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Re: Spontaneous Recovery

From: Bob Quesal
Date: 10/18/00
Time: 5:26:37 PM
Remote Name: 143.43.201.96

Comments

Hello Beth:

This is an extremely difficult question to answer--I wonder why I'm even doing this, but I'll give it a stab....

There is a reasonable amount of controversy about the whole idea of "Spontaneous Recovery." (It's probably one of those terms that, over the years, has lost whatever usefulness it may have once had.) Depending on who/what you read and how you interpret findings, there may be as many as 80% (that's probably a very high estimate) of DISFLUENT children who go on to have normally fluent speech. Whether those children ever "stuttered," in the sense that I would use the term, is questionable.

By the time most SLPs see disfluent children, something has been going on long enough that the parents are concerned about the child's fluency. In some cases, parents may be overly concerned about normal disfluency (but that typically is not the case--the parents' concerns about their children's fluency are valid ones). I suppose (am I going out a limb here?) that for those parents whose children are truly showing normal disfluency, we could talk about the 80% who recover "spontaneously."

However, I see the issue of spontaneous recovery as being a dangerous one in that parents (and people who stutter) often hold out hope that their child (or they) will be one of those who "outgrow" stuttering. In last year's ISAD conference, there was a spirited debate about whether we should withhold treatment until we are sure that a child is showing signs that s/he is a "stutterer." The arguments on both sides are compelling (and made by folks a lot smarter than I am) but the notion that I kind of like is that if we provide intervention and the child spontaneously recovers, we haven't hurt the child by intervening. If we withhold treatment in the child who truly is at risk to stutter, we may be delaying valuable intervention.

I'm all over the place with this answer (I told you it was a tough question), but let me try to summarize:

Some disfluent kids will spontaneously recover--whether those kids represent a subgroup of "stutterers" is subject to question.

If we see any signs of possible stuttering in kids, I think it's a good idea to intervene. We may do very minimal or peripheral intervention, but I think we should do SOMETHING.

To tell parents that their child could spontaneously recover is dangerous, in my humble opinion, because it has the potential to delay treatment and set the parents up for disappointment.

So, my considered opinion would be that it's best not to talk about spontaneous recovery with parents. If they bring it up, I think we need to discuss it with then rationally, but make them aware of the many unresolved questions that surround the concept.

I sure hope someone else will help me out on this one! ;-)>

I hope this helps, at least a little bit.

Bob Q.


Last changed: September 12, 2005