Recovery and Relapse: Perspectives From Adults Who Stutter
Publication: Journal of Speech, Language, and Hearing Research
Volume 63, Number 7
Pages 2162-2176
Abstract
Purpose
Recovery and relapse relating to stuttering are often defined in terms of the presence or absence of certain types of speech disfluencies as observed by clinicians and researchers. However, it is well documented that the experience of the overall stuttering condition involves more than just the production of stuttered speech disfluencies. This study sought to identify what recovery and relapse mean to people who stutter based on their own unique experiences to account for both the stuttering behaviors and the broader adverse impact of the condition.
Method
In this study, 228 adults who stutter participated in a mixed-methods exploration of the terms “recovery” and “relapse.” Participants categorized themselves on whether they considered themselves to have recovered or experienced relapse. Data were analyzed thematically through the lens of the speaker self-categorizations to determine how adults who stutter define recovery and relapse regarding stuttering.
Results
Results indicate that, to adults who stutter, recovery from stuttering is associated with increases in positive affective/emotional, behavioral, and cognitive reactions to the condition and simultaneous decreases in associated negative constructs. These group-level definitions did not change as a function of whether respondents reported that they had experienced recovery or relapse themselves.
Discussion
Recovery or relapse from stuttering behaviors can occur independently from recovery or relapse from the broader adverse impact related to the condition, suggesting that researchers and clinicians should consider recovery and relapse as involving more than just a reduction or an increase in observable behaviors. These findings support recent research evidence further specifying the many individual phenotypes of stuttering, in that pathways to recovery and relapse can be experienced in different ways for people with different stuttering phenotype profiles.
Get full access to this article
View all available purchase options and get full access to this article.
References
Ambrose, N. G., Yairi, E., Loucks, T. M., Seery, C. H., & Throneburg, R. N. (2015). Relation of motor, linguistic and temperament factors in epidemiologic subtypes of persistent and recovered stuttering: Initial findings. Journal of Fluency Disorders, 45, 12–26.
Anderson, T. K., & Felsenfeld, S. (2003). A thematic analysis of late recovery from stuttering. American Journal of Speech-Language Pathology, 12(2), 243–253. https://doi.org/10.1044/1058-0360(2003/070)
Andrews, G., & Harris, M. (1964). The syndrome of stuttering (Clinics in Developmental Medicine No. 17). Spastics Society Medical Education and Information Unit, in association with W. Heinemann Medical Books.
Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—The pinnacle of patient-centered care. The New England Journal of Medicine, 366(9), 780–781.
Blumgart, E., Tran, Y., Yaruss, J. S., & Craig, A. (2012). Australian normative data for the Overall Assessment of the Speaker's Experience of Stuttering. Journal of Fluency Disorders, 37(2), 83–90.
Boyatzis, R. E. (1998). Transforming qualitative information: Thematic analysis and code development. SAGE Publications.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Chang, S.-E., Erickson, K. I., Ambrose, N. G., Hasegawa-Johnson, M. A., & Ludlow, C. L. (2008). Brain anatomy differences in childhood stuttering. NeuroImage, 39(3), 1333–1344.
Chow, H. M., & Chang, S. E. (2017). White matter developmental trajectories associated with persistence and recovery of childhood stuttering. Human Brain Mapping, 38(7), 3345–3359.
Cooper, E. B. (1972). Recovery from stuttering in a junior and senior high school population. Journal of Speech and Hearing Research, 15(3), 632–638. http://www.ncbi.nlm.nih.gov/pubmed/5080055
Cooper, E. B. (1986). Treatment of disfluency: Future trends. Journal of Fluency Disorders, 11(4), 317–327.
Cooper, E. B. (1987). The chronic perseverative stuttering syndrome; Incurable stuttering. Journal of Fluency Disorders, 12(6), 381–388.
Craig, A. (1998). Relapse following treatment for stuttering: A critical review and correlative data. Journal of Fluency Disorders, 23(1), 1–30.
Craig, A., & Andrews, G. (1985). The prediction and prevention of relapse in stuttering: The value of self-control technniques and locus of control measures. Behavior Modification, 9(4), 427–442.
Craig, A., & Calver, P. (1991). Following up on treated stutterers: Studies of perceptions of fluency and job status. Journal of Speech and Hearing Research, 34(2), 279–284.
Craig, A., & Hancock, K. (1995). Self-reported factors related to relapse following treatment for stuttering. Australian Journal of Human Communication Disorders, 23(1), 48–60.
Cream, A., O'Brian, S., Onslow, M., Packman, A., & Menzies, R. (2009). Self-modelling as a relapse intervention following speech-restructuring treatment for stuttering. International Journal of Language & Communication Disorders, 44(5), 587–599.
Creswell, J. W. (2013). Qualitative inquiry & research design: Choosing among five approaches. SAGE Publications.
Culton, G. L. (1986). Speech disorders among college freshmen: A 13-year survey. Journal of Speech and Hearing Disorders, 51(1), 3–7.
Einarsdóttir, J. T., Crowe, K., Kristinsson, S. H., & Másdóttir, T. (2020). The recovery rate of early stuttering. Journal of Fluency Disorders, 64(June), Article 105764.
Dickson, S. (1971). Incipient stuttering and spontaneous remission of stuttered speech. Journal of Communication Disorders, 4(2), 99–110.
Epstein, R. M., & Street, R. L. (2011). The values and value of patient-centered care. Annals of Family Medicine, 9(2), 100–103.
Erdemir, A., Walden, T. A., Jefferson, C. M., Choi, D., & Jones, R. M. (2018). The effect of emotion on articulation rate in persistence and recovery of childhood stuttering. Journal of Fluency Disorders, 56, 1–17.
Evesham, M., & Fransella, F. (1985). Stuttering relapse: The effect of a combined speech and psychological reconstruction programme. British Journal of Disorders of Communication, 20(3), 237–248.
Finn, P. (1996). Establishing the validity of recovery from stuttering without formal treatment. Journal of Speech and Hearing Research, 39(6), 1171–1181.
Finn, P. (1997). Adults recovered from stuttering without formal treatment: Perceptual assessment of speech normalcy. Journal of Speech, Language, and Hearing Research, 40(4), 821–831.
Finn, P., Howard, R., & Kubala, R. (2005). Unassisted recovery from stuttering: Self-perceptions of current speech behavior, attitudes, and feelings. Journal of Fluency Disorders, 30(4), 281–305.
Frank, L., Basch, E., & Selby, J. V. (2014). The PCORI perspective on patient-centered outcomes research. JAMA, 312(15), 1513–1514.
Franken, M.-C. J. P., Koenraads, S. P. C., Holtmaat, C. E. M., & van der Schroeff, M. P. (2018). Recovery from stuttering in preschool-age children: 9 year outcomes in a clinical population. Journal of Fluency Disorders, 58, 35–46.
Fusch, P. I., & Ness, L. R. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report, 20(9), 1408–1416. http://nsuworks.nova.edu/tqr/vol20/iss9/3
Glasner, P. J., & Rosenthal, D. (1957). Parental diagnosis of stuttering in young children. Journal of Speech and Hearing Disorders, 22(2), 288–295.
Hancock, K., & Craig, A. (1998). Predictors of stuttering relapse one year following treatment for children aged 9 to 14 years. Journal of Fluency Disorders, 23(1), 31–48.
Hertzman, J. (1948). High school mental hygiene survey. American Journal of Orthopsychiatry, 18(2), 238–256.
Howell, P., & Davis, S. (2011). Predicting persistence of and recovery from stuttering by the teenage years based on information gathered at age 8 years. Journal of Developmental & Behavioral Pediatrics, 32(3), 196–205.
Howell, P., Davis, S., & Williams, R. (2008). Late childhood stuttering. Journal of Speech, Language, and Hearing Research, 51(3), 669–687.
Huang, R. (2016). RQDA: R-based qualitative data analysis(Version 0.2-8) [Computer software] . http://rqda.r-forge.r-project.org/
Ingham, R. J. (1983). Spontaneous remission of stuttering: When will the emperor realize he has no clothes on. In D. Prins & R. J. Ingham (Eds.), Treatment of stuttering in early childhood (pp. 113–140). College-Hill Press.
Jackson, E. S., Quesal, R., & Yaruss, J. S. (2012). What is stuttering: Revisited [Paper presentation] . International Stuttering Awareness Day Online Conference (ISAD 2012).
Jackson, E. S., Yaruss, J. S., Quesal, R. W., Terranova, V., & Whalen, D. H. (2015). Responses of adults who stutter to the anticipation of stuttering. Journal of Fluency Disorders, 45, 38–51.
Janssen, P., Kloth, S., Kraaimaat, F., & Brutten, G. J. (1996). Genetic factors in stuttering: A replication of Ambrose, Yairi, and Cox's (1993) study with adult probands. Journal of Fluency Disorders, 21(2), 105–108.
Johnson, W., & Millsapps, L. S. (1937). Studies in the psychology of stuttering: VI: The role of cues representative of past stuttering in the distribution of stuttering moments during oral reading. Journal of Speech and Hearing Disorders, 2(2), 101–104.
Kloth, S., Kraaimaat, F., Janssen, P., & Brutten, J. (1999). Persistence and remisson of incipient stuttering among high-risk children. Journal of Fluency Disorders, 24(4), 253–265.
Kreidler, K., Hampton Wray, A., Usler, E., & Weber, C. (2017). Neural indices of semantic processing in early childhood distinguish eventual stuttering persistence and recovery. Journal of Speech, Language, and Hearing Research, 60(11), 3118–3134.
Leech, K. A., Ratner, N. B., Brown, B., & Weber, C. M. (2017). Preliminary evidence that growth in productive language differentiates childhood stuttering persistence and recovery. Journal of Speech, Language, and Hearing Research, 60(11), 3097–3109.
Månsson, H. (2000). Childhood stuttering: Incidence and development. Journal of Fluency Disorders, 25(1), 47–57.
Mohan, R., & Weber, C. (2015). Neural systems mediating processing of sound units of language distinguish recovery versus persistence in stuttering. Journal of Neurodevelopmental Disorders, 7(1), 1–13.
Neumann, K., Euler, H. A., Zens, R., Piskernik, B., Packman, A., St. Louis, K. O., Kell, C. A., Amir, O., Blomgren, M., Boucand, V. A., Eggers, K., Fibiger, S., Fourches, A., Franken, M.-C. J. P., & Finn, P. (2019). “Spontaneous” late recovery from stuttering: Dimensions of reported techniques and causal attributions. Journal of Communication Disorders, 81, 105915.
Perkins, W. H. (1984). Stuttering as a categorical event: Barking up the wrong tree—Reply to Wingate. Journal of Speech and Hearing Disorders, 49(4), 431–434.
Perkins, W. H. (1990). What is stuttering? Journal of Speech and Hearing Disorders, 55(3), 370–382.
Plexico, L. W., Manning, W. H., & DiLollo, A. (2010). Client perceptions of effective and ineffective therapeutic alliances during treatment for stuttering. Journal of Fluency Disorders, 35(4), 333–354. 1
Porfert, A. R., & Rosenfleld, D. B. (1978). Prevalence of stuttering. Journal of Neurology, Neurosurgery, & Psychiatry, 41(10), 954–956.
Qualtrics. (2019, February). Qualtrics. https://www.qualtrics.com/
Quarrington, B. (1977). How do the various theories of stuttering facilitate our therapeutic approach? Journal of Communication Disorders, 10(1–2), 77–83.
Quesal, R. W. (1989). Stuttering research: Have we forgotten the stutterer? Journal of Fluency Disorders, 14(3), 153–164.
Quinan, C. (1921). Sinistrality in relation to high blood pressure and defects of speech. Archives of Internal Medicine, 27(2), 255–261.
R Core Team. (2019). R: A language and environment for statistical computing [Computer software] . R Foundation for Statistical Computing.
Ramig, P. R. (1993). High reported spontaneous stuttering recovery rates: Fact or fiction? Language, Speech, and Hearing Services in Schools, 24(3), 156–160.
Revelle, W. (2019). psych: Procedures for psychological, psychometric, and personality research (Version 1.9.12.31) [Computer software] . Northwestern University. https://cran.r-project.org/package=psych
Riley, G. D., & Riley, J. (1981). Stuttering prediction instrument for young children. CC Publications.
RS Team. (2018). RStudio: Integrated development for R [Computer software] . RStudio, Inc.
Ryan, B. P. (2001). A longitudinal study of articulation, language, rate, and fluency of 22 preschool children who stutter. Journal of Fluency Disorders, 26(2), 107–127.
Sandelowski, M. (2001). Real qualitative researchers do not count: The use of numbers in qualitative research. Research in Nursing & Health, 24(3), 230–240.
Schork, N. J. (2015). Personalized medicine: Time for one-person trials. Nature, 520(7549), 609–611.
Seider, R. A., Gladstien, K. L., & Kidd, K. K. (1983). Recovery and persistence of stuttering among relatives of stutterers. Journal of Speech and Hearing Disorders, 48(4), 402–409.
Shames, G. H., & Beams, H. L. (1956). Incidence of stuttering in older age groups. Journal of Speech and Hearing Disorders, 21(3), 313–316.
Sheehan, J. G., & Martyn, M. M. (1966). Spontaneous recovery from stuttering. Journal of Speech and Hearing Research, 9(1), 121–135.
Sheehan, J. G., & Martyn, M. M. (1970). Stuttering and its disappearance. Journal of Speech and Hearing Research, 13(2), 279–289.
Silverman, F. H. (1981). Relapse following stuttering therapy. In N. J. Lass (Ed.), Speech and language: Advances in basic research and practice (Vol. 5, pp. 51–78). Academic Press.
Spencer, C., & Weber-Fox, C. (2014). Preschool speech articulation and nonword repetition abilities may help predict eventual recovery or persistence of stuttering. Journal of Fluency Disorders, 41, 32–46.
Tichenor, S. E., Leslie, P., Shaiman, S., & Yaruss, J. S. (2017). Speaker and observer perceptions of physical tension during stuttering. Folia Phoniatrica et Logopaedica, 69(4), 180–189.
Tichenor, S. E., & Yaruss, J. S. (2018). A phenomenological analysis of the experience of stuttering. American Journal of Speech-Language Pathology, 27(3S), 1180–1194.
Tichenor, S. E., & Yaruss, J. S. (2019a). Group experiences and individual differences in stuttering. Journal of Speech, Language, and Hearing Research, 62(12), 4335–4350.
Tichenor, S. E., & Yaruss, J. S. (2019b). Stuttering as defined by adults who stutter. Journal of Speech, Language, and Hearing Research, 62(12), 4356–4369.
Tichenor, S. E., & Yaruss, J. S. (2020). Repetitive negative thinking, temperament, and adverse impact in adults who stutter. American Journal of Speech-Language Pathology, 29(1), 201–215.
Usler, E., Smith, A., & Weber, C. (2017). A lag in speech motor coordination during sentence production is associated with stuttering persistence in young children. Journal of Speech, Language, and Hearing Research, 60(1), 51–61.
Usler, E., & Weber-Fox, C. (2015). Neurodevelopment for syntactic processing distinguishes childhood stuttering recovery versus persistence. Journal of Neurodevelopmental Disorders, 7(1), 4.
Voelker, C. H. (1942). On the semantic aspects of stuttering in non-stutterers. Quarterly Journal of Speech, 28(1), 78–80.
Watkins, R. V., & Yairi, E. (1997). Language production abilities of children whose stuttering persisted or recovered. Journal of Speech, Language, and Hearing Research, 40(2), 385–399.
WHO. (2001). International Classification of Functioning, Disability and Health. World Health Organization.
Wickham, H. (2016). plyr: Tools for splitting, applying, and combining data (Version 1.8.4) [Computer software] . https://github.com/hadley/plyr
Wickham, H. (2019). dplyr: A grammar of data manipulation (Version 0.8.0.1) [Computer software] . http://dplyr.tidyverse.org
Wingate, M. E. (1964). Recovery from stuttering. Journal of Speech and Hearing Disorders, 29(3), 312–321.
Yairi, E., & Ambrose, N. (1999). Early childhood stuttering I: Persistency and recovery rates. Journal of Speech, Language, and Hearing Research, 42(5), 1097–1112.
Yairi, E., & Ambrose, N. (2005). Early childhood stuttering for clinicians by clinicians. Pro-Ed.
Yaruss, J. S. (1998). Describing the consequences of disorders: Stuttering and the International Classification of Impairments, Disabilities, and Handicaps. Journal of Speech, Language, and Hearing Research, 41(2), 249–257.
Yaruss, J. S., & Quesal, R. (2004). Stuttering and the International Clasification of Functioning, Disability, and Health (ICF): An update. Journal of Communication Disorders, 37(1), 35–52.
Zebrowski, P. M., Conture, E. G., & Cudahy, E. A. (1985). Acoustic analysis of young stutterers' fluency: Preliminary observations. Journal of Fluency Disorders, 10(3), 173–192.
Information & Authors
Information
Published In
Journal of Speech, Language, and Hearing Research
Volume 63 • Number 7 • July 2020
Pages: 2162-2176
PubMed: 32598208
Copyright
Copyright © 2020 American Speech-Language-Hearing Association.
History
- Received: Jan 9, 2020
- Revised: Mar 5, 2020
- Accepted: Apr 13, 2020
- Published online: Jun 29, 2020
- Published in issue: Jul 20, 2020
Authors
Metrics & Citations
Metrics
Article Metrics
View all metricsCitations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
Citing Literature
- Ryan A. Millager, Talia Liu, Dillon G. Pruett, Robin M. Jones, A year in stuttering research: A systematic review of global representation and sociodemographic reporting practices in English-language journals in 2020, Journal of Communication Disorders, 10.1016/j.jcomdis.2025.106500, 114, (106500), (2025).
- Camila Eduarda Elias Silva, Denise Brandão de Oliveira Britto, Stela Maris Aguiar Lemos, Self-perception of stuttering: association with self-perception of hearing, fluency profile, and contextual aspects, CoDAS, 10.1590/2317-1782/e20240103en, 37, 1, (2025).
- Alan Kamhi, 40 Years Later: Reassessing Views on the Core Deficit, Variability, Relapse/Recovery, and Attention in Stuttering, Communication Disorders Quarterly, 10.1177/15257401241290797, (2024).
- Eric S. Jackson, Noam Goldway, Hope Gerlach-Houck, Noah D. Gold, Stutterers’ experiences on classic psychedelics: A preliminary self-report study, Journal of Fluency Disorders, 10.1016/j.jfludis.2024.106062, 81, (106062), (2024).
- Jóhanna T. Einarsdóttir, Brynja Hermannsdóttir, Kathryn Crowe, A prospective 14-year follow-up study of the persistence and recovery of stuttering, Journal of Fluency Disorders, 10.1016/j.jfludis.2024.106058, 80, (106058), (2024).
- Andrew Bowers, Will Brain Imaging Lead to a Translational Neuroscience of Stuttering?, Perspectives of the ASHA Special Interest Groups, 10.1044/2023_PERSP-23-00007, 8, 5, (943-954), (2023).
- Yoshikazu Kikuchi, Masamutsu Kenjo, Eriko Yoshida, Saburo Takahashi, Daisuke Murakami, Yumi Yamaguchi, Kazuo Adachi, Motohiro Sawatsubashi, Masahiko Taura, Takashi Nakagawa, Toshiro Umezaki, Social anxiety disorder in adolescents who stutter: A risk for school refusal, Pediatrics International, 10.1111/ped.15622, 65, 1, (2023).
- Seth E. Tichenor, Scott Palasik, J. Scott Yaruss, Understanding the Broader Impact of Stuttering: Suicidal Ideation, American Journal of Speech-Language Pathology, 10.1044/2023_AJSLP-23-00007, 32, 5, (2087-2110), (2023).
- Patrick Minton Briley, Claire Brownlow, Charles Ellis, Provision of Maintenance Therapy for People Who Stutter Via Telepractice, Clinical Archives of Communication Disorders, 10.21849/cacd.2021.00332, 8, 1, (9-22), (2023).
- Evan Usler, Communicative Fluency and the Experience of Stuttering: A Viewpoint, Journal of Speech, Language, and Hearing Research, 10.1044/2022_JSLHR-22-00073, 65, 10, (3827-3834), (2022).
View Options
Sign In Options
ASHA member? If so, log in with your ASHA website credentials for full access.
Member Login