1. Evaluation Purposes of an evaluation –determine if a problem exists –determine the cause, if possible –determine the need for treatment –determine the course of treatment

2. Stuttering Evaluation Considers Dysfluent Behavior and Language Stuttering Evaluation is divided into –1. Eliminating other communication factors, such as language and motor speech – 2. Specifying OVERT characteristics visible behaviors stutterer displays measurable –pre-post measure –3. Specifying COVERT characteristics attitudes anxieties belief system

3. Evaluation Considerations In clinic –1. Clinician-client sample 3 modes other language tasks varying listener (your) reaction –2. Child-parent playing construction task not seen before narrative task

4. Out of Clinic –most critical measure, besides parent-child –baseline for transfer and maintenance –various locations school settings such as classroom, bus, lunchroom shopping walk around and sit outside talking with others at home –with parents –with siblings –friends

5. Evaluating the Young Child Article: Onslow, M., “Identification of Early Stuttering: Issues and Suggested Strategies.” 1992, AJSLP consensus that stuttering should be treated when it first appears effective early identification would enable clinicians to monitor very young children at risk for developing stuttering

6. Gordon, P & Luper H, 1992. The Early Identification of Beginning Stuttering II: Problems AJSLP, September Protocols differ in the number, type of speech and non-speech criteria –All use frequency and/or % criteria –Differences in weighting of the criteria –Lack of agreement on which behaviors are crucial and what amount of dysfluency should be given categorical label of stuttering –variation creates clinician uncertainty

7. Gordon and Luper continued, #2 Difficulties in using behavioral signs as a basis for categorical markers –clinician assigns to 1 of 3 categories: stutterer, nonstutterer, potential stutterer problem –overlaps in classification –subjective –weighting of continues variables clinician attempts to evaluate –need to look for »1. need to look for predominant type »2. overall frequency and proportion of types remain distinguishing characteristic »3. degree of effort »4. reaction to dysfluency

8. Gordon and Lure continued, #2 Van Riper in 1982 stated: –When stuttering behaviors occur frequently and are severe, the clinician has little difficulty in recognizing that a disorder exists. More advanced stutterers, by their struggle or avoidance reactions and emotionality, show that they have a serious fluency problem. However, in young children, the differential diagnosis is more difficult

9. Possible solutions –1. Decrease the possibility of diagnostic errors PROBLEM: CHILD INCORRECTLY DIAGNOSED AS HAVING NORMAL DYSFLUENCIES –Solutions continued monitoring enroll in short-term diagnostic treatment individualized treatment for all

10. 2. Role of Spontaneous Recovery –rate of spontaneous recovery: 40%-80% problem: rate is exaggerated –research by Curlee, Ingam, Martin & Lindammod in the ‘80’s

11. 3. Consider importance of Language Sample –need standardization of sample size range: Riley’s 100 word to Miller & Cahpman’s 100 utterances # of settings –Always include home or parents in sample

12. 4. Consider Clinician Quantification Issue –quantification is variable clinician judgements form the basis of several quantitative measures issues of frequency, typography and severity measures

13. Article Summary Early detection provides an opportunity for early treatment Early treatment holds a promise of preventing the young incipient stutterers from having to undergo many distressful experiences

14. End of Lecture Notes