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From: Luc De Nil
Date: 10 Oct 2007
Time: 21:11:10 -0500
Remote Name: 24.197.196.252
I think that the definition of stuttering as a fluency disorder that is characterized by frequent repetitions of sounds or syllables, sound prolongations and blocks is well accepted now in the literature. Unfortunately, when it comes to neurogenic stuttering patients will sometimes show these characteristics as part of their apraxic or aphasic impairment and the differential diagnosis is not always easy to make. Not infrequently, clinicians working with neurogenic communication disorders such as stroke or TBI will say that they have never seen a patient with neurogenic stuttering. That is, until you either tell them the symptoms or show them some examples of patients with neurogenic stuttering, and all of a sudden, they start to recognize it in their clinical practice. My guess is that previously they just did not recognize it as neurogenic stuttering but saw it as a symptom of whatever other communication impairment was present. Of course, this raises the question who is correct!? Indeed, some patients labelled as neurogenic stuttering can show some very atypical disfluency patterns that do not seem to conform to the typical pattern seen in people with developmental stuttering - is it a different form of stuttering? or not stuttering at all? I realize this must be frustrating for clinicians who need to put a label on a disorder for reimbursement or other purposes. But I hope that my call to action on more focused and intense research in this area will provide answers to at least some of these questions.