Childhood-Onset Fluency Disorder (Stuttering)

Childhood onset fluency disorder is usually called stuttering. It is a neurodevelopmental speech disorder with disturbed speech. This disorder interrupts the regular flow of speech. The person suffering from childhood onset fluency disorder is unable to maintain the correct rhythm of speech with even flow while speaking. This flow of speech is inappropriate to the age of the person. This is also called stammering as well. Childhood onset fluency disorder includes continuation of speech with repetition of some words, long pause in speech while speaking and hesitation in speaking or while speaking. This is a neurodevelopmental disorder it’s symptoms start to develop during 2 to 7 years of age. In 70% to 80% cases of childhood onset fluency disorder the symptoms start to develop at the age of 6.

Diagnostic Criteria of Childhood Onset Fluency Disorder

The diagnostic criteria of Childhood onset fluency disorder according to DSM 5 TR is:

Diagnostic Criteria A.

In childhood onset fluency disorder there are disturbances in the usual speech fluency and time imitating of speech. This disturbance is inappropriate according to the chronological age of individual. The speaking disturbances and lack of language skills must persist over a long period of time. The occurrence of childhood onset fluency disorder is diagnosed by the presence of one (or more) of the following:

1. If there is noticeable repetitions of sound or a single word.
2. Prolongations of vowels and consonant sounds.
3. Long pauses in words or sentences with broken words
4. Audible/filled or silent/unfilled pauses in speech & blocking.
5. Silent problematic words which the child is unable to speak this is also called Circumlocutions.
6. Some words are spoken with an extra of physical tension.
7. Repetitions of whole word for example I-I-I-I see him, Monosyllabic.

Diagnostic Criteria B.

The speech disturbance can be a result of speaking anxiety in individual. This speech anxiety can lead towards restrictions in effective communication and lack of social participation.

Diagnostic Criteria C.

The symptoms of childhood onset fluency disorder starts to develop in the early developmental period.

Diagnostic Criteria D.

The disturbance is not due to speech-motor or sensory deficit or another medical condition.

The disturbance in speech fluency can also interfere with academic achievement of individual and with social communication. The range of the speech disturbances are different in different situations. Often the stuttering is more severe if there is extra pressure to communicate for example while child may stutter severely while giving a report at school or an individual have more speech disturbance during job interview. This dysfluency is often not noticeable during oral reading, talking to inanimate pets or objects and while singing a favorite song. The speaker may face more disturbences in speech fluency during public speaking, telephonic speaking and may try to avoid dysfluencies by using some linguistic mechanisms such as altering the rate of speech and avoiding certain words or sounds. Studies have shown in childhood onset fluency disorder there are some structural and practical neurological differences have been noticed in children who stutter. Males are more probable to stutter as compared to females. There are many causes of stuttering which includes certain neurophysiological and genetical factors.

Development and Course

The childhood onset fluency disorder starts to develop in early stage of development. It occurs by the age of 6 for 80%–90% of affected individuals. The onset of childhood onset fluency disorder is insidious and more sudden. Typically, dysfluencies start progressively. Firstly it starts with repetition of initial consonants, or with the repetition of first words of a phrase then it leads towards the repetition of long words. The child at the start may not be aware of these dysfluencies. As the disorder starts to develop, the dysfluencies become more recurrent. These start occurring in the most meaningful words or phrases in the utterance. As the child develops awareness of the speech difficulty, he or she may avoid these discrepancies and develop mechanisms which includes use of simple utterances and avoidance of public speaking.