87 Stuttering (315.31)
DSM-IV-TR criteria
- A. Disturbance in the normal fluency and time patterning of speech (inappropriate for the individual’s age), characterized by frequent occurrences of one or more of the following:
- Sound and syllable repetitions
- Sound prolongations
- Interjections
- Broken words (e.g., pauses within a word)
- Audible or silent blocking (filled or unfilled pauses in speech)
- Circumlocutions (word substitutions to avoid problematic words)
- Words produced with an excess of physical tension
- Monosyllabic whole word repetitions (e.g., “I-I-I-I see him”)
- B. The disturbance in fluency interferes with academic or occupational achievement and with social communication.
- C. If a speech-motor or sensory deficit is present, the speech difficulties are in excess of those usually associated with these problems.
Associated features
- When stuttering first comes about, the affected individual may not realize there is a problem. After time goes on, most people with stuttering issues will realize there is a problem; some may begin to fear that they will stutter in front of others. To avoid embarrassment, a person with a stuttering problem may try to create ways to avoid stuttering. They might avoid speaking in front of a crowd where they know they would become more anxious and more likely to stutter. They could also change the way they speak. Slowing down the rate of speech would make pauses less noticeable and drawing out certain words wouldn’t be as obvious either if all words were spoken at a slower pace.
- In extreme cases, a person may choose to avoid social contact entirely in order to prevent occurrences where they now some form of stuttering will occur regardless of what precautions they may take.
- Stress makes stuttering more likely to occur. The anxiety about stuttering can lead to several other issues with social functioning. Self-esteem in individuals with a stuttering problem is typically lower than the “normal” population who have less issues with social communication. Nervous twitches may arise in those who stutter such as eye blinks, tics, tremors, and other “twitches” non of which are uncommon.
– Other people may try to hide their unorthodox speech from others by rearranging the words in their sentence
(circumlocution), pretending to forget what they wanted to say, or declining to speak.
Child vs. adult presentation
- The presentation of stuttering in children and adults is very similar; however, the manner in which it affects their lives can be quite different. In children and adults, stuttering can create a major impairment of social functioning.
- In adults, this impairment may also carry over into the work place. Stuttering can limit career options for adults, considering occupations dealing with frequent speaking in front of groups could cause considerable distress or anxiety to an individual who stutters. Stuttering could also limit opportunity for job advancement.
- In children, stuttering causes more of