NRNP 6665 WEEK 8 Study Guide: Child- Onset Fluency Disorder (Stuttering)
Child-Onset Fluency Disorder or Stuttering Disorder is a communication disorder characterized by disruptions in the flow and timing of speech. These disruptions are typically inappropriate for an individual’s age and expected language skills and tend to persist over time. The purpose of this assignment is to outline a study plan for this disorder.
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Signs and symptoms according to the DSM-5-TR:
The DSM-5 diagnostic criteria encompass the presence of the following:
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1. Repetition of syllables, sounds, or monosyllabic words.
2. Broken words with pauses within a word.
3. Prolonging the vocalization of consonants and vowels.
4. Filled or unfilled pauses in speech.
5. Substituting words to avoid challenging words.
6. Producing words with excessive physical tension like jerking the head or fist clenching.
7. Exhibiting frustration or embarrassment when giving a speech.
8. The symptoms are often associated with motor movements, like eye blinks, tics, and shaking of the lips or face.
Differential diagnoses:
Stuttering should be differentiated from sensory deficits like hearing impairment or speech-motor deficit, normal speech dysfluencies, Tourette’s disorder, and medication side effects.
Incidence:
Approximately 5% of all children experience stuttering lasting six months or more. About three-quarters of those who stutter show improvement by late childhood. However, the problem persists in the long term in roughly 1% of children who stutter.
Development and course:
Developmental stuttering typically begins between the ages of 2-6. The disorder has an insidious and sudden onset and is linked with psychological, genetic, environmental, and neurophysiological factors. It exhibits a speech profile comprising sound distortions, repetitions, and blocking. Speech dysfluencies start gradually and may involve the repetition of initial consonants, first words of a phrase, or long words.
Risk factors for Stuttering Disorder include male sex, onset of dysfluencies more than 6-12 months ago, persistent familial stuttering, onset of stuttering past 3-4 years, and failure to decrease stuttering severity within the first 7-12 months.
Prognosis:
About 70-80% of children with Stuttering Disorder recover spontaneously. While approximately 5% of preschool children have a stuttering disorder, this percentage decreases to 1% by the end of junior high school. However, the percentage that does not recover remains with the disorder in the long term.
Considerations related to culture, gender, and age:
The practitioner examining a child with Stuttering Disorder should conduct a comprehensive cultural assessment to ensure culturally competent care. Treatment interventions should be culturally sensitive, and the assessment and treatment should be age and gender-appropriate.
Pharmacological treatments, including any side effects:
Currently, there are no FDA-approved drug therapies to treat Stuttering Disorder.
Non-pharmacological treatments:
Speech therapy with a speech pathologist is the most commonly used non-pharmacological intervention for Stutter Disorder. During speech therapy, affected children are taught techniques to form sounds and words, speak slowly, and remain calm when struggling to speak.
Parental therapy is an indirect form of therapy where parents of affected children are trained to create a relaxing environment that helps improve the child’s speech independently.
Diagnostics and labs:
There are no diagnostic tests for Stuttering Disorder. Diagnosis is based on a child’s symptoms matching the DSM-5 criteria, which require a disturbance in normal fluency for the diagnosis to be established.
Comorbidities:
Stuttering Disorder can occur alongside other disorders such as phonology disorders, learning disabilities, articulation disorders, autism spectrum disorder, literacy disorders, attention deficit and hyperactivity disorder (ADHD), social anxiety disorder, and dysphagia.
Legal and ethical considerations:
Legal factors to consider when handling a child with Stuttering Disorder include informed consent and confidentiality. The healthcare practitioner must obtain consent from the child’s guardian or parent before examining or providing treatment interventions, as most patients are minors. Maintaining the confidentiality of the child’s health information is crucial to avoid legal implications. Ethical considerations revolve around nonmaleficence, with the practitioner avoiding interventions that may harm the patient, either psychologically or physically.
Pertinent patient education considerations:
Patient education primarily targets the child’s parents or guardians. It involves training parents to model positive speech for the child, provide patient and empathetic listening, create a relaxing environment, and avoid completing the child’s sentences or conveying negative reactions.
In conclusion, Stuttering Disorder is a speech condition characterized by repetitions, prolongations, and interruptions in speech. While most children who stutter improve over time, some do not recover, and the disorder persists long-term. Speech therapy is the most widely used treatment approach, as no drug therapies exist for Stuttering Disorder.
References
American Psychiatric Association, A. P., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 10). Washington, DC: American psychiatric association.
Kraft, S. J., Lowther, E., & Beilby, J. (2019). The role of effortful control in stuttering severity in children: Replication study. American Journal of Speech-Language Pathology, 28(1), 14–28. https://doi.org/10.1044/2018_AJSLP-17-0097
Nang, C., Hersh, D., Milton, K., & Lau, S. R. (2018). The impact of stuttering on development of self-identity, relationships, and quality of life in women who stutter. American Journal of speech-language Pathology, 27(3S), 1244–1258. https://doi.org/10.1044/2018_AJSLP-ODC11-17-0201
Özgür, B. G., & Özgür, E. (2019). An analysis of sociodemographic and clinical characteristics in children and adolescents diagnosed with childhood-onset speech fluency disorder. ENT Updates, 9(3), 185-190. https://doi.org/10.32448/entupdates.610265
Saad, M. A. E., & Kamel, O. M. (2019). Childhood-Onset Fluency Disorder (Stuttering): An Interruption in The Flow of Speaking. Psycho-Educational Research Reviews, 11-13.
Sommer, M., Waltersbacher, A., Schlotmann, A., Schröder, H., & Strzelczyk, A. (2021). Prevalence and therapy rates for stuttering, cluttering, and developmental disorders of speech and language: evaluation of German health insurance data. Frontiers in human neuroscience, 15, 645292. https://doi.org/10.3389/fnhum.2021.645292
NRNP 6665 STUDY GUIDE FORUM
Abnormal brain development or damage at an early age can lead to neurodevelopmental disorders. Within this group of disorders, some are resolvable with appropriate and timely interventions, either pharmacological or nonpharmacological, while other disorders are chronic and need to be managed throughout the lifespan.
For this Assignment, you will develop a study guide for an assigned disorder and share it with your colleagues. In sum, these study guides will be a powerful tool in preparing for your certification exam.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
TO PREPARE
- Your Instructor will assign you to a specific neurodevelopmental disorder from the DSM-5-TR.
- Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder.
THE ASSIGNMENT
Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5-TR but also supported by at least three other scholarly resources.
Areas of importance you should address, but are not limited to, are:
- Signs and symptoms according to the DSM-5-TR
- Differential diagnoses
- Incidence
- Development and course
- Prognosis
- Considerations related to culture, gender, age
- Pharmacological treatments, including any side effects
- Nonpharmacological treatments
- Diagnostics and labs
- Comorbidities
- Legal and ethical considerations
- Pertinent patient education considerations
BY DAY 7 OF WEEK 8
You will need to submit your Assignment to two places: the Week 8 Study Guide discussion forum as an attachment and the Week 8 Assignment submission link. Although no responses are required in the discussion forum, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study.
Access the Study Guide Forum (or click the Next button).
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
- To submit your completed assignment, save your Assignment as WK8Assgn+last name+first initial.
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
Rubric
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Create a study guide, in outline form with references, for your assigned disorder. Incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards.
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Content areas of importance you should address, but are not limited to, are:• Signs and symptoms according to the DSM-5-TR• Differential diagnoses• Incidence• Development and course• Prognosis• Considerations related to culture, gender, age• Pharmacological treatments, including any side effects• Nonpharmacological treatments• Diagnostics and labs• Comorbidities• Legal and ethical considerations• Pertinent patient education considerations
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Support your guide with references to the DSM-5-TR and at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines. Be sure they are current (no more than 5 years old).
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Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation
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Written Expression and Formatting – The guide follows correct APA format for parenthetical/narrative in-text citations and reference list.
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Total Points: 100
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