Childhood-Onset Fluency Disorder (Stuttering)
Childhood-Onset Fluency Disorder (Stuttering)
The next neurodevelopmental disorder and the last communication disorder that I will go over the criteria for will be Childhood-Onset Fluency Disorder (Stuttering). This criteria is specific to the diagnostic criteria for this disorder for children and should not be confused with Adult-Onset Fluency Disorder.
(Text in italics is sourced directly from the DSM-5 followed by my explanation of the information where needed.)
Criterion A
Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills, persist over time, and are characterized by frequent and marked occurrences of one (or more) of the following:
The individual being diagnosed has difficulty with the normal pattern of speech that is unusual for the age and language skills typical for the age range of the individual. It doesn’t get better over time and includes one or more of the following examples below.
Sound and syllable repetitions.
Repetition of a sound or syllable within a sentence such as c-c-c-cat (sound repetition) or mo-mo-mo-money (syllable reptition).
Sound prolongations of consonants as well as vowels
A prolongation used in this context is when the sound for either the consonant or vowel is elongated more than it should. An example for the sentence “Look at the bus” a child may say “llllllllllook at the bus extending the sound of the “l” within the sentence.
Broken words (e.g., pauses within a word)
This is more straightforward example provided by the example within this one. Using the aforementioned sentence, “look at the bus” a child may instead say “lo…ok at the bus” or “look at the b…us”.
Audible or silent blocking (filled or unfilled pauses in speech)
An audible or silent block is when the child is unable to formulate a sound in between the sentence causing instead only air to come out or just silence prior to continuing. An example of this would be “look at [pause] the bus”. An audible block would be the air that comes out in between the sentence and a silent block would be silence prior to continuing.
Circumlocutions (word substitutions to avoid problematic words)
As the example states a circumlocution is the use of other words that the child may find easier to use in order to avoid a word they have found to be problematic. Sometimes this leads to the sentence to becoming longer to convey a simple point. A famous example that can be used would be from the Harry Potter series where instead of people saying Voldemort they would instead say, “He-who-must-not-be-named”. In this example Voldemort’s name is too difficult whereas the sentence is a simpler way for the user to get their point across.
Words pronounced with an excess of physical tension
For this example the child shows physical difficulty in stating certain words that they find difficult. If we once again use the sentence, “look at the bus”, when the child gets to word “bus” they would show physical tension such as grimacing or eye blinking to convey physical difficulty with that specific word.
Monosyllabic whole-word repetitions (e.g., “I-I-I-I see him”)
For this last sentence it is pretty straightforward as well. For words with one syllable they may continuously repeat the word prior to continuing the sentence.
Criterion B
The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic or occupational performance, individually or in any combination.
The child experiences anxiety due to the experience dealing with one of the examples above and it negatively impacts their experience in social settings as well as in academic or occupational settings
Criterion C
The onset of symptoms is in the early developmental period. (Note: Later-onset cases are diagnosed as 307.0 [F98.5] adult-onset fluency disorder.)
For this specific disorder it is specific to early development however people can be diagnosed as adults with the proper ICD-10 code.
Criterion D
The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological insult (e.g., stroke, tumor, trauma), or another medical condition and is not better explained by another mental disorder.
The issues that the child is dealing with can’t be attributed to another disorder that may cause similar issues. Proper differential diagnosis needs to be done to rule out any other potential causes.
Image sourced from Freepik