids were young, because I was here. They were old enough, though, to know, even if they were eight or nine, they knew if mom's at work that they were not going to run downstairs. So I happened to have a fairly large area in the back of my home. So that always worked for me.
Kadie: Right. So that's so nice. You never had that commute. You never had that office expense. That's great.
Lori: Yes. I will say, honestly, there are many times, and this is kind of interesting for anybody else, I think in my mind, I thought at one point, oh, I should move out and I should rent a space. But there really was no valid reason unless I was going to expand and I was going to hire people.
Kadie: Right. So you've kept it just yourself by choice the last 20 years?
Lori: I have. And like I said, since COVID, it seems to have exploded even more. I think with many of us home, it's affected speech issues. It's affected stuttering much more. It's affected language. So yeah, it is exploding now. And I'm finding myself at a point now, do I stay solo? Do I hire? But these are always choices that as business owners, I think we all have to make.
Kadie: Right. And so I'm sure marketing yourself when you were in one location, seeing patients directly was a little bit different than now marketing yourself for teletherapy across five different states. How has that changed? And how are you marketing at this point?
Lori: So I'll be honest. Really word of mouth now. Back in 2001, were we online? Yes, but it was a lot of writing articles for magazines. I think I started my blog at some point. I was doing a lot of public speaking, which took me a while to build up to. Social media was different, but I was able to establish myself as a stuttering expert.
Lori: And now I've been in the field almost 28 years. I've spoken at several state and local organizations. I was even a consultant for the children's show Arthur. They did an episode on stuttering. I was a professor, so I would say at this point, so much of it is word of mouth.
Lori: I also have a Facebook group called SLP's Stuttering Demystified for speech-language pathologists to learn more about stuttering. I belong to a private practice networking group, so I provide a lot of free information on it.
Lori: Another thing that was really cool was that when the movie The King's Speech was out, I was actually featured in Newsday, which is our local newspaper on Long Island. I had gotten a couple of awards for helping others. I had led support groups for the National Stuttering Association so I could help others.
Lori: A lot of articles, a lot of education at schools, to other speech-language pathologists also. I just always believe in always kind of pushing not only myself but the people I work with to the next level in a very positive manner.
Kadie: Amazing. Yes. I'm inspired just from this conversation so far. We're only a little over 10 minutes in. So regarding your business structure a little bit. Are you private pay? Do you take insurance? What has been your choice and why?
Lori: So I am private pay except for Blue Cross Blue Shield. Stuttering therapy is not covered by most insurances, and I don't know why. A lot of the insurances do not consider things medical. Even if an adult is like 39, they still consider it developmental. I'm hoping that changes.
Lori: There are so many insurance plans. So if you go that route, you're sort of going in another direction. I do very unique and successful programs for all ages who stutter, and you just can't do that in an insurance model. And to me, communication matters more than anything. It matters more than math, it matters more than language arts.
Lori: I think sometimes communication is downplayed. Personally, I invested thousands of dollars in myself to get where I am now. Most of the time it was not covered. I just feel the value that I offer cannot be offered under many of these insurance plans.
Kadie: Right. And so you mentioned that your therapy model might be unique. What is your typical program look like, obviously individualized for everyone, but how do you prefer the scheduling or the treatment?
Lori: So I'm like a very, very, probably unusually involved therapist. And interestingly, it's gotten even more involved being online. Up until I would say age eight or nine, the parents are heavily involved in this therapy. I provide a huge amount of education of not only stuttering but speech and language issues and the power of language and the power that our voice has. I just think it's such an important skill that sometimes is not really emphasized in an educational setting.
Lori: So I have a huge amount of parent involvement. I am very encouraging, always very encouraging. With the teens and the adults, I provide more intensive therapy several times a week so they can see progress faster. They do have access to me during the week if they encounter any issues. I don't like people waiting. They can just call or text.
Lori: Sometimes I'll have them do a recording of a home assignment. I try and get the adults, especially anyone over 17, I try and get the adults to connect with each other. So one, they have support, they meet other people, which also kind of helps with networking because they're meeting people out there in the business world or in the health world.
Lori: So they are sort of learning from them, but it does give them experiences of practicing their fluency strategies, of meeting others, of interviewing skills, and they don't feel alone, which has been, since COVID and so many people working from home, I think it's just such an added bonus.
Kadie: Yes, absolutely. So in the future, do you see yourself continuing what you're doing now? You're enjoying the teletherapy, you want to stay solo, or you're still debating on expanding?
Lori: So right now I am staying solo. I'm very, very busy. So I'm thinking about it, but I also added a coaching part to my practice, which is also all online, because I did develop my own business and I did have to work a lot on mindset to overcome being able to speak with others. So I also became a certified life coach, a certified ADHD coach, so I did add a coaching part to my business also.
Kadie: And how many clients or sessions a week is your capacity?
Lori: I see a lot. I work six days a week. I would say I see around 58 to 60.
Kadie: Wow.
Lori: And some of those, some are coming multiple times. Not all, but it's something that I really love. I think people need a lot of help. I think they need a lot of encouragement. I probably won't go over that. If I start going over that, then yeah, I'll have to consider it. But I think for the stuttering part, people are coming to me because it's something that I've worked through and I've overcome, and I think with stuttering you really almost have to experience it to really understand it.
Kadie: I can't even imagine. Absolutely. You're someone that they trust and who they would want to send their child to or go to themselves. What's the youngest child that you've seen through teletherapy?
Lori: I mean, I see a few kids through early intervention who are, I would say, age two, but I wouldn't say it's like, I would say mostly not. I would say it's mostly ages four and up, and it's a huge amount of school-age kids, teenagers, and adults.
Kadie: And do you have the same standpoint that, as far as I know, is truth to this, but for a toddler stuttering, do you say give it four to six months and it can be normal?
Lori: No. See, I think that, well, first of all, I think sometimes with, and I'm really happy you asked that. I think sometimes with stuttering in young children, people forget about parents, and parents are extremely nervous. So a lot of times, I mean, I'll just see the parents, just to explain to them how to work with stuttering at home.
Lori: Personally, I don't wait that long if I see there are warning signs. I would say two to three months max, because there are some kids at that early age who are aware and who are actually saying like, "Mom" or "Dad, I'm stuck. I can't get my words out." So I think it's not a textbook thing. I think it's very, very important to talk to the parents and tell them some things that they can help at home. That alone is going to decrease the anxiety on the part of the parents, and that will help their children a lot.
Kadie: Yeah, that's something, right now, I was previously in private practice and saw a lot of preschool kids and had a lot of phone calls about that. And right now, I'm doing teletherapy with school-age children, but I still get people who ask that a lot. And it's probably because my own child is that age, so we have a lot of connections with people with children that age. And I'm always like, oh, I hate saying that, like, oh, just wait four to six months, but it's hard to know, because I know at times it does just go away, but also to tell the parents the strategies that maybe they need to look within themselves.
Lori: Yeah, I just think sometimes there's so much counseling that we do as speech pathologists, and I don't think we all give ourselves as much credit for the amount of knowledge we have. And a lot of us are parents.
Lori: So if someone calls and the parents are nervous and I say, "Okay, wait a couple of months," they hang up with extreme anxiety. I know, like, my older daughter stuttered. You need somebody helping you. And I have a younger daughter who has ADHD. I think we as parents are kind of left out in the open, like, "Okay, they need help, but we're not going to really explain how."
Lori: So I think it's so important, and again, I'm so glad that you asked that. I think the parents need help. On a teletherapy session, I don't necessarily need a two-and-a-half-year-old on for maybe more than five minutes, but you can certainly send me an audio version. I like audio, because I feel like the kids don't know, so it's not putting the pressure on.
Lori: And I feel it takes a lot of anxiety off the parents, because a lot of parents, which I'm sure you know, a lot of parents tend to feel responsible. And I think the biggest gift we can say to a parent is that, "You didn't do anything wrong. You didn't do anything wrong. It is not your responsibility or not your fault why this is happening." And that alone takes off a tremendous amount of relief.
Kadie: Right. Absolutely. Well, I think that's very, very helpful moving forward. Is there anything that you could tell me just about owning your own business? What's been the most rewarding part, or also mention maybe the most difficult part?
Lori: So I personally love owning my own business. I find myself a little bit more imaginative, more creative. I love the freedom. And I love being able to help the population that I feel I can help the most.
Lori: I would say the hardest part, and also I think it's really important with private practice, I say word of mouth because as people get more experienced, their name gets out there more. And word of mouth is huge. And I remember when I first started, I was afraid people wouldn't refer anybody to me.
Lori: Well, I'll be honest with you. At the time, I was still stuttering more, and I was still very nervous about me, and I was younger. So one thing I did learn about owning a private practice is, believe in you, believe in the services you offer because people need it. They really, really need it.
Lori: The most challenging part is probably the administrative part of it, the paperwork, the organization. It took me years to hire a virtual assistant who's been a lifesaver. And again, I made the choice not to go the insurance route because I felt I would have had to hire more people, and I wouldn't be able to provide the services that I wanted.
Lori: There's a lot involved in a private practice, and when I coach people, you really have to do a lot of work on owning who you are. It's very important to be very personable with your clients because I have had clients where I started seeing them at the age of eight, and then in high school, they start stuttering more, and they come back.
Lori: So you always want to keep that open. You always want to do word of mouth. To me, you must establish yourself as an expert because people have to have a reason to come. There are so many speech pathologists out there. And especially now with everything being online, I always ask people, "Why would they choose you?" Not that you're not a wonderful person, but why would they choose you? What skills do you have?
Lori: When I became certified years ago, that was a great skill, and it was a skill that parents really thought their kids needed. When I kept expanding my stuttering knowledge, I found they wanted more and more.
Kadie: I love that saying. You said, "Give them a reason to come to you because there are a lot of speech therapists out there, especially in busy areas." Goodness.
Lori: Right. Oh, yes.
Kadie: Well, I appreciate you sharing your story so much. It was a pleasure getting to interview you today.
Lori: Thank you so much for having me on. If anybody wants to look at my website, it's www.allislandspeech.com.
Kadie: Perfect, and we will be sure to link your social media and website whenever we post the podcast.
Lori: And if I can add one more thing. I always like to give a shout out to the adults who stutter because a lot of them have had therapy in the past and it really hasn't given them the results they need. To all of the teens and adults, there really is hope because honestly, I could not say my name. So hang in there.
Kadie: Amazing. You are so inspirational. Thank you very much.
Lori: Thank you, Kadie.
Kadie: Thank you for joining me and listening to Clinic Chats, the speech therapist's private practice podcast. If you have a moment, please leave a five-star review for Clinic Chats to help other SLPs find our podcast. If you'd like to share your own personal journey through private practice, please email me kadie at clinicnote.com. That's K-A-I-D-E at clinicnote.com.