Scoring stuttering frequency and severity

specific procedures for frequency

-multiple iterations of single disfluency=only one space on coding form ("I-I-I want that") -disfluencies involving multiple words= only one space for each individual word ("I want - I want that"). -multiple disfluencies on single syllable= code all disfluencies in one space ("IIII-I-I want that") -multiple disfluencies on phrase = code each disfluency in the different spaces spanning the disfluency ("IIIII want- I want that") -non-disfluent repetitions= only count first production as fluent and ignore later productions (look daddy...look daddy) -play noises = count as fluid word if they fill a grammatical spot ("the car goes vroom-vroom") -unintelligible words or phrases = generally ignore -non-representative sample = take new sample or make note on scoring sheet -added codes for breaks, secondary behaviors, visible or audible tension, etc. (use if desired)

Block

B

other disfluency

OD

Prolongation

P

Phrase repetition

PR

part word repetition

PWR

sound repetition

SW

assessing duration

- Common practice to average duration of three longest stutters - This is a component of severity assessment - Use stopwatch to measure duration (to nearest one-half second of longer stutters in sample). Average longest three. -The SSI-4 has software that allows easy assessment of mean duration of three longest stutters

assessing secondary behaviors

-Major division = escape versus avoidance behaviors -Escape behaviors occur after stutter has started. They are an attempt to stop stutter and produce a word (ex. Head nod, eye blink) -Avoidance behaviors occur before stutter has begun. They are attempts to keep from stuttering (ex. Saying extra sound, changing word) -Severity assessments often include measure of secondary behaviors

assessing frequency

-Most common: Percentage syllables stuttering (%SS) -%SS = total stutters/total syllables -When counting stutters, each syllable can only be stuttered once (ex. N-n-n-n-n-nuh-nuh...[silent block]...name" = one stutter) -interjections and postponements leading up to a stutter are not considered in the %ss count ("where is my...my...uh...well...ba-ba-ba-basketball?") -If client has obvious avoidance behavior without stutter, count as stutter (ex. "My name is uh...uh...uh...uh...Barry.")

assessing speaking and reading rate

-Severe stutterers may produce speech at a very slow rate, decreasing their communicative effectiveness -Individuals who both stutter and clutter may have excessively fast rates of speech, making them somewhat unintelligible -Common practice to assess client's speaking and reading rates in terms of syllables per second -Speaking rate can be assessed using stopwatch and counter or various computer-based or handheld devices -Reading rates can be assessed by timing a client's reading of a standard passage of known syllable length

assessing severity

-assessment of severity is a clinically relevant measure because it captures what listeners experience -good for measuring progress in treatments that reduce abnormality of stuttering but don't eliminate stuttering altogether -SSI-4: Stuttering Severity Instrument-4

speech sample

-for assessment, attain two samples (one in clinic and one outside) -ensure sample is representative of current level of stuttering -videotaping is important for major samples -samples must be long enough to get representative sampling of each -for major assessments, use 300-400 syllables for conversation and 200 for reading -for reading sample, ensure passage is at or below client's level

word repetition

WR