ACQ Vol 13 no 2 2011

Results of the study showed that overall the raters’ judgements of WVQ were not sensitive to the presence of material in the larynx. Only two of the five raters identified wet phonation samples significantly more when material was present in the larynx. Furthermore, interrater reliability between pairs of raters was variable and overall interrater reliability indicated only slight agreement. The results of this study suggest the use of vocal wetness alone as a clinical indicator for aspiration risk is insufficient, and highlights the need for dysphagia clinicians to also evaluate post-swallow voicing for other perceptual changes to phonation that may result from material in the larynx (e.g., roughness, hoarseness). Limitations associated with high variability of clinician ratings of vocal quality and the need for the development of careful perceptual characterisation of the vocal consequences of material in the larynx should also be recognised. Assessing quality of life in stuttering Yaruss, J. S. (2010). Assessing quality of life in stuttering treatment outcomes research. Journal of Fluency Disorders , 35 , 190–202. Charn Nang It is generally well accepted that stuttering is a complex disorder that involves not only the overt stuttering behaviours that can be seen (i.e., secondary non-verbal features of stuttering) and heard (i.e., disruptions in flow of speech), but also the features that underlie the disorder. A well-known analogy illustrating such complexity comes from Sheehan (1970) who coined the iceberg concept of stuttering, highlighting the not-so noticeable features of stuttering including negative behavioural and cognitive reactions associated with stuttering that a speaker may experience. Yaruss began exploring the impact of stuttering on an individual’s life in the late 1990s and developed the Overall Assessment of the Speaker’s Experience of Stuttering (OASES; Yaruss & Quesal, 2006) to measure that impact. The OASES is based on the International Classification of Impairments, Disabilities, and Handicaps (ICIDH; WHO, 1980), and subsequently the International Classification of Functioning, Disability, and Health (ICF; WHO, 2001). This framework was identified as useful for describing the consequences of stuttering and for evaluating the outcome of treatment (Yaruss, 1998; Yaruss & Quesal, 2004). In this article, Yaruss emphasises the measurement of the experiences of stuttering for an individual and argues that measures of these experiences should be an important treatment outcome in addition to measures of impairment (i.e., overt stuttering behaviour). Yaruss focuses on the concept of quality of life (QOL) as a “construct that is broad enough to account for many aspects of the speaker’s experience of the stuttering disorder,” (p. 192). He defines QOL as satisfaction with communication, taking into account the degree of interference with relationships, interference with employment, and interference with other aspects of life experience. He then presents preliminary data to support the position that people who stutter do experience reduced QOL and that QOL can be used as a measure of treatment outcome. Improving the QOL of clients is essentially the crux of speech pathology and any tool that can assist in measuring

the social impact of communication disorders on individuals should be valued and utilised. This article is the next step forward for validation of the OASES which has been a journey spanning over a decade for Yaruss and colleagues. Yaruss concluded that ongoing validation of the OASES is required and that development of a version for children and adolescents who stutter is already underway. References Sheehan, J. G. (1970). Stuttering: Research and therapy . New York: Harper & Row. World Health Organization. (1998). The International classification of impairments, disabilities, and handicaps: A manual of classification relating to the consequences of disease . Geneva: World Health Organization. World Health Organization. (2001). The international classification of functioning, disability, and health . Geneva: World Health Organization. Yaruss, J. S. (1998). Describing the consequences of disorder: Stuttering and the International Classification of Impairments, Disabilities, and Handicaps. Journal of Speech, Language and Hearing Research , 41 (2), 249–257. Yaruss, J. S., & Quesal, R. W. (2004). Stuttering and the international classification of functioning, disability, and health (ICF): An update. Journal of Communication Disorders , 37 , 35–52. Yaruss, J. S., & Quesal, R. W. (2006). Overall assessment of the speaker’s experience of stuttering (OASES): Documenting multiple outcomes in stuttering treatment. Journal of Fluency Disorders , 31 , 90–115. Friberg, J. C. (2010). Considerations for test selection: How do validity and reliability impact diagnostic decisions? Child Language Teaching & Therapy , 26 , 77–92. Chris Brebner This is a timely and clinically relevant article from US author Jennifer Friberg. This easy-to-read article outlines a study which aimed to evaluate the overall psychometric validity of nine preschool and school-age language assessment tools. The tests used were selected from a large pool of commercially available assessments and were selected because of their established identification accuracy (i.e., the tools could accurately diagnose language disorder). Of particular relevance for the Australian context was the inclusion of the widely used Clinical Evaluation of Language Fundamentals (4th ed.) (CELF-4; Semel, Wiig, & Secord, 2003), the Clinical Evaluation of Language Fundamentals Preschool (2nd ed.) (CELF-P2; Wiig, Secord, & Semel, 2004), the Preschool Language Scale (4th ed.) (PLS-4; Zimmerman, Steiner, & Pond, 2002) and the Test of Narrative Development (Gillam & Pearson, 2004). Each of the assessments were reviewed using criteria based on those from McCauley and Swisher (1984); each tool was evaluated against 11 psychometric criteria. These criteria included whether the purpose of the assessment was adequately explained in the test manual, whether the standardisation sample was adequate, and whether measures of validity and reliability were provided. It was interesting that none of the assessment tools met all of Validity and reliability considerations in test selection

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ACQ Volume 13, Number 2 2011

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