Connecting stuttering management and measurement: I. Core speech measures of clinical process and outcome

Abstract

Background: There will always be a place for stuttering treatments designed to eliminate or reduce stuttered speech. When those treatments are required, direct speech measures of treatment process and outcome are needed in clinical practice.

Aims: Based on the contents of published clinical trials of such treatments, three 'core' measures of treatment outcome are presented for consideration by clinicians: measures of stuttering rate, speech rate and speech naturaleness.

Main contribution: In contrast to clinical trials, however, clinicians are at liberty to have as many outcome measures as thought necessary, and to design non-standard ones to suit their needs and those of their clients. In that context, the merits of severity ratings of stuttering are considered. It is argued that the prime source of guidance of suitable measures of treatment process are the manuals of the treatments that have figured in clinical trials.

Conclusions: Although there are independent data sources that contradict the axiom that treatment outcomes should be measured beyond the clinic, it is argued that it is premature to dispense with beyond-clinic process outcome measures for clinical practice. It is argued that for clinicians who conduct treatments in non-research contexts, one pretreatment outcome measurement occasion is sufficient, along with post-treatment measures at each maintenance visit. More than anything else, the numerous advantages of severity ratings of stuttering facilitate clinical measurement of treatment outcome and treatment process in several settings and on several occasions.