Monday, June 04, 2007

What is a cure?

Here is my cure level ranking.

Cure Level 4: relatively fluent but massive avoidance.
Cure Level 3: noticeable but not severe disfluency with only minor avoidance.
Cure Level 2: relatively fluent and minor avoidance.
Cure Level 1: no stuttering signs and no avoidance.
Cure Level 0: fluent without thinking and no tendency for relapse.

My statements for the day:

1) I give preference to less avoidance at the cost of less fluency.
2) Nearly everyone can be at level 1, 2 and 3 after therapy.
3) Most slowly fall back to level 3 and 4 sometime after therapy.
4) No-one ever reaches Level 0 fully.
5) Level 2 is realistic with hard work, and patience.
6) Depending on the severity, some people can reach a higher level more easily.


Anonymous said...

The patient of the report below seems to have reached the level 1 with the help of medication.

Fluoxetine for persistent developmental stuttering.

Kumar A, Balan S.
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.

Stuttering is a disturbance in the normal fluency and time patterning of speech. Developmental stuttering (DS), with or without associated psychiatric illness, is the most common form and includes all cases with gradual onset in childhood that are not the result of acquired brain damage. Persistent developmental stuttering (PDS) is DS that has not undergone spontaneous or speech therapy-induced remission. Adults in speech therapy behavioral programs will often show regression and even total relapse if they stop practicing. This case report deals with a patient of PDS who responded significantly to treatment with fluoxetine.

NCBI link:

Anonymous said...

Tom, what about cure levels that would include a level of disfluency with NO avoidance?

Anonymous said...

Adrian, Good point. The underlying idea behind the proposed scale is that obviously less stuttering goes hand in hand with less avoidance - and vice versa. You've decoupled them, which reminds us that they need not be linked. Significant disfluency can easily be accompanied by low avoidance... with according to some, is a desirable outcome.