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From: Anne Bothe
Date: 20 Oct 2004
Time: 10:04:17 -0500
Remote Name: 128.192.78.134
This is one of my favorite topics -- glad it came up. I think I am one of those people who is occasionally typecast as supporting the view that the "only" goal of "all" stuttering treatment is "just" to "get to zero stuttering." I suppose I can see how some of the things some researchers (including me) have written might be oversimplified to get to a statement like that, but I also also think that all of us who have ever thought about, written about, or researched anything in the general territory of "What is the goal of stuttering treatment, and how do we know that we have achieved it?" really do have much more complex views than any sound-bite can capture -- and I mean that from both directions: I think people like me who tend to emphasize the importance of measuring stutters in speech and reducing stutters in speech really do recognize that fear of speaking, word avoidances, etc., just to use the examples you raised, really are important, and, equally, I think people who tend to emphasize those kinds of variables really do also recognize that the number of times a speaker stutters might also be something relevant that we might want to be able to get a handle on. That said -- is there "real research" on "devising a set of metrics" that would then somehow be required of all studies, or used in all studies, so that those studies or treatments can be compared? No, not that I'm aware of, and I also don't think it's necessary. Even if we could all agree on some set of all the POTENTIAL variables that COULD BE relevant for any given person (such a set, by the way, being essentially infinite, as far as I'm concerned), I don't think there is such a thing as the set of variables that ARE BY DEFINITION relevant to ALL persons who stutter. Equally, I don't believe that any two studies need to have used the same measures to be compared -- if one study shows that Treatment X reduced percent syllables stuttered and increased self-efficacy scores, and another study shows that Treatment Y increased percent of fluent utterances and decreased self-reported instances of word avoidance, then any clinician or client who is interested in any of those four outcomes has relevant information. Of course, any of us who have "favorite" measures then start, at this point in the discussion, to suggest that the "minimal set" that everyone should use looks like, basically, "my favorite measure plus whatever else you feel like throwing in." My own personal take on this is that we would be better off, as a research and clinical community, if all stuttering treatment research at the very least gave us information about the number or percent of stutters, speech rate, and speech quality, before, during, and after treatment -- but that's just my bias coming through. I hope that got at your question -- Thanks for raising it.