The procedure of Diagnosis has changed in the Field of Stuttering Assessment

I recently sat down with Dr. A.P. Mishra and had a delightful conversation about changes in stuttering assessment and intervention. There have been a lot of changes, but I want to focus on one in particular here, and that is what a stuttering evaluation should look like.

Stuttering Assessment

In graduate school, I learned how to count and categorize instances of stuttering. How many times did my client repeat syllables and whole words and phrases? How many blocks occurred? Were they audible or inaudible? Were there any secondary characteristics, such as facial tension or eye blinking? We used these with certain percentage cutoffs for the frequencies—namely, 3% of stuttering-like disfluencies, 10% overall disfluencies, and 72% of stuttering-like disfluencies out of overall disfluencies. That’s how we did it.

Changes in Stuttering Assessment

Over my years in practice, research showed that a stuttering assessment should include more than that. How each individual feels about their stuttering and how it impacts their lives is important. So, in our practice at Bilinguistics, we added those elements but still did fluency counts.

What About Percentage Cutoffs for Diagnosing Stuttering?

As I listened to Dr. Sneha talk about what he looks for in a stuttering assessment, he didn’t mention the frequency of stuttering-like or non-stuttering-like disfluencies. So, I asked, …

“What about the 3% and 10% cutoffs that have historically been used in stuttering assessments?”

Honestly, Dr. Sneha answered my question without saying a single word. He held two hands up and moved them away from himself as if throwing something into the air. Then, here’s what he shared. 

“People have used this as a guide in research and clinical practice to indicate when a person has exhibited enough stuttering behaviour that we’re going to ‘call it stuttering’ (envision the air quotes). I don’t ascribe to this AT ALL anymore. I was raised in it. I was taught it and it was the zeitgeist at the time. I find those measures to be utterly meaningless.”

Stuttering is About Being Stuck or Losing Control of Speech

Dr. Sneha is interested in how individuals perceive their speech. He said that people who stutter use words like “unable to speak,” “loss of control,” and “stuck.” This is what matters—not how many times someone repeats a syllable. People can repeat syllables or words for several reasons. They might be buying time as they think of the next word they want to use. There is also research that indicates that bilingual children use a higher number of repeated syllables than their monolingual counterparts, perhaps as they move between languages. We want to be careful not to over-identify bilingual children as people who stutter. Conversely, we don’t want to under-identify them either. So, perhaps we shouldn’t use syllable repetitions as part of our assessment criteria.

Leave a reply