Childhood-Onset Fluency Disorder (stuttering)
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Childhood-onset fluency disorder is a communication disorder characterized by a disturbance in the flow and timing of speech that is inappropriate for an individual’s age. Also referred to as stuttering, this condition includes the repetition or prolongation of speech sounds, hesitations before and during speaking, long pauses in speech, effortful speech, and/or monosyllabic whole-word repetitions. This condition is typically accompanied by anxiety about speaking and can place limitations on how comfortable a child feels participating in social or academic environments.
Symptoms of childhood-onset fluency disorder develop between the ages of 2 and 7, with 80 to 90 percent of cases developing by age 6. While mild stuttering is common in children who are learning to speak, this behavior becomes a fluency disorder when it persists over time and causes distress in the child. Stuttering is more commonly found among males than females.
According to DSM-5, there are certain criteria that must be met in order for the diagnosis of childhood-onset fluency disorder (American Psychiatric Association, 2013).
A. Interruptions in normal fluency and time patterning of speech (unsuitable for the individual’s age), exemplified by repeated occurrences of 1 or more of the following:
Sound and syllable repetitions
Sound prolongations
Interjections
Broken words (such as breaks within a word)
Audible or silent blocking (filled or unfilled gaps in speech)
Circumlocutions (word substitutions to evade challenging words)
Words formed with an overload of physical tension
Monosyllabic whole-word repetitions
B. The interruptions in fluency gets in the way with academic or occupational accomplishments or with social communications
C. If a speech-motor or sensory deficit is evident, the speech challenges are in excess of those typically connected with these problems:
Deficits in intellectual functions, like reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience, established through the use of both clinical assessment and individualized, standardized intelligence testing.
Deficits in adaptive functioning that end up in failure to achieve developmental and sociocultural standards for personal autonomy and social responsibility. Lacking continuing support, the adaptive deficits hinder functioning in one or more activities of daily life, including communication, social participation, and independent living, across multiple environments, such as home, school, work, and community.
Start of intellectual and adaptive deficits throughout the developmental period.
Childhood-onset fluency disorder usually consists of reiterations of words or sections of words, in addition to prolongations of speech sounds. While this is seen in the general population, it is more common in those who stutter. A few individuals who stutter may appear to be experiencing shortness of breath while talking. In some cases, even when the mouth appears to be in the process of formulating a sound, nothing may come forth for some seconds. The individual may require some effort in other finish up the word.