SPA 528 - Lecture 5

1. Acess Problem 2. Guide to Treatment Decisions and Programing (to determine the long and short term goals, to assess progress and make modifications) 3. Evaluate Effectiveness of Treatment 4. Demonstrte Accountability (for yourself, colleafues, clients, funding bodies, development of the profession) 5. Provide Objective Information to clients and others regarding -severity of stuttering -progress in treatment

1. Stuttering frequency (%SS) 2. SSI-4; Severity Raitings 3. Overall speech rate; Articulatory rate 4. Naturalness (9 point raiting scale) 5. stuttering frequency, severity raitings, speech rate, naturalness 6. questionnaires & raiting scales regarding attitudes, anticipation & avoidance, confidence, QoL

-most commonly used measure of overt stuttering -may be expressed as: -% syllables stuttered (%ss) <- most common -% words stuttered (%ws) -number of stutters per 100 words -stuttering frequency is reported in combination with speech rate for older childen and adults -very useful in; assessmnet, evaluation & tracking progress -helps distinguish cws from cns -highly correlated with severity

# stuttered syllables (or words) / total # syllables (or words) x 100 = %SS (or %WS) "True Talk" a device that can calculate the above

300-500 utterances

-doesn't capture duration of stuttering or physical tension -does not always reflect severity -it takes time to develop skilland reliability in counting (poor agreement across clinicians)

<1%SS - WNL 2%-5% - Mild 6%-10% - Moderate 11%-15% - Moderate-Severe 16%-20% - Severe 21+% - Profound

-Stuttering Severity Instrument (SSI-4); most commonly used severity instrument (standerdized procedure for assessing severity of children and adults) -Severity Raiting Scales

Incorporates: %SS (stuttering frequency) + provides norms, duration of 3 longest stutters, physical concomitants (secondary characteristics), naturalness of the individual's speech Provides: overall score, percentile, verbal descriptor of severity Limitations: time consuming, need additional testing to demonstrate reliability and validity

1. Scales with general descriptions(e.g., Scale for Raiting Severity of Stuttering) 2. Simple numerical scales (e.g., 1-10 scale used by Lidcombe Program) -the numerical ones are more popular, can be used by clinicans, parents and clients

-the reliability is questionable (even with training get quite a range, hard to discriminate a 2 from a 3 or a 7 from an 8) -may be less sensitive than %SS to small changes in stuttering -perceptions can drift over time -need to train clients and continually assess agreement

1. Frequency of the stutter - the higher the %SS or %WS, the higher the severity raiting 2. Duration of the stutter - the longer the stutter, the higher the severity raiting 3. The type of the stuttering pattern - repetitions are considered mildre (less severe) than prolongations and blocks (more severe) 4. Presence of secondary behaviors - the more, the higher the severity raiting

-easy to use -useful in tracking progress -easy to obtain beyond the clinic -useful for communicating with parents and clients

-useful in assessment, uoutcome and evaluation -at the end of treatment, one wants the client's speech rate to be WNL -great to use in treatment because can be a target goal and provides feedback to clients -most often expressed in syllables per minute (SPM) -includes both dysfluent and fluent speech but excludes long pauses (over 2 sec long) -reflects time needed to convey content -provides indication of extent to which stuttering disrupts flow of information -usually reported in combination with %SS -inversely related to severity

Total syllables (or words) spoken / tme in seconds x 60 sec = SPM (or WPM)