Pediatrics Book

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Stuttering

Aka: Stuttering, Stutter
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  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): 342-52
    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): 1271-8
    4. Costa (2000) CMAJ 162(13):1849-55

Stuttering (C0038506)

Definition (MEDLINEPLUS)

Stuttering is a problem that affects the flow of your speech. If you stutter, you may

  • Make certain words sound longer than they should be
  • Find it hard to start a new word
  • Repeat words or parts of words
  • Get tense when you try to speak. You may blink your eyes rapidly, or your lips and jaw may tremble as you struggle to get the words out

Stuttering can affect anyone. However, it is most common in young children who are still learning to speak. Boys are three times more likely to stutter than girls. Most children stop stuttering as they grow older. Less than 1 percent of adults stutter.

Scientists don't fully understand why some people stutter. The problem seems to run in families. There is no cure, but stuttering therapy for young children can keep it from becoming a lifelong problem.

NIH: National Institute on Deafness and Other Communication Disorders
Definition (NCI) A speech disorder characterized by frequent sound or syllable repetitions, sound prolongations, or other dysfluencies that are inappropriate for the individual's age.
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.
Concepts Mental or Behavioral Dysfunction (T048)
MSH D013342
ICD10 F80.81
SnomedCT 29916003, 39423001, 416163003
DSM4 307.0
English STUTTERING, Stuttering (finding), Stammering (finding), stuttering (symptom), speech fluency stuttering, stuttering (diagnosis), speech fluency stuttering (physical finding), stuttering, Stuttering [Disease/Finding], stutter, stuttered, stutters, Stuttering NOS, Stuttering, Stammering, Non-fluent speech, Stammer, Stutter, dysphemia
German STOTTERN, Balbuties, Dysphemie, Psellismus, Stottern
Dutch stotteren, gestotter, Stotteren
Portuguese Gago, Gaguez, Paralalia Literal, Pselismo, GAGUEZ, Gagueira
Spanish Tartamudez, Tartajear, tartamudeo (hallazgo), tartamudeo, Paralalia Literal, Pselismo, BALBUCEO, disfemia, tartamudez, tartamudez (hallazgo), Tartamudeo
Swedish Stamning
Japanese ｷﾂｵﾝ, ﾄﾞﾓﾘ, どもり, 吃音, 吃, 吃り
Czech balbuties, koktavost, Zajíkání
Finnish Änkytys
Russian ZAIKANIE, ЗАИКАНИЕ
French BREDOUILLEMENT, Bégaiement
Croatian MUCANJE
Polish Jąkanie się
Hungarian Dadog, Dadogás
Italian Balbuzie
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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