Prognostic factors in stuttering.

This paper seeks to review the phasic information in the literature on stuttering which concerns itself with prognosis. We know that many beginning stutterers overcome the problem without professional speech therapy. We also know that cures and improvement have been reported by clinicians using a wide variety of approaches. It is also clear that many stutterers do not improve either through self-help or with the help of speech therapists. A survey of the meager research and the many statements by clinicians concerning prognostic data would seem to have some usefulness at this time, if only to demonstrate the importance of the problem. Are there any Characteristics of the Normal Speech Shown by Stutterers which might have Prognostic Value? Wendahl and Cole49 have shown that the apparently normal speech of severe stutterers is characterized by irregularity in time and by more force and strain than that of normal speakers. These features could conceivably be used in prediction, and so too could measures of hesitation phenomena such as that of Mahl's31 non-ah ratios. Schilling and Goeler,39 Luchsinger and Dubois30 and many others have shown that the pitch range and inflections are more restricted in certain stutterers even when not stuttering and that these features usually indicate a severe problem. Hirschberg21 says that a better prognosis is shown when the respiration is not affected. Froeschels17 mentions that the amount of air inhaled prior to speaking is a good measure of prognosis, that if it is normal rather than excessive in amount of intake, the prognosis is more favourable. Shearer42 states that his recovered stutterers attributed their improvement to speaking more slowly. Luper and Mulder29 mention good eye-contact with the listener as a favourable sign and the presence of excessive tension as an unfavourable one. Robinson3S stresses the importance of speech consciousness and concern about communication as important factors in prognosis. These presumably must have their impact on the normal as well as the abnormal speech of stutterers. Other prognostic factors might be the sheer amount of daily talking time, the mean length of normal utterence, the average sound level of the stutterer's normal speech, and even the intelligibility. To our knowledge, no investigator has systematically investigated the incorporation of these leads in devising a prognostic measure. Surely the normal speech which the stutterer does possess might provide some important information? Are There any Overt Features of the Stuttering Behaviour which Might Yield Prognostic Clues? There are many statements in the