Functional Fluency: Assessment That Goes Beyond % Syllables Stuttered

For the past two weeks, I’ve been talking about the subject of Adolescents Who Stutter (AWS) and what we can do to challenge the idea of the more “traditional” approach of focusing solely on increasing fluency. By the time our students reach us, they’ve liked been receiving services for years and years (unless you have the occasional covert stutterer come find you from out of the blue!). After several previous triennial assessments, do you feel assessment is still important at this age? What assessment tools do you like to use with your students? Let me know in the comments! If you're looking for therapy techniques for AWS, check out my previous two blogs here and here.

Going Beyond the SSI-4 - Using the OASES-T

In graduate school, I learned how to administer the SSI-4. In my undergraduate fluency class, we practiced assessment skills by transcribing a speech sample and getting an accurate % of syllables stuttered. I came out of grad school feeling pretty comfortable in my ability to categorize a PWS based on their % syllables stuttered. I had copies of a few dated rating scales (e.g. Does your stuttering cause anxiety?) and some teacher/parent rating scales I modified so that I could send them out over e-mail (see Blog Post #1 on how to do that here).  

I felt like there was something missing, though. I was fortunate enough to end up at a school with a copy of The Overall Assessment of the Speaker’s Experience of Stuttering - Teen (OASES - T), published by Stuttering Therapy Resources (remember their awesome materials from my previous blog post?). The OASES-T provides adolescent-specific questions relating to, “General information about a teen's perceptions of stuttering; affective, behavioral, and cognitive reactions to stuttering (feelings, actions, thoughts); Functional communication difficulties in key situations (at home, at school, in social situations, and in general); [and the] Impact of stuttering on the teen's quality of life,” (Stuttering Therapy Resources). Using the OASES-T with my AWS has revealed great information about my student’s deep-seated beliefs about their stuttering. I have been surprised to learn that one student deeply believed that her stuttering would keep her from going to college; another student’s responses reflected her confidence and acceptance of stuttering as one facet of her life. In the end, the OASES has given me great descriptive information about my students, their beliefs and their needs. You do get a "score" you can use to help teens and parents understand their responses, but I find the descriptive information and insights gained during administration to be most beneficial!

Here's an actual example of how I wrote up the OASES findings in a report:

Section	Raw Points	Items Completed	Impact Score	Descriptive Statement
General Information	59/75	15/15	3.93	Severe
Reactions to Stuttering	89/125	25/25	3.56	Moderate/Severe
Communication in Daily Situations	72/100	20/20	3.60	Moderate/Severe
Quality of Life	70/100	20/20	3.5	Moderate/Severe
Total	290/400	80/80	3.625	Moderate/Severe

"These results indicate that stuttering has a moderate to severe impact on Student’s quality of life, her interactions with others, and her own impressions of herself. Throughout this assessment, Student was noted to engage in instances of negative self-talk, such as "There's no way I could ever do a presentation." She strongly agreed with statements like “My stuttering keeps me from doing the things I want to do in my life,” “I don’t want people to know that I stutter,” and “People who stutter should not take jobs that require a lot of speaking." Her reactions and statements illustrate that Student has not reached a point of acceptance and that stuttering may be a contributing factor to her poor academic performance, low self-reported self-confidence, and low self-reported academic ambition."

Locus of Control: Where Does the Power Lie?

So you've given the SSI-4 and OASES. You've got parent and teacher rating scales. Want some extra information to spice up your report and really get in your students' heads? I present to you: the Locus of Control Scale.

This year at the California Speech-Language Hearing Association (CSHA) Conference, I attended an excellent talk on the subject of addressing fluency for teenagers and adults. It contained great information, including the idea to use a Locus of Control rating scale to identify whether or not your AWS believe they are in control or if they live their lives at the whims of uncontrollable factors.

You can find these scales all over the internet, but I like Rotter's Locus of Control Scale, found here. Please take a minute to check it out and look at the kinds of questions that are asked on this scale.

As you can see, the questions really drive at one question - Who do your AWS believe is the holder of power in their lives? Themselves or someone else? Using this scale has revealed some big insights for several of my AWS. Before AWS can attempt to take ownership of their stuttering, they have to believe they can take ownership of their life in general. If they receive a high score, then that means that they likely believe that life circumstances are out of their control and there's not much they can do to change things. When an AWS scores high on this test, I first teach the idea that they have control of their own life... including their stuttering

Conclusion

I hope this 3-part series has given you some new perspectives on fluency and given you some ideas on new ways to tackle your tough stuttering cases. Please leave me a comment with ideas, successes, or frustrations you've had with your AWS! Thanks for reading!

As always, it doesn't have to be fancy, just keep it fun and functional!

• Jillian, the No-Frills SLP