Classification of child stuttering: Part I. Transient developmental, neurogenic acquired, and persistent child stuttering.

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A historical and current review of theories and treatments of child stuttering reveal a dichotomy between psychiatrists who support the view that all stutterers have a psychoneurosis, and the speech pathologist who supports the view that all stutterers are psychologically normal. The chronological development of stuttering and the phenomenology of the disorder are presented and point to stuttering as representing a psychologically heterogeneous population; transient developmental stuttering (developmental deviation versus developmental interference), neurogenic acquired stuttering, and persistent stuttering. The author, a child psychiatrist, psychiatrically studied 30 persistent child stutterers, mostly referred from speech pathology outpatient clinics. Eighty percent were boys, and all had been stuttering for at least nine months and 95 per cent had a prior period of speech therapy that was unsuccessful in ameliorating stuttering. None were mentally retarded, borderline or psychotic. Three classes of persistent child stuttering are distinguished: early onset male stuttering, female stuttering, and late onset male stuttering. Persistent early onset male stuttering is described on the basis of “silently cumulative” parental patterns, child's level of developmental conflict, and psychodynamic etiological factors.