ABSTRACT
An approach that has been taken to improve information about stuttering is to distinguish different groups within an overall sample of speakers who stutter and examine them separately. This is called subtyping. Affectual factors have often been used to specify subtypes (e.g., neurotic versus psychotic). This approach would be commended if the resulting information provided guidance that allowed diagnosis, prognosis, and treatment of that particular subtype to be improved. To give a hypothetical example, if a heterogeneous group of children who stutter contained some who had difficult temperaments, diagnosis could possibly be improved if the sample was given a temperament screening test to distinguish the two subtypes (those who have a temperament problem and those who do not). Further improvements in diagnosis would arise if age of onset for the children with poor temperament was different from the age of onset for the children with ordinary temperament (and similarly for other risk factors that distinguish the subtypes). The impact on prognosis could be established by comparing the course of stuttering development for the two subtypes (e.g., one subtype may be more likely to be bullied than the other subtype). Behavioral treatments that have been developed for children with temperamental difficulties could be examined to see if they are effective with children who stutter. The fluency problems of adults with temperamental difficulties could be managed in a different way from adults who stutter who are not from this subtype.
