Assessment of Fluency Disorders In the Context of the WHO ICF Framework

The WHO ICF framework can be used to describe the following comprehensive set of assessment features for fluency (Coleman & Yaruss, 2014; Yaruss, 2007; Yaruss & Quesal, 2004, 2006).

Impairment In Body Function

Assessment Related to Measuring Speech Fluency and the Severity of Observed Disfluencies

Examples of specific assessment areas include:

  • determining speech efficiency and spontaneity in communication,
  • measuring the frequency and severity of disfluencies,
  • assessing physical concomitant behaviors and learned escape/avoidance behaviors,
  • assessing tension and effort in communication (during both fluent and disfluent speech).

Activity Limitations And Participation Restrictions

Assessment Related to Measuring the Adverse Impact of Stuttering or Cluttering on the Speaker's Life, Including Functional Communication Abilities Across Situations and Determining if the Speaker is Able to Communicate

Examples of specific assessment areas include:

  • determining if the speaker is able to communicate effectively in various speaking situations (e.g., at school, in social settings, at home);
  • assessing the impact of stuttering or cluttering on the speaker's ability to achieve educational objectives and interact with others;
  • assessing the impact of stuttering or cluttering on the speaker's perceived quality of life (e.g., satisfaction with communication and impact of stuttering or cluttering on life as a whole);
  • determining comfort, spontaneity, and naturalness in functional communication across a range of situations.

Personal and Environmental Context

Assessment Related to Determining Less Helpful Coping Reactions on the Part of the Speaker, as well as Negative Responses by Those in the Speaker's environment (e.g., Parents, Teachers, Peers, and Others)

Examples of specific assessment areas include:

  • assessing emotional responses to stuttering or cluttering and to communication in general (e.g., anxiety, shame, frustration, fear, and apprehension);
  • assessing self-confidence and participation in and enjoyment of communication;
  • assessing attitudes about stuttering and self-perception as a competent communicator;
  • assessing knowledge about stuttering or cluttering, initiative in educating others, and advocacy for appropriate accommodations;
  • assessing support systems, including family involvement, support groups, teachers, mentors, and peers;
  • assessing competence in responding to questions about stuttering or cluttering and managing teasing/bullying and other listener reactions;
  • assessing self-therapy, self-management, and problem-solving skills.

Coleman, C., & Yaruss, J. S. (2014). A comprehensive view of stuttering: Implications for assessment and treatment. SIG 16 Perspectives on School-Based Issues, 15(2), 75-80. 

Yaruss, J. S. (2007). Application of the ICF in fluency disorders. Seminars in Speech and Language, 28(4), 312-322.

Yaruss, J. S., & Quesal, R. W. (2004). Stuttering and the International Classification of Functioning, Disability, and Health (ICF): An update. Journal of Communication Disorders, 37(1), 35-52.

Yaruss, J. S., & Quesal, R. W. (2006). Overall Assessment of the Speaker's Experience of Stuttering (OASES): Documenting multiple outcomes in stuttering treatment. Journal of Fluency Disorders, 31(2), 90-115.

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