Stuttering disorder has been included in the DSM-IV Classification and includes certain criteria for the disorder to be classified as a stuttering disorder. Only if the individual or child can meet these criteria will they be diagnosed with a stuttering disorder. There is an important note that the disorder should not be considered a mental disorder, but should be included as a “speech disorder” or a “developmental disorder”. Stuttering is coded DSM 307.0 and is generally coded as an Axis III disorder that includes motor speech disorders (Karlen, 2006).
“According to the classification of the DSM-IV Stuttering: –
HAS. Disturbance in the normal fluency and temporal pattern of speech that is inappropriate for the
The age of the individual. This disturbance is characterized by frequent:-
has. repetitions or prolongations of sounds or syllables
b. Various other types of disfluencies in speech interjections,
against broken words,
d. audible or silent lockout,
me. ambiguities,
F. words produced with an excess of physical tension,
gram. and monosyllabic repetitions of whole words.
b. The fluency disturbance interferes with academic or occupational activities. achievement or with social communication.
against If there is a motor or sensory speech deficit, speech difficulties are in excess of those usually associated with these problems(Quoted from DSM-IV, 1994)
Characteristic
The cause of the disorder is not yet known, although scientists believe that a combination of factors may be responsible, including abnormal speech development, inherited brain abnormalities, stroke or cerebral infarction, or certain mental health problems. Usually when it comes to developmental problems, the child can outgrow the problem. However, if the problem is related to a genetic brain abnormality or brain injury (such as a stroke or trauma), the disorder tends to persist even into adulthood. Risk factors for developing the disorder include delayed childhood development, a family history of the disorder or unnecessary stressful situations, and unrealistic expectations from parents (Mayo Clinic, 2012).
Signs and symptoms of stuttering include difficulty starting or continuing a sentence, word, or phrase, repetitions of a word or syllable, tension and tightness in the lips, face, and upper body, jaw and lip tremors , and blinking of the eyes. People who stutter have difficulty giving public speeches (Mayo Clinic, 2012).
Diagnosis
The diagnosis of stuttering disorder is made by the presence of certain signs that are mentioned in the DSM-IV-TR. The three cardinal signs include a disturbance of normal speech and fluency, disturbances that affect occupation, academic or social performance, and a motor or sensory speech deficit. There are frequent repetitions of words, sentences, phrases, or syllables, words appear fragmented, and blocks of silence or fragmented words may be heard. The speech therapist can perform evaluations to determine the developmental course of the disease, the types and frequencies of abnormalities (dysfluencies), and the speech and language disabilities experienced by the child (Yaruss, 2012).
The pathologist’s evaluation takes 3 hours and includes a detailed interview with the parents, observation of the child speaking, and direct speech and language testing. Some of the stutter tests performed are stutter prediction and stutter severity instruments. Speech therapists would take into account psychosocial factors, psycholinguistic factors, and physiological factors that may be involved. The speech problem may not be directly limited to fluency of speech, but may be related to the child’s phonological development, language development, and word finding skills. The pathologist would also like to rule out underlying disorders, such as Tourette’s syndrome, which could lead to speech problems (Yaruss, 2012).
Treatment
The treatment required would depend on the nature of the problem, the severity of the problem, and whether the disorder is associated with an underlying brain or systemic disorder. Treatment is usually recommended in 50% of children, and in 43%, after a detailed evaluation, the treatment plan can be established. There are different approaches to treating the disorder. The treatment is usually carried out by the speech and language therapist in coordination with the child psychologist. Some of the suggested therapies for stuttering include fluency modeling therapy, electronic fluency devices, interpersonal therapy, anti-stuttering medications, support group therapy and psychotherapy, or a combination (Mayo Clinic, 2012).
Fluency modeling therapy includes controlled breathing to control speech and articulation of the jaw, tongue, and lips (Mayo Clinic, 2012). Interpersonal therapy is one of the therapies that can be used for stuttering, as each client is given unique treatment and value. It consists of strategic therapies along with interactional and systemic therapies. It can be carried out only after examination of the psychological and interpersonal aspects involved (Labuschagne, 2004). Some of the medications that can be used in the treatment of stuttering include antidepressants, anticonvulsants, benzodiazepines, and dopamine antagonists. There was a slight but noticeable reduction in stuttering after drug therapy. Support groups can be used in conjunction with pharmaceutical, interpersonal, and psychotherapy to help reduce symptoms. There is also evidence that psychoanalysis provides some relief for stuttering (Mayo Clinic, 2012).
The outcome of stuttering is usually good, as about 2-3 of school-age children who develop stuttering in their childhood are able to recover. The remaining 10% may become normal in their teens, with only a small portion having the disorder persisting into adulthood (Mayo Clinic, 2012).
References
Karlen, H. (2006). What is stuttering? Retrieved on April 10, 2013, from:
Labuschagne, J. L. (2004). Interpersonal psychotherapy with a person who stutters. Retrieved on April 10, 2013, from:
Mayo Clinic (2012). Stuttering. Retrieved on April 10, 2013, from: http://www.mayoclinic.com/health/stuttering/DS01027
Yaruss, J.S. (2012). Diagnosis of childhood stuttering: results of 100 clinical evaluations. Retrieved on April 10, 2013, from:
