Lately, I have received several evaluation referrals for preschool children who stutter. Fortunately, last year I took a CEU course on stuttering taught by Scott Yaruss. This CEU turned everything I thought I knew, upside down!
In the past, I have always used frequency of stutters as a big determining factor in my recommendations for services. The problem with using frequency is that inevitably, the child will come into the evaluation and be completely fluent. Frequency only provides a snapshot of stuttering in that moment. Scott Yaruss instead points out that it is better to be able to identify whether stuttering is likely to persist or not. To do so, he identifies several risk factors consider.
- Gender- Males are more likely to persist with stuttering than women
- Language/Motor mismatch- Any mismatch in language and motor skills (typically observed as articulation skills) can be a negative risk factor.
- Child’s temperament- A highly reactive child is more likely to persist in stuttering. Reactivity could be to stuttering, or anything else in the child’s life.
- Concomitant disorder- If the child has any concomitant disorder, stuttering is more likely to persist.
- Parental concern- Highly concerned parents tend to increase the chance that stuttering will persist. Often parents are the ones who request the evaluation, so it is typically safe to assume parents hold some level of concern.
- Time since onset (TSO)- This is how long the stuttering has persisted. Typically a TSO greater than 6 months is a negative risk factor.
Typically I use the Stuttering Severity Instrument-4th edition to also give that “number” information that school districts look for. Providing the above information gives additional support to recommendations and helps boost students who may have had a spike in fluency during the evaluation!
Now for goal writing…