Stuttering treatment outcomes measurement: assessing above and below the surface

Most researchers now acknowledge that stuttering is a multidimensional disorder (Smith & Kelly, 1997). Therefore, any assessment of stuttering treatment requires a multifaceted approach. A multifaceted approach typically includes assessing both surface elements as well as elements of stuttering that exist "below the surface." Surface elements include aspects of the core behavior of stuttering such as stuttering frequency and stuttering moment durations. Elements that exist "below the surface" include symptomatic aspects of stuttering such as speaking avoidance, reduced social and occupational participation, and negative affective functioning in areas like locus of control, mood, and anxiety. Because there is often disagreement regarding the essential components of stuttering treatment there is also disagreement about appropriate treatment outcome measures (Blomgren, Roy, Callister, & Merrill, 2006a; Blomgren, Roy, Callister, & Merrill, 2006b; Reitzes & Snyder, 2006; Ryan, 2006). This article aims to summarize some of the issues of conducting a multidimensional appraisal of stuttering treatment.