Measuring Progress Beyond Fluency
How can SLPs provide meaningful therapy for people who stutter without focusing solely on fluency, and what measures do you use to track progress toward individualized goals beyond the percentage of fluent speech?
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Measuring Progress Beyond Fluency — 3 Comments
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Great question. Goals might include telling someone they stutter, saying what they want without substituting words, participating more at work or school, or feeling more comfortable stuttering openly in a particular situation.
Although I’m not an SLP, a few ways to track progress might include the following. Your colleagues or supervisor may offer additional guidance on appropriate measures.
– Self-advocacy: Requesting more time to speak, addressing interruptions, or making an intentional choice about whether to disclose stuttering.
– Participation: Making a phone call, contributing to a meeting, or ordering what they actually want.
Thanks for stopping by. Happy ISAD. – Nora
Hi Marcella,
I appreciate that you’re thinking about how to measure the change we are hoping to support people to make!
Building on what Nora wrote, it can be so helpful to co-create goals around holistic communication experience, rather than listener perception. I find the World Health Organization’s International Classification of Functioning framework to be a useful support for thinking holistically about an individual’s communication diagnosis and its impact on their life. This can help “categorize” goal areas and make sure that we’ve helped an individual explore many possible areas of impact in order to tailor our work together according to their priorities.
In terms of more specifically how to word therapy objectives for these co-identified treatment goals, I most often use a Likert scale (based on client self-report) or write the criterion for objectives as a certain number of opportunities that the client will do the behavior we’re measuring. For example, a Likert scale could be measuring increased comfort in a certain situation or decreasing mental energy spent on a certain aspect of communication (listener reactions, etc.) compared to gathered baseline data. We could measure other things through number of exposures/opportunities such as entering a certain number of previously feared communication situations by the end of the treatment period.
-Carrie
In addition to what Nora already has said: if you really want to measure (which most of the times is not strictly the best way), the CARE assessment is a great tool. Otherwise VAS (visual Analoque Scales) is amazing. You can think of whatever question you want to ask, like the impact of stuttering. Saying everything you want to say, talking to strangers, having fun in speaking, speaking up in a meeting or class, etc etc