why do we assess
- To gather information relevant to the patient
- To understand the patient’s history and the development of the disorder
- To obtain a baseline
- To identify outcomes
principles of assessment
- Explore impact of stuttering on patient
- Explore impact of previous intervention
- Identify outcomes patient hopes for
- Create a plan for attainable outcomes with patient
what information should we gather from our assessment
Consensus Guidelines for Assessment (Brundage et al, 2021)
- Stuttering related background information
- Speech, language, temperament and related background information
- Speech, fluency and stuttering behaviour
- Speaker’s reactions to stuttering
- Reactions to stuttering within speaker’s environment
- Adverse impact associated with stuttering
- Follow ICF (International Classification of Functioning and Health, WHO 2001)
what does OASES stand for
overall assessment of the speaker’s assessment of stuttering
what is the OASES
stuttering assessment which focuses on impact on quality of life rather than stuttering behaviours - based on ICF framework
what does WASSP stand for
Wright-Ayre Stuttering Self-Rating Profile (Wright and Ayre, 2000)
what is the WASSP
- Based on the ICF framework
- Developed to assess the person who stutters perceptions of stuttering behaviours, thoughts and feelings about stuttering, avoidance of speaking situations and any perceived disadvantage due to stuttering
difference between OASES and WASSP
WASSP is shorter than OASES, more suitable for patients with literacy or attention issues
what is the most common way to assess stutter
percentage of syllables stuttered
postponement
as the PSW approaches a feared word, there is often a moment of hesitation or the speaker may use a serious of sounds e.g. um/ah/let me see/you know
normal non fluency
- Part or whole word repetitions (less than three)
- Phrase repetitions
- Single syllable word repetitions
approximately how many CWS spontaneously recover
70- 80%
predictive factors of persistent stutter
- Bernstein Ratner (2010) suggests that a child’s relative level of language development may be a factor in predicting remission and persistence in early stuttering.
- Family history may also be a significant factor
- Walsh et al (2018) provides supplemental evidence of the role of known predictive factors (e.g., sex and family history)
- Provide evidences that
- Early delays in basic speech motor processes (especially in boys),
- Poor performance on a non word repetition test
- Stuttering severity at the age of 4 to 5 years
- Delayed or atypical functioning in central nervous system language processing networks are predictive of persistent stuttering
factors which indicate a sutter is less likely to persis
(manning 2010)
- No relatives who stutter
- Female
- Within one year of onset
- Few reactions to stuttering by child/parents
- Early onset of stuttering (2-3 years)
- Decreased severity ratings by parents and clinicians
ICF guided assessment
coleman (2018)
- Determine if the speaker is able to communicate effectively and efficiently in various speaking situations.
- Assess the impact of stuttering on the speaker’s ability to achieve educational objectives and interact with others.
- Assess the impact of stuttering on the speaker’s perceived quality of life.
- Determine comfort, spontaneity, and naturalness in functional communication across a range of situations.
- Determine the child’s perceived knowledge of stuttering and their ability to educate their peers regarding stuttering and advocate for appropriate accommodations
cluttering severity instrument
- Overall intelligibility
- Speech rate regularity
- Speech rate
- Articulatory precision
- Typical disfluency
- Language disorganisation
- Discourse management
- Use of prosody
cluttering assessment
- Monologue
- Reading
- Story retelling
- Speech motor coordination (10 repetitions of puhtukkuh) - judging articulatory accuracy, smooth flow and rate
- Skills in oral motor coordination in multisyllabic words (Van Zaalen, 2009)
