The development of stuttering

When someone is dx with stuttering, commonly, questions surrounding the onset of stuttering will arise.

When did the stuttering start?

How did it start?

When someone is dx with stuttering, commonly, questions surrounding the onset of stuttering will arise.

Why are these questions important?

Based on what we know about when stuttering usually develops – in early childhood, the following are taking place…

1. children are influenced by their immediate environment

2. anatomical structures for speech are developing

3. speech and language skills are developing rapidly (for most children)

Due to _____ during this sensitive time period, it is important for these to be taken into consideration into the possible role they play in the ______

caregiver roles; onset of stuttering.

In considering these 3 factors, theories regarding the ________ etc. as playing a part in the onset of stuttering are given a lot of attention.

home environment/parental demands on the child

These factors also contribute to theories regarding how stuttering may arise when demands ______ to the child exceed their developing _____, _____, and ______ capacities to produce fluent speech

internal and external; motor, linguistic and cognitive

Manner of onset questions

Does the stuttering occur quickly?

from one day to the next?

Or does it develop over time?

Quick duration?, duration in bursts? or does it persist?

What are the symptoms that are noted?

Emotional reaction from the child – anxiety etc

disfluent speech

If these symptoms do not occur (emotional mal adjustment, psychological issues) then theories that propose emotional maladjustment as the cause of stuttering are less relevant

Consideration of these factors is important tx selection..

Develop over time, persistent symptoms

From 1 day to the next? Run a short course?

Develop over time, persistent symptoms: speech therapy

sudden onset: play based psychotherapy

Other developmental communication disorders such as ____ or ____, the child has not developed the skills they are “missing” or have not previously shown mastery of these skills yet.

DLD or phonological issues

There is often a significant ____ reaction to this loss as well as a reaction by the ____.

parent/caregiver; child

With stuttering, children often develop stuttering _____ they have shown the capacity for fluent speech – SO, there is often a significant change in their _____ and the LOSS of the ability to produce ______

AFTER; speech pattern; fluent speech.

When does stuttering begin?

• Most stuttering will start before the age of 5 years old.

• Range: 16 - 60 months

• Mean: 33.40 months

  • for boys: 33.60

  • for girls: 32.95

• **After the age of 9 years the onset of stuttering is low

Stuttering onset in adults is _____

RARE

Stuttering onset in adults is usually linked to a clear origin –

either an emotional trauma or brain damage.

Adult onset stuttering is distinguished from ______________ as the stutter developed in an adult likely has a different _______

developmental stuttering (stuttering that developed in childhood); etiology/cause.

Stuttering-Like Disfluencies (per 100 syllables)

*Includes: part word repetitions, single syllable word repetitions, disrythmic phonation

CWS vs NFC

CWS: 10.37

NFC: 1.33

About __ out of _ children that begin stuttering ( %) recover!!

4 out of 5 (80%)

criteria for many studies:

• No stuttering present for a minimum of ____ as judged by ____ and ____

• Parental rating of stuttering severity of less than __ on a __ point scale.

• Clinician rating stuttering severity less than _

• SLD observed to be less than _ per ___ ____

• Maintained no stuttering for ____ to demonstrate _____ in recovery

• 12 months; parent and clinician.

• 1 on an 8

• 1

• 3 per 100 syllables

• 4 years stability

Risk for persistency: Primary factors

• Family History

• Gender

• Stuttering trends

• Duration of stuttering

• Age at onset

• Disfluency length

• Disfluency type; Prolongations/blocks