ACQ Vol 13 no 2 2011

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ACQ Volume 13, Number 2 2011 99
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.
Validity and reliability considerations
in test selection
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
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