Abstract
There are few reported cases of mitigation or improvement in developmental stuttering that has progressed to the fourth of the developmental phases. Tsuzuki (2002) reported that phase four stutterers could also improve, but the process of mitigation or improvement has yet to be clarified. This study examined the effects of treatment and the mitigation/improvement process when mental rehearsal built in systematic desensitization was applied during the commencement of treatment. The treatment was performed on 21 cases 8 to 50 years old suffering from developmental stuttering phase four. According to subjective evaluation results of patients who received treatment, indicated on a seven-point (or four-point) scale concerning "state of fear and action" and "state of dialogue," 10 cases reached the normal range. There was one case -a school child- that reached phase one, five cases that reached phase two, one case of phase three, and four cases that remained in phase four. The improvement process of the school child traced the progression process. However, with adult cases, the patients went from phase two to the normal level without exhibiting the phase one state. In phase two, there emerged the action of talking without caring about speech disorders, despite the appearance of blocks. Furthermore, there were examples of cases where the behavior of paying attention to one's own speech remained after regressing to a phase two state, as well as one case where it disappeared. This indicates that even in phase two during development, there is a stage where one pays attention to one's speech and a stage where one does not do so.
