CALMS Rting Scle for School-Age Children Who Stutter This rting scle is designed to evlute cognitive, ffective, linguistic, motor, nd socil (CALMS) components tht re relted to stuttering. It is recommended tht clinicins bse their clinicl judgment on deriving score for ech item using scores nd/or dt from scles, tests, s well s documented evidence bout the child being evluted. Tke the scores for ech rted item nd divide by the totl number of items scored within ech component to obtin n verge score for ech component. The verge component scores become the dt points for plotting the CALMS profile. COGNITIVE: (Rting scle: 1= Norml, No Concern, High Ability 2= Borderline, Slight Concern, Good Ability 3 = Mild Impirment, Some Concern, Vrible Ability 4= Moderte Impirment, Significnt Concern, Poor Ability 5 = Severe Impirment, Extreme Concern, Very Poor Ability) Recommended items to be rted: 1. Child s bility to identify moments stuttering 1 2 3 4 5 Mesure: % of moments identified from reding pssge nd/or spontneous speech smple 2. Child s thoughts nd concerns bout being person who stutters 1 2 3 4 5 Mesure: Rte responses to questions such s How concerned re you bout your sp? How much do you think bout your stuttering ech dy? Wht hppens when you stutter? How often does it hppen? Are there ny tricks you use to tlk esier? 3. Child s rections bout how others view his/her stuttering Mesure: Rte the degree of concern the child hs bout rections from his fmily, peers, or techers hve to his stuttering 1 2 3 4 5 4. Child s knowledge nd understnding of stuttering nd/or Tx techniques 1 2 3 4 5 Mesure: Here s Wht I Think (C & R workbook) nd explntions, drwings, demonstrtions of techniques s well s informtion bout bsic fcts bout stuttering (e.g. mle/femle rtio, prevlence of stuttering, etc. ) Averge Cognitive Component Score: When evluting thoughts nd perceptions, rting of 1 refers to positive thoughts/ no concerns bout being person who stutters nd positive perceptions of how others view stuttering. A rting of 5 reflects extremely negtive thoughts, rections or perceptions. Use rtings 2-4 to reflect vrying degrees of positive/negtive thoughts nd rections. Wht s True For You is one of severl pper-pencil tsks suggested by Kristin Chmel nd Nin Rerdon (2001) The School-Age Child Who Stutters: Working Effectively With Attitudes nd Emotions A Workbook (pp. 22-86). Other pper nd pencil tests from this book will be cited in other fctors within this rting scle. This workbook is published by the Stuttering Foundtion of Americ (1-800-992-9392). Child Client Forms in Crowe s Protocols (T. Crowe, A, Di Lollo, & B. Crowe (2000) The Psychologicl Corportion) lso cn be used.
AFFECTIVE: (Rting scle: 1= Norml, No Concern, High Ability 2= Borderline, Slight Concern, Good Ability 3 = Mild Impirment, Some Concern, Vrible Ability 4= Moderte Impirment, Significnt Concern, Poor Ability 5 = Severe Impirment, Extreme Concern, Very Poor Ability) Recommended items to be rted: 1. Level of child s positive/negtive ttributes of self 1 2 3 4 5 Mesure: Importnt Stuff About Me (C & R workbook) Note percentge of positive nd negtive words used to describe him/herself A greter number of negtive comments bout self contributes to higher rting. 2. Child s ttitudes nd feelings bout communiction 1 2 3 4 5 Mesure: Communiction Attitudes Test (CAT or CAT-R) record score nd compre to norms. 3. Affective fetures of the child s stuttering b Lbels child uses for ttitudes/feelings bout stuttering 1 2 3 4 5 Mesure: Frming My Speech (C & R workbook) this form could be used to count the number nd types of words used to describe stuttering Child s feelings bout stuttering 1 2 3 4 5 Mesure: Wht Pops nd/or Wht s True For You? (C & R workbook) Wht Pops could be used to determine the % of the 20 items tht relte to negtive comments bout stuttering. Wht s True could rte this item bsed on child s scores on ll questions. Child s feelings bout others rections to stuttering 1 2 3 4 5 (e.g., rections to prent nd peer comments, tesing, etc.) Mesure: Rte whether the child s rections to stuttering re positive or negtive.the greter the number of negtive comments, the higher the rting. Averge Affective Component Score: Use of the Communiction Attitudes Test (CAT or CAT-R) nd/ or A-19 scles requires comprison of child s score with normtive dt supplied with ech mesure. We recommend tht if the child who stutters (CWS) hs score tht equls the men for CWS, then tht score would be rted t lest 3 on the CALMS rting scle. [For CWS the CAT Men=17.3, SD=7.7 nd A-19 Men=9.07, SD=2.44]. Scores between 1 & 2 stndrd devitions from the men score for CWS would be rted 4 nd score of more thn 2 stndrd devitions would be rted 5. b Child Client Forms in Crowe s Protocols (T. Crowe, A, Di Lollo, & B. Crowe (2000) The Psychologicl Corportion) lso cn be used
LINGUISTIC: (Rting scle: 1= Norml, No Concern, High Ability 2= Borderline, Slight Concern, Good Ability 3 = Mild Impirment, Some Concern, Vrible Ability 4= Moderte Impirment, Significnt Concern, Poor Ability 5 = Severe Impirment, Extreme Concern, Very Poor Ability) Recommended items to be rted: 1. Overll reltionship between stuttering nd the length nd complexity of utternces: 1 2 3 4 5 Mesure: Assess level of fluency/stuttering during simple orl reding, nming, sentence repetition, picture description, nd story retelling. 2. Overll lnguge bility Mesure: Informl or forml ssessment) b 1 2 3 4 5 3. Articultion nd/or Phonologicl bility 1 2 3 4 5 Mesure: Informl or forml ssessment) c 4. Word finding/expressive/receptive vocbulry bility 1 2 3 4 5 Mesure: Informl or forml ssessment) d Averge Linguistic Component Score: The Stocker Probe (Stocker, 1995) could be used to rte performnce in this ctegory. (The Stoker Probe is published by The Speech Bin). Or, go to www.unl.edu/fluency for list of simple to complex, contextulized nd decontextulized speech tsks. The rting for this item will depend on the level of linguistic length nd complexity where fluency disruptions occur consistently (e.g., rting of 1 would indicte tht stuttering only occurs t the highest level of lingiuitic difficulty nd 5 would be rting for stuttering consistently t simple linguistic levels or where the child needs considerble contextul support). b Select forml lnguge tests for this section. Rte level of impirment. c Select forml test for rticultion/phonologicl process nlysis. Rte level of impirment d Suggested forml tests for this ctegory include EOWPVT, PPVT-3. Rte level of impirment
MOTOR: (Rting scle: 1= Norml, No Concern, High Ability 2= Borderline, Slight Concern, Good Ability 3 = Mild Impirment, Some Concern, Vrible Ability 4= Moderte Impirment, Significnt Concern, Poor Ability 5 = Severe Impirment, Extreme Concern, Very Poor Ability) Recommend Items to be rted: 1. Chrcteristics of the child s stuttering 1 2 3 4 5 Mesure: Document number of units per repetition, durtion of typicl prolongtion, etc. Mesure: Degree of struggle, effort, tension produced during stuttered moments 1 2 3 4 5 2. Frequency of stuttering with vrious communictive prtners Mesure: Smple with clssroom techer 1 2 3 4 5 Mesure: Smple with peers 1 2 3 4 5 Mesure: Smple with clinicin 1 2 3 4 5 3. Presence of Secondry Coping Behviors Mesure: Number nd type of behviors, plus subjective rting of severity 1 2 3 4 5 of these behviors 4. Frequency of stuttering: Mesure: Orl reding nd spontneous speech smple 1 2 3 4 5 (Rtings for SSI-3) 1 2 3 4 5 5. Durtion of disfluent moments Mesure: Averge of three longest stuttering events 1 2 3 4 5 6. Clinicl impression of overll speech motor control b Mesure: Speech rte nd/or didochokinetic rtes 1 2 3 4 5 Averge Motor Component Score: Frequency nd durtion of stuttering re mesured in the SSI-3 (Stuttering Severity Instrument-3). If the SSI-3 is used, do not rte frequency nd durtion of stuttering items on this prt of the CLAMS rting scle. Use the following rtings to reflect the totl SSI-3 score: (1= 0-5) (2= 6-10) (3=11-20) (4=21-27) (5= 28+). b The OMAS by Riley nd Riley (1985) could be used to rte this ctegory.
SOCIAL: (Rting scle: 1= Norml, No Concern, High Ability 2= Borderline, Slight Concern, Good Ability 3 = Mild Impirment, Some Concern, Vrible Ability 4= Moderte Impirment, Significnt Concern, Poor Ability 5 = Severe Impirment, Extreme Concern, Very Poor Ability) Recommended items to be rted: 1. Reported voidnce of speking situtions Mesure: Reports from child, prent, techers bout number nd severity of voidnce of words, people, nd speking situtions 1 2 3 4 5 2. Frequency of stuttering in curriculr nd extrcurriculr ctivities: Mesure: Reports of the frequency of stuttering: In cdemic subjects (mth, science, lnguge rts) 1 2 3 4 5 In non-cdemic subjects (music, bnd, PE) 1 2 3 4 5 In extrcurriculr ctivities (e.g., clubs, sports, dnce, etc) 1 2 3 4 5 3. Child s bility to meet district curriculum objectives relted to orl performnce Mesure: Reports from child s techers 1 2 3 4 5 4. Impct of stuttering on peer reltionships Mesure: Report from child nd prent bout how much the child s stuttering is ffecting the friendships or interction with peers. 1 2 3 4 5 Averge Socil Component Score:
Quntifiction of 1-5 Vlue for the CALMS Rting Scle 1 = Norml: Function is considered within norml limits in terms of behvior, performnce, bility, ttitude or perception. There re no concerns bout function or performnce. Test dt re well within norml limits. 2 = Borderline: Slight vrition or some concern bout behviors, performnces, bilities, ttitudes or perceptions. Test dt show stndrd score of.5 to 1.4 SD below norml level 3 = Mild Impirment: Clinicl judgment suggests mild degree of difficulty or deficit in certin functions. Also suggests tht behviors, performnces, bilities, ttitudes or perceptions re just below expected levels of function. Mild concern bout function or performnce. Test dt show stndrd score of 1.5-1.9 SD below norml level. 4 = Moderte Impirment: Clinicl judgment suggests moderte degree of difficulty in certin functions. Also suggests tht behviors, performnces, bilities, ttitudes or perceptions re consistently below expected levels of function. Test dt show stndrd score of 2.0 2.4 SD below norml level. Significnt concern bout function nd performnce. 5 = Severe Impirment: Clinicl judgment suggests severe degree of difficulty in certin functions. Also suggests tht behviors, performnces, bilities, ttitudes or perceptions re substntilly below expected levels of function. Exceptionl concern bout function or performnce. Test dt show stndrd score of > 2.5 SD below norml level.
C.A.L.M.S. Profile Client: Scores: Cognitive: Age: Affective: Dte of Profile: Linguistic: Motor: Socil: 5 4 3 2 1 0 Cognitive Affective Linguistic Motor Socil