AJSLP Review Integrating Functional Measures With Treatment: A Tactic for Enhancing Personally Significant Change in the Treatment of Adults and Adolescents Who Stutter Roger J. Ingham, a Janis C. Ingham, a and Anne K. Bothe b Purpose: It is proposed that stuttering treatment, particularly for adults and adolescents who stutter, may benefit from more inventive and extensive use of functional measurement— measures that are also treatment agents. Such measures can be tailored to produce more personally significant and evidence-based treatment benefits. They may be especially useful when employed in conjunction with partial self-management and performance-contingent procedures. Method: Previous approaches to the definition of stuttering treatment goals and the measurement of stuttering treatment outcomes are critically reviewed. Suggestions for improvements are presented within the framework of an evidence-based and relatively standardized stuttering treatment. Results and Conclusion: Results from a review of exist- ing literature and from 2 case studies show that 2 specific personally significant problems, saying one’s name and addressing large audiences, were improved by implementing these strategies in treatment. Functional measures directly connected to treatment, and partially self-managed perfor- mance-contingent schedules, merit further research as methodologies that are suitable for conducting personally significant and evidence-based treatments with adults and adolescents who stutter. Key Words: stuttering, personal significance, evidence- based practice, self-management, performance-contingent, maintenance, treatment outcomes B othe and Richardson (2011) recently introduced the term personally significant to refer to treatment outcomes that are demonstrably of value to the client who underwent that treatment. As they wrote, it has long been recognized from many academic and therapeutic points of view that, in many cases, the client may be in the best position to judge whether any putatively therapeutic pro- cedure resulted in a desirable and valued outcome. The term clinical significance has been used to refer to some similar ideas, but the value in separating clinical significance from personal significance lies in the distinction between the clinician’ s or researcher ’ s judgments and the client’ s own personal assessment of the worth of an achieved treatment outcome. 1 Such assessments require, at the very least, def- initions and measurement procedures that can result in valid and reliable data about the clinical goals that were achieved and the value placed on those achievements by a client. In a critical review of measures used in the behavioral sciences, Blanton and Jaccard (2006) highlighted similar a University of California, Santa Barbara b University of Georgia, Athens Correspondence to Roger J. Ingham: rjingham@speech.ucsb.edu Editor: Carol Scheffner Hammer Associate Editor: Marilyn Nippold Received July 7, 2011 Revision received November 29, 2011 Accepted March 29, 2012 DOI: 10.1044/1058-0360(2012/11-0068) 1 In recent years, two other concepts appear to have addressed personal and clinical significance: (a) that treatment should be shown to result in a socially valid outcome, and (b) that treatment should relieve the client’ s point of complaint (i.e., the precise reason why the client sought treatment). These concepts were embraced by treatment researchers because, ostensibly, they focus attention on whether the treatment “ makes a real (e.g., genuine, palpable, practical, noticeable) difference in everyday life to the clients or to others with whom the clients interact ” (Kazdin, 1999, p. 332). Given the now wide-ranging use of other persons (e.g., family and friends) to evaluate stuttering, it seems fair to argue that social validity is almost a cornerstone of current treatment outcome studies. However, the reactions or evaluations of the client’s community do not necessarily mean that the outcome addresses personal concerns or complaints. Baer’ s (1988, 1990) point of complaint idea was clearly directed toward what the individual considered to be the problem. That concept was taken up by many researchers involved with stuttering treatment research, but there is no evidence that it actually generated specific investigations. American Journal of Speech-Language Pathology • Vol. 21 • 264–277 • August 2012 • A American Speech-Language-Hearing Association 264