Review by Jan Logan, speech and language therapist at City Lit.
At a study day on outcome measures organised by the Special Interest Group in Disorders of Fluency, Louise Wright and Anne Ayre presented WASSP. I was extremely impressed and awaited its publication in order to use it with clients at the City Lit in London where evaluation of the progress of students has increasing importance.
WASSP provides an assessment procedure which offers a simple yet reliable method of measuring change and therapy outcomes in adult stammering therapy. The manual is accessible and easy to follow.
The book begins with a brief summary of the background and development of the assessment as well as information about its reliability and validity. The method is clearly well tried and tested and our attention is drawn to the fact that the authors have involved people who stammer at all stages in the development of the profile. A description of the WASSP is given in this section and reference to relevant literature on stuttering is given.
The profile goes beyond looking at stammering behaviours. It includes reactions to stuttering as well as the social dimension, identifying possible disadvantage. The self-rating sheet identifies the following: behaviours, thoughts, feelings about stuttering, avoidance and disadvantage.
The following section explains the assessment process. It is quick and easy to administer with clear instructions and the results allow you to see change in visual or numeric form. The assessment uses clients' self-rating of change as they perceive it. Clients complete a self-rating sheet at the start and end of a period of therapy and rate, on a scale of 1-7, their perceptions of each of the aspects of their stutter identified above. At the end of a period of therapy, the client and therapist jointly transfer the results of both rating sheets to the summary profile chart where the use of highlighter pens provide a visual picture of change. Discussion between client and therapist forms a central part of the procedure, the purpose being to offer them both an opportunity to gain greater insight into what has changed and any implications this may have for therapy.
The procedure can be repeated at the beginning and end of consecutive blocks of therapy, thus providing a record of long-term change. It also might offer a record of the effects of breaks from therapy and/or that of self-help.
The manual comes complete with laminated copies of the self-rating sheet and summary profile chart/folder for photocopying. Useful examples of completed summary profiles and comments sheets of clients with different patterns of stammering are included in the appendix. The manual is attractive with a colourful glossy cover and fold-in flaps to secure photocopied rating sheets and profiles.
What I like about WASSP is that, in line with my own beliefs about therapy, the focus is not on changing speech alone but includes changes in feelings and attitudes towards stammering, offering qualitative information reflecting changes in these areas. The partnership approach for me fits well with my own model of therapy. I liked the idea of the assessment being a shared venture. While there is clearly some flexibility in terms of the depth of the discussion between client and therapist, it nevertheless is seen to be a vital part of the process. Discussion and self-reflection not only contribute to the findings but may have implications for the direction of future therapy. I felt the social dimension which acknowledges the possibility of disadvantage at home, in the workplace, educationally or socially to be a particularly important inclusion.
While there are a number of good questionnaires and tests available which can be used to measure change, I have tended to prefer the clients own self report written to headings which offers some qualitative information about the client's perceptions of what has changed for them. It seems to me that WASSP is an excellent tool for assessment and measuring outcomes and will be extremely beneficial for me as therapist and for clients. Because of its simplicity and accessibility for clients I can envisage my being able to incorporate it easily into my work and am keen to start using it.
'WASSP: Wright and Ayre Stuttering Self-Rating Profile' by Louise Wright and Anne Ayre. Published by Winslow Press.
From the Summer 2000 issue of 'Speaking Out'.