Test of Childhood Stuttering (TOCS)
Authors: Ronald B. Gilliam, PhD, CCC-SLP / Kenneth J. Logan, PhD, CCC-SLP / Nils A. Pearson, PhD
The Test of Childhood Stuttering assesses speech fluency skills and stuttering-related behaviors in children. It helps identify children who stutter, determine the severity of the stuttering, and document changes in speech fluency over time. The TOCS has three major components:
Standardized Speech Fluency Measure: Four subtests rate speech fluency:
Rapid Picture Naming: Children name a series of 40 pictures as quickly as possible.
Modeled Sentences: Children are shown two pictures differing in one important detail. The examiner says a sentence about one of the pictures. Children are to produce sentences that contain the same syntactic structure of the sentence the examiner has modeled.
Structured Conversation: Children are asked to answer open-ended questions about a sequence of eight pictures.
Narration: Children are to generate a story that is based on the picture cards used in the Structured Conversation subtest.
Observational Rating Scales: The Speech Fluency Rating Scale and the Disfluency-Related Consequences Rating Scale provide information about stuttering and related behaviors from parents, teachers, and other individuals who have known the child for an extended period of time.
Supplemental Clinical Assessment: Eight supplementary fluency-related assessments enable examiners to probe disfluency-related data in greater detail: (1) clinical interviews, (2) comprehensive analysis of disfluency frequency and types, (3) speech rate analysis, (4) disfluency duration analysis, (5) repetition length analysis, (6) associated behavior analysis, (7) stuttering frequency analysis, and (8) speech naturalness analysis.
The TOCS was normed on a sample of 173 typically developing children and 123 students identified as stutterers. Statistical analysis produced coefficient alphas for internal consistency ranging from .76 to .98 on the Speech Fluency Measure subtests, and .83 to .93 on the two rating scales. Test-retest coefficients exceeded .90 for the Speech Fluency Measure and .85 for the two rating scales. Interrater reliability exceeded .90 on all components of the assessment.
Administration and Scoring
Administration time is 20-30 minutes. Raw scores for the four subtests on the Standardized Speech Fluency Measure are used to identify the severity level (Typical Fluency, Mild Disfluency, Moderate Disfluency, or Severe Disfluency) and are converted to an index score and percentile rank.