Extended Clinical Follow-Up and Long-Term Stuttering Outcomes: A 24-Month Observational Study

Background: Relapse following successful stuttering treatment is a common clinical challenge, yet strategies to support long-term stability after therapy termination remain insufficiently examined. We examined whether sustained clinical follow-up, without additional therapy, was associated with maintenance of treatment gains and a low incidence of relapse in adults who stutter after completion of therapy. Methods: In this prospective longitudinal study, 40 adults who stutter completed structured treatment and entered post-treatment follow-up. Nineteen completed 24 months of monthly monitoring, involving a monthly self-rated five-point Speech Satisfaction Rating Scale (SSRS) to track perceived speech satisfaction and to detect relapse, defined a priori as a sustained decline in satisfaction relative to the post-treatment rating. No additional therapy was provided during follow-up. Results: Across the 24-month follow-up period, one participant (5.3%) met the predefined criterion for sustained relapse; six participants (32%) showed a transient two-point decline in satisfaction at one or more follow-up points, which had resolved by 24 months in all but one. Speech satisfaction increased significantly from pre-treatment to post-treatment (p < 0.001) and remained significantly higher at 24 months compared with pre-treatment levels (p < 0.001). Although a modest reduction in speech satisfaction was observed at 12 months (p = 0.048), no significant difference was found between post-treatment and 24-month follow-up scores (p = 0.109). Longitudinal analysis demonstrated a significant effect of time on speech satisfaction (p < 0.001), with no significant effects of age or gender. Conclusions: Sustained clinical follow-up without additional therapy was associated with long-term maintenance of self-rated speech satisfaction and a low incidence of sustained relapse over 24 months. These findings suggest that structured follow-up may be a useful component of relapse monitoring in stuttering management, although the single-group design and reliance on a single self-report measure limit causal interpretation.