Problems in the Evaluation of Progress and Outcome

Abstract

In the Devil's Dictionary, Ambrose Bierce defined outcome as "a particular kind of disappointment." That speechlanguage clinicians are discouraged about the results of working with stutterers, at all ages, is practically a chronic condition of the profession. On the other hand, success percentages claimed by many current writers on stuttering, particularly those following operant approaches, are highly optimistic. In his recent presentation to the Atlanta meeting of ASLHA, Andrews reassured the assembled experimenters that they were doing very well, better in fact, than psychiatrists in treating the problems they address (Andrews, 1980). That may be so, but are the operant workers entitled to such a bouquet? Why such a discrepancy between rosy reports in the operant literature and the commonly bleak experiences of public school clinicians? The evaluation of outcome in either therapy with stuttering, or with psychotherapy, is not as simple a matter as much of the burgeoning operant literature implies. The stutterer presents many problems beyond those typical of psychotherapy cases, despite the deceptively easy availability of frequency measures. We have chosen to respond to the invitation to participate in this monography assessing some of these problems. Since we have not seen the contributions of others to this issue, this writing is not specifically responsive to theirs. Rather, we wish to express broader concerns about the flotation of success claims.