As busy SLPs, we are always looking for ways to do our jobs faster. The Bilinguistics team created a cool free tool that we want to share with you to speed up your stuttering evaluations. It helps you to quickly calculate percentages of different types of speech disfluencies and includes research-based guidelines to guide your diagnostic decisions about whether you are evaluating a person who stutters or not.
Fluency Evaluations Aren’t Frequent for Many SLPs
Most SLPs have caseloads made up of a lot of children with articulation, phonology, and expressive language disorders. Occasionally we work with children with fluency or stuttering disorders. The prevalence of stuttering disorders is lower than many other communication disorders, estimated at 0.72% by Craig and colleagues (2002) with higher estimates in the preschool ages that range from 2.2%-5.6%, as estimated by Yairi and Ambrose (2013). The impact of that is that we may not have the process down. Some of us do fluency evaluations so seldom that it feels like we have to study up on the process every time one appears in our inbox.
What are the Components of a Fluency Evaluation?
A bunch of experts in the field of fluency and stuttering recently got together to evaluate the consensus in the field about what a fluency evaluation should look like. Their 2021 article in AJSLP is titled Consensus Guidelines for the Assessments of Individuals Who Stutter Across the Lifespan. The came up with 6 components they all agreed are important in a stuttering evaluation. Here are the 6 components of a fluency evaluation:
- Stuttering-related background information
- Speech-language temperament development
- Speech fluency and stuttering behaviors
- Reactions to stuttering by the speaker
- Reactions to stuttering by people in the speaker’s environment
- Adverse impact caused by stuttering
It is definitely agreed upon that stuttering evaluations are complex and include a wide range of components. In this post we are going to focus on speeding up one of the most time-consuming parts of this process—the speech analysis. We created an Excel Spreadsheet that you can download from our website to calculate percentages of different types of disfluencies. We call it the Fluency Calculator and you can find it the Bilinguistics library of free resources.
Want a Free Tutorial Video on How to Use the Fluency Assessment Calculator?
Next week we are doing a live ASHA CEU presentation fluency and have included some great free resources. Check it out: An Innovative and Game Changing Approach to Stuttering Intervention
Is it necessary to calculate the percentages of stuttering and disfluencies?
Yes, it is important to calculate levels of disfluencies for a variety of reasons. First, in order to make a diagnosis of stuttering, it’s important to have an understanding of the types of disfluencies and the level at which they occur. Second, it’s important to be able to track changes in disfluencies over time and across settings. We might want to better understand how levels of stuttering correlate with some of the other components of the evaluation, such as the reactions to stuttering.
Some level of disfluencies is typical
It is typical for people to exhibit some level of disfluencies. There is not consensus among experts on exactly what that cutoff is. The cutoffs we used in our tool are 3% or greater of stuttering like disfluencies in the sample or 10% or greater of overall disfluencies in the sample (that includes both stuttering-like disfluencies and non-stuttering-like disfluencies.
What types of disfluencies should I be concerned about?
Disfluencies are often broken into two types—stuttering-like disfluencies and nonstuttering-like disfluencies. Stuttering-like disfluencies include single syllable repetitions, whole word repetitions, audible sound prolongations, and inaudible sound prolongations. Non-stuttering-like disfluencies include phrase repetitions, interjections, and revisions. The table below includes the codes that we use when analyzing a speech sample.
|Instances of Stuttering||Non-Stuttering Disfluencies|
|Single Syllable Repetition [SSR]||Phrase Repetition [pr]|
|Whole Word Repetition [WWR]||Interjections [I]|
|Audible Sound Prolongation [ASP]||Revisions [REV]|
|Inaudible Sound Prolongation [ISP]|
How do you use this tool?
The fluency calculator helps you to quickly calculate percentages of disfluencies. You still have to transcribe and code your speech sample. Once that’s done, use the search function in your word processing program to search for each code. It will highlight them for easy counting.
Why is the Fluency Calculator Free?
Why not? It’s formulas in Excel. It’s not rocket science. At Bilinguistics, we’re all about helping SLPs do their jobs better. When we create things that work for us, we want to share them with you.
What if I don’t want to use the same guidelines you do?
You don’t have to use the same guidelines we use. In fact, our guidelines change depending on who we are evaluating because we know bilingualism introduces new factors. We wrote a separate post on that: Stuttering and Bilingual Students: Explanation and Resources.
Brundage and colleagues (2021) shared research that has several different guidelines. They noted that there is a lack of consensus about what the best guidelines are in the research. Check out the appendix in their article for a list of research in this area.
How do I use the Fluency Calculator?
Download the Excel Spreadsheet. It looks like this.
Add information in the boxes outlined in black. The first box is the type of sample. This is where you’ll include information about whether your speech sample is a narrative, a conversational sample, a passage read aloud, or something else. The box to the right of it is very important. This is where you’ll include the number of words in your sample. It’s best to run your word count before you add your codes so you don’t get “extra” words for codes that are not directly attached to your words. The number of words in the sample is your denominator. Next, you’ll put in your frequency counts of each type of disfluency and it will automatically calculate your percentages. Use the guidelines to the right to compare or, pick your own guidelines if you prefer another measure. There are three copies in the file so you can follow the consensus guidelines and include several different types of speech samples in your fluency assessment. You can also copy and paste to add more if you do more than three samples in your stuttering evaluation.
And that’s it! I hope that you’ll find that the Fluency Calculator speeds up your analysis of disfluencies and your overall stuttering assessment. Check out what SayItLabs is creating to help us out with stuttering therapy.
Once you’ve completed your stuttering evaluation, be sure to check out our fluency goals in the Bilinguistics Goal Bank.