Pediatrics Book

http://www.fpnotebook.com/

StutteringAka: Stutter

Advertisement

  1. Definition
    1. Involuntary dysfluency in verbal expression
  2. Epidemiology
    1. Genetic component (from twin studies)
    2. Prevalence
      1. Children under age 10 years: 1.4% (66% are boys)
      2. Adults: <1% (80% are men)
  3. Signs
    1. Involuntary dysfluency
      1. Repeated sounds, syllables or words
      2. Speech blocks
      3. Prolonged pauses between words
    2. Associated compensatory behaviors
      1. Eye blinking
      2. Jaw jerking
    3. Provocative Factors
      1. Stressful circumstances
      2. Public speaking
  4. Types
    1. Developmental Stuttering (80% of cases)
      1. Stuttering occurs at begining of words
      2. Prominent secondary behaviors
      3. Onset at age 3-8 years and resolves within 4 years in 75% of cases
    2. Neurogenic Stuttering
      1. Acquired stuttering due to neurologic trauma (e.g. Cerebrovascular Accident, Head Trauma)
    3. Psychogenic Stuttering (rare)
  5. Grading
    1. Normal Stuttering
      1. Onset age 1.5 to 3 years old
      2. Repeated syllables and sounds at the begining of sentences
      3. Children have no awareness of their stuttering
    2. Mild Stuttering
      1. Onset age 3 to 5 years old
      2. Similar to normal stuttering but more frequent, associated with secondary behaviors
    3. Severe Stuttering
      1. Onset age 1-7 years
      2. Stuttering occurs in most phrases and sentences
  6. Management
    1. Refer Mild and Severe Stuttering to Speech Pathology
    2. Best therapies focus on reducing, not eliminating stuttering
      1. Decrease stuttering to less than half the prior events
      2. Decrease secondary behaviors
    3. Medications are ineffective in stuttering
      1. Bothe (2006) Am J Speech Lang Pathol 15(4):342
    4. Devices (Contremporary stuttering devices, Fluency-shaping mechanisms)
      1. Example: Delayed auditory feedback device (slows speaking rate)
    5. Behavioral Techniques
      1. Provide relaxed environment that allows child enough time to speak without hurrying
      2. Parents and teachers praise fluent speech
      3. Ocasionally acknowledge and correct stuttering in a gentle non-judgemental way
        1. Examples of feedback: Noting either bumpy or fluid speech
  7. Resources
    1. Stuttering Foundation of America
      1. http://www.stutteringhelp.org
  8. References
    1. Moore and Jefferson (2004) Handbook Psychiatry , 2nd ed, Chap. 20
    2. Simms in Kliegman (2007) Nelson Pediatrics, 18th ed., Chap. 32
    3. Prasse (2008) Am Fam Physician 77(9):1271
    4. Costa (2000) CMAJ 162(13):1849

Stuttering (C0038506)

Definition (MSH)A disturbance in the normal fluency and time patterning of speech that is inappropriate for the individual's age. This disturbance is characterized by frequent repetitions or prolongations of sounds or syllables. Various other types of speech dysfluencies may also be involved including interjections, broken words, audible or silent blocking, circumlocutions, words produced with an excess of physical tension, and monosyllabic whole word repetitions. Stuttering may occur as a developmental condition in childhood or as an acquired disorder which may be associated with BRAIN INFARCTIONS and other BRAIN DISEASES. (From DSM-IV, 1994)
Definition (CSP)disorder in which speech is involuntarily interrupted by hesitations, repetitions, and spasms of the muscles involved in breathing or vocalization.
ConceptsDisease or Syndrome (T047)
ICD9307.0
MSHD013342
EnglishNon-fluent speech, STUT1, Stutter, Stuttering
Spanishsufre tartamudeo, tartajeo
Parent ConceptsSpeech Disorders (C0037822), Signs and Symptoms (C0037088), Special symptoms or syndromes, NEC in ICD9CM_2008 (C0302370), Duplicate concept (C1274013)
SourcesAOD, COSTAR, CSP, CST, DXP, ICD9CM, LCH, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



Navigation Tree