Evaluation Tools for Holistic Stuttering Assessments

As SLPs demonstrate the necessity and value of the services we provide for people who stutter, we must look beyond percentages of stuttered speech as the primary measure of “severity” and/or progress. 

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We can begin by using the ICF model on the experience of stuttering (Tichenor & Yaruss, 2019) to demonstrate the totality of stuttering, and we can demonstrate progress based on assessment measures related to increased life participation, improved quality of life, and reduced negative impact. 

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If we as professionals only consider disfluency counts and erroneously ignore the entire condition of stuttering, we invite potential negative outcomes for the individual, especially children who stutter.

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There are many ways SLPs can demonstrate “severity” of stuttering as well as tangible growth and progress based on affective and cognitive factors that are unrelated to visible stuttering behaviors (or “quantifying” stutters). Additionally, no single measure or assessment should be used as the sole criterion to determine eligibility and need for speech services.

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Need ideas on evaluation tools to assess stuttering holistically? Here are some options that may be considered, depending on the individual’s age and circumstances, which dive into impact, participation, communication apprehension, stuttering anticipation, emotional reactions and attitudes, coping responses, and quality of life:

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• Overall Assessment of the Speaker's Experience of Stuttering (OASES)
• Personal Report of Communication Apprehension (PRCA)
• Palin Parent Rating Scale (Palin PRS)
• Observational Rating Scales of the Test of Childhood Stuttering (TOCS)
• Stuttering Anticipation Scale (SAS) 
• Speech Situation Checklists (SSC-ER and SSC-SD) of the Behavioral Assessment Battery for School-Age Children Who Stutter (BAB)
• Behavior Checklist (BCL) of the BAB
• Communication Attitude Test (CAT) of the BAB
• Erickson S24 Scale
• Self-Efficacy Scales
• Stuttering Pride & Prejudice Scale
• The Stuttering Perceptions Scale
• The Communicative Participation Item Bank (CPIB)
• Vanderbilt Responses to Your Child’s Speech (VRYCS) Rating Scale
• Classroom Observations
• Teacher Questionnaires

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Here are key questions to consider in relation to educational impact for a child or adolescent who stutters (Wisconsin DPI, n.d.): 

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• Is there decreased oral participation in classroom activities and discussions, including asking
• Is there difficulty reading aloud or giving oral presentations?
• Are there unusual language patterns (i.e., word substitutions, circumlocutions) and pragmatics (i.e., frequent interrupting) in an attempt to avoid stuttering?
• Are there increased absences or increased somatic complaints when classroom oral demands increase?
• Is the student withdrawing from social situations?
• Is the student being teased or bullied by peers?
• Is the student withdrawing from large and small group conversations?
• Is the student choosing classes and extracurricular activities based on speaking demands rather than interests and aptitudes?

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Let’s move beyond disfluency counts in our comprehensive assessments!

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Tichenor, S.E. & Yaruss, J.S. (2019). Stuttering as defined by adults who stutter. Journal of Speech, Language, and Hearing Research, 62, 4356-4369.

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Wisconsin Department of Public Instruction (DPI). (n.d.). Assessment of fluency. https://dpi.wi.gov/sites/default/files/imce/sped/pdf/sl-asses-fluency-doc.pdf