What does the WHO say about stuttering?
The World Health Organization does not specifically define stuttering, or propose a treatment plan for stuttering. It does, however, present a framework that can be immensely helpful to understand the impact of stuttering on any given person: the International Classification of Function, Disability, and Health (the WHO ICF; 2001). It offers a framework of stuttering assessment and treatment which is important in several ways:
Assessments include not only a description of the behaviour itself (e.g. what happens when the person stutters) but also attitudinal and environmental factors (e.g. how others react to their stutter, how their school or workplace is set up to minimize or maximize their success, their own thoughts and feelings about stuttering). For a person who stutters to function well in their life, all of these things must be considered in developing a treatment plan.
Treatment targets are selected based on the client’s needs, rather than determined by their clinicians. Clients whose normal interpersonal activities are more demanding (e.g. a professional voice user), or who use their voices for unique tasks (e.g. a voice actor) may have different requirements than people who work in jobs that do not require much speaking, or who are introverted and prefer to socialize less often.
Treatment is not based on the stuttering itself, but based on improving how well people can function in their day-to-day lives. For example, a person who can control their stutter using fluency shaping strategies may not stutter during a presentation, but may experience severe anxiety about whether or not they will lose control of their speech. A person who stutters heavily during a presentation but is not made anxious or uncomfortable by their stuttering may not feel impacted at all by their stuttering, even if an evaluation would determine that they have a severe fluency disorder.
The WHO ICF itself can be accessed at https://www.who.int/classifications/icf/icfbeginnersguide.pdf?ua=1 for those interested in learning more about this model of care.