In order to see progress, you must know know what you’re looking for. Seems like a pretty obvious statement, but having a skewed vision of progress or success is the reason why so many people who stutter (PWS) report either jumping from therapist to therapist or quitting therapy altogether. It is the job of the speech pathologist to teach strategies, but even more importantly to help clients set realistic and obtainable goals so that they will ultimately recognize the progress they’re making when it happens!
When therapy begins for a school aged child, adolescent or adult, benchmarks for success must be clearly outlined. It is common and quite natural for a PWS to come into therapy wanting to cure or reduce their stuttering. It is up to the therapist to highlight that there are other benchmarks of success too, including increasing their knowledge of the nature of stuttering, increasing their understanding of their feelings about stuttering, increasing participation in activities previously avoided and reducing avoidance and escape/struggle behaviors. Without highlighting this from the get-go, clients (and their families) may easily concentrate on things that may be out of the their control and miss out on giving themselves the credit they deserve!
Putting insurance and school guidelines aside, I think progress for PWS is best measured qualitatively. Changes in attitudes and perceptions can not be measured in fractions or percentages. Even changes in severity can not accurately be described by numbers because that is assuming that severity is only based on frequency, with no emphasis on the type of disfluency and the amount of struggle and tension. With all that being said, there are reasons beyond our control that we do need to report some numbers. I do my best to use goals that are measurable so that they will meet the standards to receive insurance coverage or to be included in individualized education plans (IEPs) at schools. However, always back up all your “numbers” with qualitative information to create an accurate picture of the client and their progress.
The file below contains some sample goals that I typically use with school-aged children, adolescents, and adult clients. The goals that are included primarily follow a stuttering modification and avoidance reduction therapy approach, however I included a few fluency shaping goals that I use with pre-school/early elementary aged children as examples for therapists and clients that are using that type of approach.
It is important that these goals are adapted to meet the age and cognitive level of the client, as well as consider the client’s baseline information.
Have any suggestions on goals not included in this list? Share with us below!