Stuttering Therapy - Post-therapy Recurrence of Stuttering

Post-therapy Recurrence of Stuttering

Every clinician who has worked extensively with adult stutterers has encountered the tendency for the stutterer to begin to stutter again after treatment has helped the person talk with little or no stuttering; only preschool children seem immune from this tendency. It has been suggested that this return to stuttering be avoided by dealing with a stutterer's fears during therapy.

For example, stutterers whose speech had been improved by fluency shaping techniques may stutter again if he becomes tired of the effort involved in trying to maintain a nonspontaneous, unnatural form of speaking; the stutter itself was never dealt with in the first place. While attempts may be made to render the learned manner of speech more natural-sounding and less burdensome, these attempts cannot address the problem that the new way of speaking does not feel right to the stutterer, which may lead him to decide to return to his pre-therapy manner of speech. Moreover, experts have argued that fluency shaping is stuttering in a new form, and Starkweather (1998) asserts that the return of stuttering is a fault of the treatment.

Additionally, there is a tendency for stuttering behaviors to return after stuttering modification therapy. While this type of therapy requires less effort that in fluency shaping, some concentration nonetheless needs to be applied. Moreover, a client that feels as if he has been cured of stuttering and stops doing the various exercises associated with the treatment may develop "microstutters", which lead to the use of avoidance behaviors that increase the fear of stuttering further, which in turn leads to more severe stuttering. The main issue is that the fear of stuttering was not removed by therapy in the first place. If the microstutters were simply accepted as a reality, or if voluntary stuttering were used to prevent the development of new fears, the microstutters may occur but a relapse into severe stuttering may not.

In another form of recurrence, a stutterer who has undergone therapy has an emotional reaction to a situation as a result of previous experiences, that causes him to stutter. This is often related to "struggles and forcing learned when the stutterer was very young". The solution to this is to resurrect and focus on as much "unfinished business" as can be found during therapy, which may, for example, include dealing with a fear of reading aloud in front of a group that is related to avoidance and humiliation experienced in similar childhood situations. Clinicians trained in experiential techniques know how to find such "business" and "finish" it.