ASSESSMENT OF STUTTERING
EXPERIENCE WITH PROBLEM
- History of stuttering from onset to present
- Exacerbations and remissions
- Past treatment
(professional and nonprofessional) - Results of treatment
- Reasons for coming for help
HISTORY
- Birth history
- Family history – in general and re stuttering
- Developmental history
Language development
Motor development - Medical history
- School history
SOCIAL ASPECTS
- Effects on
- Behavior
- School
- Friends
- Family
- Job
PSYCHOLOGICAL ASPECTS
PSYCHOLOGICAL ASPECTS
* Client’s perspective
* Client’s personality
* Client’s adjustment in general
* Client’s objectivity regarding stuttering
VARIABLE COMMUNICATIVE
STRESS
VARIABLE COMMUNICATIVE
STRESS
* Topic variation
* Argument
* Competition and time pressure variation
* Listener reaction variation
* Fatigue variation
* Audience variation
SPEECH SAMPLE
SPEECH SAMPLE
* Conversational speech
* Automatic speech
* Choral speaking/reading
* Oral reading
* Variable communicative stress
THE STUTTERING SEVERITY INSTRUMENT – 4
(SSI-4; RILEY, 2009
Purpose, Norms and sampling task
- Purpose
Rating stuttering severity - Sampling tasks
Oral reading
Conversation/narration - Norms
Client’s performance compared to other people who stutter
Norm range: preschool to adults
STUTTERING SEVERITY INSTRUMENT (SSI)
3 components
- 3 components – frequency, duration, physical concomitance
Frequency
Sample at least 200 words, reads aloud or describes a picture, could be more than one
sample. Frequency counts of each sample translates into the task score. The total
frequency score is calculated
Duration
The 3 longest stuttering events are measured in order to calculate the mean duration
for 3, in seconds. It is converted to a total duration score.
Physical concomitants
* The secondary behaviors are divided into 4 subcategories, from 0 to 5.
* The scores from all 4 are added, to show the physical concomitants score.
The total overall score, frequency, duration, and physical concomitance
Is measured against the severity ratings, ranging from 0 to 45
MEASURES OF STUTTERING
Formula and what do you measure ?
- Fluency Measurement
- Percent words (syllables) stuttered (%SW) / (%SS)
For diagnostic assessment, post-clinic and follow-up
Count the syllables stuttered and the total number of syllables spoken
Formula – total number of stuttered syllables x 100%
total number of syllables spoken
Example – number of stuttered moments 50 x 100
total number of syllables 300
Frequency of stuttering: 16.6%
MEASURES OF STUTTERING
Duration
Overt features
- Duration
Typical measure is average length in seconds - Overt features
Core behaviors
Accessory behaviors
Severe struggle behaviors
SPEECH RATE
- Andrews and Ingham (1971) presented normative data
for adult speaker - For conversation(162-232 SPM – syllables per minute
or 115-165 WPM) - Reading rates are quicker (210—265 SPM or 150—
190 WPM)
SPEECH, LANGUAGE AND HEARING
- Articulation
- Voice
- Rate
- Receptive/expressive language
- Rule out a high level aphasia or apraxia
- Identify any coexisting language problems
- Hearing
OTHER POSSIBLE INFORMATION
Psychological and neurological testing
- Psychological testing
Achievement
Intelligence
Personality and adjustment - Neurological testing
Sensory-motor testing
Motor coordination
EEG
DIAGNOSIS OF THE
PRESCHOOLER
- Speech tasks
- Spontaneous speech – tape recorded
- Self-talk to parallel talk
- Talking about toys, pictures, family pets, friends
- Automatic speech – singing, reciting nursery rhymes
- Listener variations – parents, siblings, clinician
PERSISTENCE OF STUTTERING SIGNS
- Male
- Family history of persistence
- Little or no decrease in SLD by 12 months post-onset
- 2-3 times more SLDs:
- Children Who Stutter (CWS): SLD = 66%
- Normally Fluent Children (NFC): SLD = 28%
- Longer strings of part word repetitions
- Faster repetitions
- More secondary behaviors
- Patterns of clustering
- Relatives who stuttered, didn‘t recover
- Language delay
CHRONICITY VS RECOVERY
- Incidence about 4 – 5% (young children)
- Onset usually at 2 – 4 years (mean of 33 m.)
- Recovery rate @ 75% – 85% by age 6
- Remission especially high first 6 months
ASSESSMENT
- Frequency, duration, severity (changes in
stuttering, response to stuttering) - Core, secondary, covert behaviors
- Awareness of stuttering
- Speech and language assessment
- Personality assessment
DIAGNOSIS OF THE SCHOOL AGE
STUDENT WHO STUTTERS
Review of health and education records
Questions about client
1) Family and school situation
2) Onset of stuttering
3) Video record client in a variety of speaking tasks (imitation,
oral reading, conversation, automatic speech, role playing)
4) Observe client in a classroom or during play
