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Y'all ready for this?

Measuring adolescents’ readiness to change can provide a helpful place to start with stuttering intervention.

November 8, 2021

Conversation with a teenager:


Hey, how was your weekend? Fine. What did you do? Nothing. Ok sooo… ready to talk openly and productively about how the very personal topic of stuttering is affecting your life?  *Crickets*


Ouch. We’ve all been there—working with adolescents who stutter (or, really, any of them) can be daunting. This two-part study (see here and here) from Zebrowski, Rodgers, and colleagues is here to help you change how you help them change. 


First: what’s our goal, anyway? 


Informed by interviews with adolescent stutterers and SLPs who specialize in stuttering therapy, the researchers defined effective stuttering management as progress in these areas:

  • Learning and using speech strategies or techniques for speaking more fluently or stuttering with less tension or struggle
  • Changing negative thoughts and feelings about stuttering
  • Saying what you want to say without avoiding sounds, words, or situations


So we want to help our clients become fearless and effective communicators, but where do we start? 


Think about stuttering management as a stage-based process: 

  1. Precontemplation - I am not yet ready to make a change.
  2. Contemplation - I am thinking about making a change.
  3. Preparation - I am planning to make a change.
  4. Action - I am actively working on this change.
  5. Maintenance - I am working to maintain the change I have made and prevent regression.
Y'all ready for this?
Jennifer Yoshimura, MA, CCC-SLP

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Basically, we all go through these stages of change when we are going to address any behavioral change, like losing weight or quitting soda, and the researchers found that the same applies to adolescents’ readiness to work on how they live with stuttering. Identifying how ready adolescents are to address the affective, behavioral, and cognitive aspects of stuttering can guide us to find the best jumping-off-point for intervention. To help with this, the team created and validated three scales, available in the Appendices of this paper

  • Stages of Change (SOC) Scale - Places the individual at one of the five stages of change.
  • Decisional Balance (DB) Scale - Measures the importance of different “pros” and “cons” of addressing stuttering to the individual.
  • Situational Self-Efficacy (SSE) Scale - Measures confidence in the ability to implement change in difficult situations and persist through challenges.


"…helping an adolescent to unpack “the good” and “not so good things” about stuttering management is a fruitful avenue to explore in the clinical setting.”


– Rodgers et al., 2021


You can use the three scales as a springboard for conversation with adolescents about the pros and cons of making a change, as well as areas where they feel more or less confident about doing so. For example, they could be in the “contemplation” stage for changing negative thoughts and feelings about stuttering, but in the “action” stage for learning to speak more easily. Make sure you help them identify and emphasize the “pros” of making a change, as these were the most predictive of change readiness. Finally, expect that students might regress, or move backward on the stages of change. This is normal and should be part of the conversation.


Rodgers, N. H., Gerlach, H., Paiva, A. L., Robbins, M. L., & Zebrowski, P. M. (2021). Applying the Transtheoretical Model to Stuttering Management Among Adolescents: Part II. Exploratory Scale Validation. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2021_ajslp-21-00108 [available to ASHA members]

Zebrowski, P. M., Rodgers, N. H., Gerlach, H., Paiva, A. L., & Robbins, M. L. (2021). Applying the Transtheoretical Model to Stuttering Management Among Adolescents: Part I. Scale Development. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2021_ajslp-20-00186 [available to ASHA members]

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Christine McClary Jimenez, MS, CCC-SLP

Christine McClary Jimenez, MS, CCC-SLP

Christine McClary Jimenez is a writer for The Informed SLP. She is a speech-language pathologist who works in the public school system in Fort Worth, TX. She began her career as a bilingual elementary school teacher and is passionate about supporting equitable access to high-quality education for all students. Her professional interests include language and literacy development in bilingual populations, particularly dyslexia and phonological skills. Christine has a BA from Boston College and she completed her graduate work at Texas Christian University. In her free time, she loves baking, yoga and reading science fiction novels.
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