How do you evaluate stuttering?

Kid with stuttering problem visiting speech-language therapist

Stuttering is a speech disorder. It is characterized by the repetition of words, prolonged sounds, and interruption in speaking. An estimated 1% of the world’s population stutters.

Stuttering can affect people of all ages. However, the condition is more common in children between the ages of 2 and 6, a stage where they are still developing language skills. However, in about 80% of children, stuttering stops before they reach adulthood. 

How can you distinguish when to give treatment and when to withhold it?

The severity of stuttering differs from person to person. Age, gender, and genetics are only a few aspects that influence the condition.

Though there is no definitive procedure or treatment to stop stuttering in a person, proactive steps can be taken to control and manage the condition. 

The best way to begin the treatment is to evaluate the speech disorder. It gives the idea of what to do next. Especially when younger children are involved, parents are advised to monitor their condition.

The “wait and see” approach permits parents to assess symptoms. After 3-6 months, if the speech disorder remains or worsens, further treatment or therapy is recommended.

Essential steps in evaluating stuttering

Step #1: Assessing general aspects of communication

Sometimes, other underlying problems are masked by stuttering. Thus, all areas of communication must be evaluated to ensure that there are no concurring issues.

So, the child needs to be examined to determine whether there are any other hearings, voice, or language disorders.

Step #2: Gathering additional background information

Stuttering tends to be genetic. There is strong evidence showing that nearly 50% of all children who stutter have a family member with a history of stuttering.

If the family member is still stuttering, then the risk of a child to stutter is greater. At this stage, various people will be interviewed, and their perceptions will be discussed.

So the individual who stutters as well as the parents, other family members, teachers, and colleagues may be approached. It will help determine how severe the issue is.

Step #3: Exploring overt and covert aspects

Stuttering has several overt and covert aspects. The impairment in speaking is an overt feature of stuttering. However, several types of disfluencies can be classified as stuttering issues. Common ones include:

  • Interjections (uh,er)
  • Revisions (I was – I am going)
  • Incomplete phrases
  • Part-word repetitions (ba-ba-ba-baseball)
  • Word repetitions (Can can I go?)
  • Phrase repetitions (I was .. I was going)
  • Broken words (I was g – (pause) – oing home)
  • Prolonged sounds (sssssometimes)

After identifying the type of disfluency, it is important to measure other aspects of stuttering, such as:

  • Frequency of disfluencies: How many disfluencies per hundred words or syllables are there? On average, a stutterer can exhibit 10% disfluency, while non-stutters typically show only 2%.
  • Duration of disfluencies: How long does the disfluency last? They usually last for 1 second.
  • Speaking rate (word per minute): People who stutter tend to speak 25% slower than a normal speaker. So while the average non-stutterer has a speaking rate of 167 words per minute, a stutterer may only say 123 words per minute. 

But besides overt aspects, stuttering can have psychological effects too. Therefore, behavioral observations should be an essential part of the analysis.

By studying the covert responses to stuttering, you can look into the emotional struggles and physical tension that a stutterer endures.

Often secondary behaviors such as eye blinking, jaw jerking, involuntary head movements, twitching, etc. can be a source of embarrassment. Additionally, it’s important to discuss any adverse reactions that a child has toward his or her disfluency. 

Step #4: Consider getting tested

Various non-standardized and standardized tests can help determine the severity of the stutter. Moreover, testing can allow you to come up with the best techniques to apply for treating the stutter.

The goal is to improve overall communication skills as well as boost the self-esteem of the stutterer.

Step #5: Using the results from the evaluation(s)

Once the person who stutters is analyzed, resources need to be found to help them stop stuttering and treat them according to their requirements. It is important to consider their academic, emotional, or social environments.

Though it may be difficult to remove all hindrances from the stutterer’s environment, whether at home, school, or other social situations, you will be aware of the demands that are placed on the individual or the pressures that they are experiencing.

Final thoughts

There are varying standards for evaluating stuttering. Interestingly, evaluations can also bring diverse results. That’s because different people will listen to the same thing and interpret the style of speech differently. 

Moreover, there will always be some amount of disfluencies in everyone’s speech. So while measuring stuttering disfluencies, a margin for normal disfluencies should be considered as well.

Sometimes a single evaluation may not give accurate results. Therefore, multiple assessments may need to be taken to get a better idea of the condition.

However, with proper monitoring and testing guidelines, enough information can be gathered to find the right approach and treatment to manage and treat both the overt and covert symptoms of stuttering.

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