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Stuttering is a disorder of fluency characterized by various behaviors that interfere with the flow of normal speech. What differentiates stutterers from non stutterers is the frequency of their disfluency and/or the severity of their disfluency. Another factor that differentiates stutterers from non stutterers is that almost invariably the disfluencies that the stutterer regards as “stutters” are accompanied by a feeling of loss of control. It is this loss of control, which can’t be observed or experienced by the listener, that is most problematic for the stutterer.

Primarily characterized by repetitions (sounds, syllables, part-words, whole words, phrases), pauses, and prolongations that differ in number and severity from those of normally fluent individuals. Other disorders are characterized by disfluent speech, but the patterns of disfluency in these other disorders differ from that seen in developmental stuttering.

People with significant speech difficulty often don't stutter when singing, talking to animals, or reading to small children, or when they are alone talking to themselves. Stuttering tends to persist into adulthood more in males than females. The main characteristics are:

Inappropriate for age, the patient lacks normal fluency and time patterning of speech. This is characterized by frequent occurrences of at least 1 of the following:

Repetitions of sound and syllable.
Sound prolongations.
Interjections.
Broken words.
Blocking that is audible or silent.
Circumlocutions (substitutions to avoid words hard to pronounce).
Words spoken with excessive physical tension.
Repetitions of monosyllabic whole words (such as "a-a-a-a-a dog bit me").

These problems interfere with educational or occupational achievement or with social communication.
    
If the patient also has a sensory or speech-motor deficit, the problems with language are worse than you would expect with these problems.

Associated Features:

Depression is most commonly seen in adults and adolescents who stutter. However, this does not mean that all adults and adolescents who stutter have psychiatric disorders.

Differential Diagnosis:
Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Developmental stuttering should be distinguished from acquired stuttering. Normal speech dysfluency occurs in young children and can be difficult to distinguish from stuttering. Stuttering exhibits more nonfluencies, part-word repetitions, sound prolongations and disruptions in voice airflow. Nonfluent children are more at ease than children with stuttering.

Cause:
    
Young children often go through a short period of stuttering. For a small percentage (less than 1%), the stuttering progresses from simple repetition of consonants to repetition of words and phrases. Later vocal spasms develop with a forced, almost explosive sound to the speech. Stuttering also tends to run in families. There is also some evidence that stuttering may be associated with some neurological deficits but there is also a strong psychological component.
   
Treatment:

There are no absolute therapy or cure for stuttering.

Counseling and Psychotherapy [ See Therapy Section ]:

In persistent stuttering cases, speech therapy may be helpful although stuttering does tend to be very resistant to any therapies.

Pharmacotherapy [ See Psychopharmacology Section ] :
  
Clomipramine, an SSRI, has been shown to be superior to desipramine, an antidepressant.

 


DSM Code

307.0 Stuttering

Not Identified

Disorder Sheets

The British Stammering
Association

15 Old Ford Road
London
E2 9PJ
Tel: +442089831003
Email:Click Here
Web: Click Here

Recommended Book

Stuttering: Its Nature, Diagnosis, and Treatment - Click Here to View

 

Stuttering

Misc Information

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Communication Disorders