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From: Ken St. Louis
Date: 22 Oct 2007
Time: 14:39:53 -0500
Remote Name: 157.182.15.19
Dear Jen, You are asking questions that many, many speech-language pathologists ask. I will try to reply in two ways: (1) with my best answers and (2) with some questions of my own. Since stuttering often runs in families, we can generally say that a person's prognosis, especially for spontaneous recovery as a child, is most likely negatively affected by having one or more close relatives who stutter. "Cures" for stuttering, i.e., forgetting all about stuttering and never stuttering again, is not at all uncommon among preschoolers who stutter, but it is not very likely after a person reaches adolescence. Late recoveries can happen, but I don't think I would lead the client to expect it PROBABLY WILL happen. There are some people who believe that you can make a person who is a chronic stutterer totally "fluent" from therapy. I have seen that happen, and in fact, and almost that fluent myself. But this is a controversial area. Just because a person can speak without stuttering, e.g., with fluency shaping, does not mean that he or she will never stutter. Sometimes the person simply cannot exercise that degree of mental effort or control all the time. Sometimes, life situations change such that the person experiences increased stress (not uncommon in adolescence). We all wish we could "fix" all of our clients such that they would never again suffer from their communication disorders. Unfortunately, most of our disorders (with a few exceptions) don't work that way. Therefore, I don't think you have failed in terms of learning the wrong strategies. Stuttering IS often chronic, and some stutterers spend a good portion of their life going back from time-to-time to get refresher skills. The second part of my response deals with the question, "Why do we as SLPs think that we should be able to cure all stutterers?" I have taken the liberty to change your question to make a point. Here it is: "Hello...I have several students that I have been working with who have had speech therapy for a number of years prior to working with me. (I'm at a middle and high school.) At what point does a language disorder became something that they will live with for the rest of their lives? Can a language disorder be totally "fixed" even after a person has had it since being a toddler? Also, what is the impact of also having a family member with a language disorder? Maybe it's me, but I have never totally "fixed" an adolescent who has a language disorder. Do I not have the correct tools? Is this something they will have to deal with for the rest of their lives and that is the reason for providing them with strategies?" Jen, how would you answer these questions? Good luck with your work. You are clearly a caring person who is asking important questions. Hopefully my answers--and maybe my questions--might put this into a realistic and helpful perspective. Ken