Clinical studies dealing with the psychological reaction of the patient to laryngectomy, and those studies which evaluate the progress made by laryngectomized patients in programs for speech rehabilitation, should include all patients referred to a given program. The significantly high percentage of patients who refuse to participate and those who, after a short period of participation, discontinue their cooperation and efforts are often ignored in reported clinical studies, and only "successful cases" are reported.
It is possible that in such studies some conclusions reached without considering this group would be misleading. The patient's personality structure and the physiological limitations which may be present are Possibly of much importance in determining the degree of success which a given patient may have in the rehabilitation program. The reactions of the nonconforming or noncooperating group—per se—are important to a clinical study, and may well prove valuable to those who are trying to rehabilitate