Quick: Talk Fast & Don’t Stutter! The perils of oral-reading fluency assessments for children who stutter led a group of SLPs to investigate the issue and call on colleagues to change their school districts’ policies. Features
Features  |   July 01, 2014
Quick: Talk Fast & Don’t Stutter!
Author Notes
  • The members of the Ad Hoc Committee on Reading Fluency for School-Age Children Who Stutter contributed to this article: Nina Reeves, Kathleen Scaler Scott, Kim Krieger, Diane Games, Karole Howland, Laura Young-Campbell, Lourdes Ramos-Heinrichs and Diane Paul, ASHA ex-officio.
    The members of the Ad Hoc Committee on Reading Fluency for School-Age Children Who Stutter contributed to this article: Nina Reeves, Kathleen Scaler Scott, Kim Krieger, Diane Games, Karole Howland, Laura Young-Campbell, Lourdes Ramos-Heinrichs and Diane Paul, ASHA ex-officio.×
    The authors also acknowledge additional members of the former SIG 4 Coordinating Committee Project Team on Reading Fluency who assisted with the development of the survey discussed in this article: Lisa Cameron, Edna Carlo, Leslie Eckenthal, Sandra Garzon, Tim Mackesey and Rossanna Portley.
    The authors also acknowledge additional members of the former SIG 4 Coordinating Committee Project Team on Reading Fluency who assisted with the development of the survey discussed in this article: Lisa Cameron, Edna Carlo, Leslie Eckenthal, Sandra Garzon, Tim Mackesey and Rossanna Portley.×
Article Information
Development / Speech, Voice & Prosodic Disorders / Fluency Disorders / School-Based Settings / Features
Features   |   July 01, 2014
Quick: Talk Fast & Don’t Stutter!
The ASHA Leader, July 2014, Vol. 19, 44-48. doi:10.1044/leader.FTR2.19072014.44
The ASHA Leader, July 2014, Vol. 19, 44-48. doi:10.1044/leader.FTR2.19072014.44
Editor’s note: The committee wrote this article on accommodation and stuttering based on their own encounters with this issue across school districts. The fictional example that follows is based on their experiences.
Jaylin loves books. Her speech-language pathologist often has to wait for her to finish a chapter before Jaylin is ready for her stuttering treatment sessions.
Jaylin and her parents were quite surprised when, in second grade, she was moved from her accelerated reading group to a lower reading group.
Jaylin and her parents were told the move was based on her score on the oral reading fluency assessment used district-wide. Every week, Jaylin took a timed oral reading test to monitor her progress. Because she is a child who stutters, her oral reading rate fluctuated depending on the variability of her stuttering.
Jaylin began to experience enormous self-doubt about her ability to read aloud, and began to withdraw from any classroom activity that involved reading aloud. Jaylin told her parents she didn’t want to go to reading group anymore, and her teacher noted that she began to excuse herself from the group with frequent trips to the bathroom and school nurse.
The situation was quickly spiraling downward. As Jaylin’s case manager, the SLP knew she had to do something—but wasn’t certain where to start. She called a team meeting to investigate what was happening, and consulted with Jaylin’s parents to create an action plan.
At the team meeting, the SLP learned that oral reading rate commonly was used to assess automaticity of reading. Children with a low rate were automatically identified as “at risk” and referred for additional support services. The SLP insisted that Jaylin’s stuttering negatively affected her oral reading fluency rate and questioned the validity of the reading fluency measure for all children who stutter. The reading specialist acknowledged that a child’s reading rate might be reduced for a number of reasons totally unrelated to reading ability itself. Case in point: stuttering.
Unfortunately, this school district’s use of a catch-all fluency measure without accommodations is quite typical, as experienced by members of our committee. Many of us have been in positions like the SLP in this scenario—even though assessment manuals typically state that the oral reading fluency test is inappropriate for students with speech fluency and/or oral-motor speech disabilities, and suggest using other assessment strategies to monitor these students’ progress.
We have found that reading specialists and school administrators often are unaware of the potential pitfalls of assessing oral reading rates for children who stutter, and often don’t recognize the need for testing accommodations. SLPs have a responsibility to advocate for the students on our caseloads for whom the oral reading assessment is inappropriate. Our group was formed to further this cause and to survey school districts on current assessment practices—to show how some practices are problematic and how they can be improved.
A widespread problem
Our initiative, ASHA’s Ad Hoc Committee on Reading Fluency For School-Age Children Who Stutter, began as a project of ASHA Special Interest Group 4, Fluency and Fluency Disorders. Realizing that this issue required the expertise of a variety of professionals, ASHA’s Board of Directors approved the establishment of an ad hoc committee to include representatives of SIG 1, Language Learning and Education, and SIG 16, School-Based Issues, in addition to SIG 4.
This committee worked with ASHA’s Survey and Analysis Team to survey school districts on the tests they use to measure academic benchmarks in oral reading fluency and the accommodations they use during oral-reading fluency tests to account for stuttering-related problems.
Among other findings, the survey indicated that:
  • 36.1 percent of students who stutter were required to take the standardized oral reading assessments without accommodations.

  • Many SLPs had misconceptions about the connections between oral reading fluency and stuttering, including whether—or when—accommodations for children who stutter would be necessary. In their comments, some respondents indicated that some children who stutter read more fluently than they speak, and that children with “mild stuttering” may not need accommodations in this area.

  • Respondents were pleased that the issue was being addressed, given the wide variety of assessment measures and administrative procedures that failed to accommodate the circumstances of students with communication issues.

Implications for SLPs
Because oral reading fluency rate assessments can be affected by communication disorders, SLPs need to become “point leads” to consistently advocate for students with communication issues, including students with stuttering, cluttering, apraxia and other motor-speech disorders.
To lead the advocacy effort, SLPs need to incorporate this aspect of a student’s educational experience into our assessment, treatment planning and accommodations for any children on our workloads who may undergo oral reading rate assessments. No matter where we work (schools, hospitals or private sector), we need to know how a student’s district assesses oral reading fluency, what grades are involved in this type of testing, and which tests are being used to gather information about reading fluency. Then we can learn what, if any, accommodations or stipulations the testing manufacturer has included in the testing manual.
Overall, SLPs must be more educated on the topic of oral reading fluency assessments and the possible unintended consequences of inappropriate district testing procedures for children with communication disorders. To best help these children, we need to become informed advocates and to collaborate consistently with other professionals.
Advocate for students
So what can we do for students like Jaylin? The best way to keep her from withdrawing from reading would be to advocate for a change in the district’s reading fluency assessments. The danger of the assessment for a student like Jaylin—an avid and fast reader with good comprehension—is that a reading-group move could make her reticent to communicate, lest she stutter. A downward spiral of negativity about stuttering can make it difficult to move a student forward in a treatment plan, setting back desensitization activities and stuttering acceptance. Such students can become unwilling to take on communication challenges that could lead to increased carryover of skills to natural environments.
We have seen many students like Jaylin on our caseloads—students who may need accommodations or access to alternative measures. We should point out, however, that some students who stutter want to be tested “just like the other kids.” They make comments such as, “I read more fluently than I talk” or “I don’t want be different.” Some want to participate but welcome help to ensure that test scores aren’t counted against them for reading group placement.
Our recommendation is that SLPs prepare lists of children on their caseloads who need alternate assessments and give them to test administrators. To ensure that no children fall through the cracks, we recommend making it standard practice to write accommodations into students’ individualized education programs.
For a student who stutters, the accommodation list could be something like: “Due to difficulties with speech production, oral reading fluency should be assessed through an alternate method (such as a silent reading test).” For students who wish to be assessed in the “regular way,” but whose measures would be invalid because of their stuttering, we recommend IEP language such as: “This student’s oral reading fluency measures may be compromised due to a fluency disorder, and thus these results are not to be used for educational placement purposes.”
Enhance collaboration
Taking care of students on your own caseload is one thing, but how do you get the word out to others involved in reading assessment? Classroom teachers and paraprofessionals—typically in charge of administering tests—may be unaware that children with speech fluency and motor speech disorders need alternative oral reading fluency assessment.
To increase awareness, we recommend starting with district-wide training for all involved in the reading assessment process. Provide information about how to identify an issue with speech fluency or speech motor coordination and the reasons that standard oral reading fluency measures would not provide an accurate picture for those students. Use a story like Jaylin’s as an example of the potential far-reaching effects of using only measures of oral reading fluency as the basis for inappropriate interventions or reading group levels.
We also hope to see SLPs spreading the word of this issue and possible solutions to other SLPs in other districts, encouraging them to educate the professionals in their districts. It’s important to stress, even with other SLPs, that because of the variable nature of stuttering and motor-speech disorders, we need to provide alternate measures of oral reading fluency assessment, regardless of whether or not the child is having a “good speech day.”
To help SLPs increase their knowledge of the issues surrounding assessment of oral reading fluency in children with communication disorders, our committee plans to disseminate full results of the survey in various journals over the next year. Also, workshops at ASHA’s schools conference, ASHA’s annual convention and various state conventions will cover practical strategies for managing these situations.
It’s unfair to children to administer an inappropriate assessment and make intervention and placement decisions based on the results. But by taking the time to learn about the assessment process and identify the correct tools and guidance, professionals can work together to avoid problems for students like Jaylin.
July 3, 2014
Monica Ayrod-Waasdorp
Preaching to the choir
I have fought this battle for years. Finally the compromise, I test my students and use professional judgment for time and score. It doesn't solve the stress issue but my students are not penalized by someone who can't distinguish reading and speaking dysfluencies.
July 3, 2014
Sharon Gretz
Excellent Article: Concept Needs Expanded
This was an excellent article discussing the ramifications of inappropriate assessments! I would urge other ASHA members to consider the same thing as it relates to children diagnosed with Childhood Apraxia of Speech. Parents report to us frequently about the use of DIBELS and other oral fluency assessments for children who, by sheer nature of their speech/communication disability, are unable to read fast and then quickly their confidence is shattered. Children with CAS who are experiencing continued speech motor planning issues also should not be given these assessments! Thank you for this article!
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July 2014
Volume 19, Issue 7