Assessment and Treatment of Acquired Neurogenic Stuttering: A Single Subject Study

Neurogenic stuttering is a subtype of acquired stuttering characterized by speech disfluencies following acquired brain damage. Despite advances, research on neurogenic stuttering remains limited, particularly concerning its pathophysiology and therapy. This study aimed to explore the clinical profile of neurogenic stuttering post cerebrovascular accident (CVA) and document the outcomes of speech-language intervention. The participant, a 51-year-old Malayalam-speaking male sales manager from Calicut, experienced speech difficulties after a left parieto-temporal infarct, presenting with right-sided weakness and heart failure, alongside a history of type 2 diabetes and hypertension. Assessment revealed reduced verbal output, poor clarity, disfluencies, articulatory errors, intact comprehension, but mild deficits in naming and morphosyntax; standardized tests indicated a non-aphasic profile with mild dysarthria and mild stuttering (SSI-4: 23). The therapeutic intervention comprised three phases: Establishment (including gentle onset, continuous phonation, Melodic Intonation Therapy, voluntary stuttering, language/vocal modulation, and relaxation), Transfer (generalization via role-play and self-monitoring), and Maintenance (long-term support). Therapy resulted in reduced disfluencies, enhanced intelligibility, and improved communication attitude, with the client maintaining fluency strategies despite setbacks following a seizure. This case underscores the efficacy of individualized, evidence-based intervention incorporating fluency shaping, prosodic training, counseling, and family involvement in managing neurogenic stuttering post-CVA, while highlighting the need for further holistic research to advance clinical practice and evidence-based care.