راهکارهای درمانی خاص در درمان لکنت زبان کلینیک تخصصی لکنت کرج خیابان سعدی(اهری)- روبروی بازار میوه و تره بار اهری
(Felsenfeld, 1998, p. 64)
We note throughout this book that, from a number of perspectives, stuttering in adulthood is usually very different to the version seen at onset. For example, we have seen in this chapter, as well as in chapters 9, 10 and 11, that during the course of its development primary stuttering changes from the easy part-word repetitions to the blocks and prolongations associated with the more established condition. Consistent with this change in type of stutter¬ing, there is also a change in the linguistic focus of the stuttering and, as we see in chapter 5, a change from stuttering on function words to content words often takes place at around 8 years old. More established stuttering is also associated with an increase in secondary stuttering, tension, struggle behaviour and avoidance (see chapters 11 and 12). Environmental factors will also play a part in determining how a stutter develops (we discuss this within the therapeutic context in chapters 10, 11, 12).
In the present chapter we have considered the likelihood of some of these phenomena being underpinned by genetic predisposition, and the potential influence of hereditary factors on the phenomenon of spontaneous recovery. We have also considered the tentative possibility that there may be a number of different subtypes of stuttering, which comprise different onset types and follow different courses of development. We might further speculate as to whether, if the existence of genuine subgroups is eventually proven, whether some or all of these are genetically conditioned. However, large-scale longi¬tudinal studies would be needed to determine whether functionally different subgroups (which each follow differing courses of development, and poten¬tially with different prognoses) can really be isolated. The disparity between Van Riper’s four-track model and Starkweather’s nine-track conceptualiza¬tion suggests that this would not be an easy task, yet the potential gains from both aetiological and therapeutic perspectives are great.