Is it possible for speech therapy to improve upon natural recovery rates in children who stutter?

Abstract

Speech and language therapists treating children who stutter appear to be assigned a difficult task. Natural spontaneous remission accounts for approximately 60-80% of all children recovering from stuttering. Despite our best efforts, no protocol has ever shown its effectiveness separate from natural recovery rates (i.e. 60-80%). Although speech and language therapists have used a vast array of therapeutic protocols, the incidence and prevalence of childhood stuttering appears to have remained unchanged. Therefore, although in possession of multiple treatment tools, speech and language therapists might be ill-equipped to treat stuttering children effectively and efficiently to the point of recovery. To assess speech and language therapists' self-reported perceptions of their success in helping children 'completely recover from stuttering' (i.e. no longer exhibiting any overt or covert stuttering symptoms or using therapeutic strategies to modify speech and no longer being viewed by themselves or anyone else as a 'stutterer'). A questionnaire was sent to 290 speech and language therapists providing stuttering therapy to children attending school in North Carolina, USA, in a system similar to what can be found in many other US states. It addressed therapeutic efficacy in the management of stuttering: the numbers of stuttering children treated and those perceived to be recovered, the therapeutic methods, the time spent in practice, therapy durations and schedules. Usable questionnaires were returned by 101 respondents who reported treating a total of 2036 children who stutter. They reported using a full array of techniques known to reduce stuttering. The median reported recovery rate among respondents was 13.9%. Twenty-eight respondents reported no recoveries whatsoever, and 81 reported five recoveries or fewer. The median time spent on a caseload was 3 years. In addition, longer practising therapists reported significantly higher recover rates than those with less time practising. Remission from stuttering in children being treated in the schools of North Carolina appears to be the exception rather than the rule. The reported recovery rates suggest that not much is being done therapeutically to help children recover from stuttering. The chance of recovery decreases with age, and speech therapy for children who stutter appears to do little to improve their odds of recovery. Speech and language therapists treating these children either do not possess the tools or the tools do not yet exist to change 'nature's recovery agendum' and put children who stutter on the path towards natural sounding, fluent and spontaneous in all situations. As such, the provision of therapy, in North Carolina at least, does not yet allow for stuttering children to shed the label of 'stutterer', in their own eyes and in the eyes of all others for the rest of their lives. In light of these data, the authors suggest re-examining the tools, policies and procedures used in the treatment of stuttering children.