Week 8: Neurodevelopmental Disorders sample solution
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Create a study guide for Child- Onset Fluency Disorder (Stuttering). 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		 

Create a study guide for Child- Onset Fluency Disorder (Stuttering). 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

Childhood-Onset Fluency Disorder (Stuttering) Study Guide sample approach

·         A childhood-onset fluency disorder is distinguished by the extension of sounds, phrases, or syllables, as well as the repeating of sounds.

·         The person who stutters has a clear idea of what they want to say once they have it in their head, but they have trouble actually saying it.

·         When trying to produce a natural flow of speech, here is where the problem arises (Gürbüz Özgür & ÖZGÜR, 2019). 

Signs and symptoms according to the DSM-5

• Those affected may experience symptoms such as circumlocutions, broken sounds, sound prolongations, interjections, syllable sound repetition, and silent blockage.
• People with this condition have difficulty with cognitive tasks such as learning from experience, planning, thinking, and problem-solving. 
• It also includes intellectual and adaptive deficits during the child’s growth.

Differential diagnosis

• Sensory deficits: A hearing impairment, a sensory deficiency, or a speech-motor deficit may all be the root of stuttering or other articulation issues in speaking.
• Normal speech dysfluencies: This comprises repeats of whole words or phrases, statements that are left unfinished, interjections, pauses that are left unfilled, and parenthetical comments.
• Medication side effects: A number of different drugs may have an adverse effect on stuttering.
• Adult-onset dysfluencies: In most cases, they may be traced back to a trauma to the nervous system, underlying physical issues, or mental illnesses.

Incidence

• The beginning stuttering condition might come on at different times for different people in the United States.
• In most cases, it ranges from five to ten percent of the preschoolers who are between the ages of 18 and 48 months old (Sommer et al., 2021). 
• There are occasions when it lasts until the child is eight years old.

Development and course

• Childhood-onset fluency disorder manifests itself when the brain systems that are accountable for speech, language, and other sensitive activities are rapidly maturing.
• There are several factors that contribute to stuttering, and one of them is the speech motor. 
• Disruption in the motor impulses that are sent to the muscles may lead to anomalies in the normal patterns of muscular movement that are important for fluent speaking.
• Stroke and severe brain injuries are two other conditions that may lead to stuttering.
• The disruptions in brain function may sometimes result in neurogenic stuttering.
• It is also well-established that emotional discomfort plays a significant role in the development of stuttering and dysfluency (Gürbüz Özgür & ÖZGÜR, 2019). 

Prognosis

• Stuttering is a condition that may last a person’s whole life. However, studies suggest that up to 80% of children with this illness regain their fluency.
• When speech therapy and other therapies are begun at an early enough age, they may be quite beneficial.

Considerations related to culture, gender, and age

• The prevalence of stuttering in males is four times higher than in females.
• Because culture impacts communication methods, both verbal and non-verbal, taking cultural factors into account is vital for the treatment of stuttering.
• Stuttering is often seen in children between the ages of 2 and 7 who are attending preschool or elementary school (Gürbüz Özgür & ÖZGÜR, 2019). 

Pharmacological treatments and side effects

• There is not a drug that has been authorized to treat stuttering at this time.
• A number of medications, including haloperidol, have been recommended to improve fluency by boosting brain activity. 
• Dysphoria, sexual dysfunction, and extrapyramidal symptoms are some of the adverse effects of haloperidol (Sjøstrand et al., 2019).
• Pimozide is an additional medicine that may be used for stuttering.
• Pimozide causes adverse effects such as dysphoria, an increase in prolactin levels, and possible problems with heart conduction.

Non-pharmacological treatments

• Patients who stammer benefit from speech therapy because it teaches them to speak more slowly. 
• Interactions between parents and their stuttered children may also serve as practice sessions for coping strategies that might assist the child.
• Stuttering is related to issues of stress, worry, and low self-esteem, all of which may be ameliorated via the use of cognitive-behavioral therapy (Sjøstrand et al., 2019). 
• Stuttering patients may also benefit from the usage of electronic equipment, which can help them speak more fluently.

Diagnostics and labs

• The diagnosis of stuttering is made by medical professionals after a thorough examination of a child’s developmental history. 
• Additionally, a speech-language pathologist examines a child’s ability to speak and communicate. 
• There are various tests that may be done in a laboratory to identify whether someone stutters.

Comorbidities

• According to Donmez & Ozcan (2020), comorbidities associated with stuttering include:
  • chronic depression
  • brain trauma
  • suicide attempt
  • epilepsy

Legal and ethical considerations

• Stuttering is associated with a number of legal and ethical concerns, including: 
  • Ensuring fairness
  • Establishing and respecting autonomy
  • Meeting the needs of the patient
  • Reducing risks 

Pertinent patient education considerations

• Healthcare professionals should inform parents that stuttering therapy may not be necessary for children since the majority of youngsters overcome the condition on their own (NIDCD, 2017).
• It is important to educate parents on how to cultivate an atmosphere free of stress, how to coax their children to communicate openly, and how to maintain their composure while attentively listening to their children.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Donmez, Y. E., & Ozcan, O. O. (2020). Developmental stuttering and comorbid psychiatric disorders in school age children/Okul cagi cocuklarinda gelisimsel kekemelik ve eslik eden psikiyatrik bozukluklar. Anadolu Psikiyatri Dergisi, 21(5), 523-531.

Gürbüz Özgür, B., & ÖZGÜR, E. (2019). An analysis of Sociodemographic and clinical characteristics of children and adolescents diagnosed with childhood onset speech fluency disorder (Stuttering). ENT Updates. https://doi.org/10.32448/entupdates.610265

National Institute on Deafness and other communication disorders (NIDCD). (2017). Stuttering. https://www.nidcd.nih.gov/health/stuttering

Sjøstrand, Å., Kefalianos, E., Hofslundsengen, H., Guttormsen, L. S., Kirmess, M., Lervåg, A., Hulme, C., & Naess, K. B. (2019). Non-pharmacological interventions for stuttering in children aged between birth and six years. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd013489

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. https://doi.org/10.3389/fnhum.2021.645292