Classification of child stuttering: Part II. Persistent late onset male stuttering, and treatment issues for persistent stutterers--psychotherapy or speech therapy, or both?

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This paper is the second of a two-part study. Part I of this study presented child stuttering as a psychologically heterogeneous population so classified: transient developmental, neurogenic acquired; and persistent stuttering. In Part II, parental patterns, ego functioning and psychodynamic etiological factors are described for a group of 16 “persistent late onset male stutterers.” Specific psychotherapeutic approaches for the persistent late onset male stutterer highlights the need for the exposition and resolution of a partial negative oedipal fixation as well as the acknowledgement and relinquishment of significant narcissistic claims whose awareness is defended against by the use of the stuttering symptom. Specific psychotherapeutic techniques are described for all male and female persistent stutterers. The issue of psychotherapy versus speech therapy is addressed. The need for ongoing collaboration between child psychiatrist and speech pathologist is multiple: to address when a child psychiatry evaluation is needed, in order for the heterogeneity of stuttering to be recognized, and for further research to develop.