Assessment of Fluency Disorders

Among the diverse speech and language disorders we work with as clinicians, stuttering seems to maintain a sense of ambiguity and challenge. We have certainly made great strides in understanding various potential causes of stuttering; nevertheless, a definitive notion of its etiology continues to elude researchers. By its very nature, stuttering is a condition of inherent contrasts. It involves surface features that are easily accessible for measurement and analysis, but it is almost always complicated by a vast underlying set of emotions that are more difficult to label and organize but that are critical to understand and address. Sheehan (1970, p. 14) aptly described overt characteristics of stuttering as “the tip of the iceberg, " an analogy that highlights the need for clinical protocols that take into account both symptoms that are perceptible as well as those that may be more challenging to observe but that play a critical role in driving the development of this disorder.