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From: Nathan Lavid
Date: 10/6/02
Time: 10:28:24 PM
Remote Name: 66.171.52.66
Maggie,
You’re right about the flip side of the percentages, and 20%-40% of adults do not have significant improvement with speech therapy. Though, I believe speech therapy is still of benefit in these refractory patients. The patients that I treat in my practice are typically refractory to speech therapy to some extent. In these patients, I augment the speech therapy with medications directed at decreasing anticipatory anxiety and increasing fluency. Sometimes, I offer cognitive-behavioral therapy to help diminish the anxiety.
I’ve had success with this approach. While there are no studies of this integrated approach to developmental stuttering, other brain-based conditions, such as depression and obsessive-compulsive disorder, have the highest rate of response when an integrated approach is implemented.
As for your question concerning aphasic patients, the response to treatment depends on the underlying etiology. For example, if the aphasia is due to a stroke the extent of damage caused by the stroke is the best prognostic factor. Thank you for the comments, Nathan