NRNP 6665-18 Wk 8 NEWEST 24/25 WELL GRADED

NRNP 6665-18 Wk 8 NEWEST 24/25 WELL GRADED Childhood-Onset Fluency Disorder (Stuttering)ANSWERChildhood-Onset Fluency Disorder (Stuttering) a condition characterized by disturbances in the normal fluency and time pattering of speech which are inappropriate for the individual's age and language skills and persist over a period of time (Saad & Kamel, 2019). DSM-5 CriteriaANSWERDisturbances in normal fluency and time patterning of speech inappropriate for age and language skills which persists over time, causes anxiety about speaking or limits effective communication, onset is in the early development period, is not attributable to motor or sensory deficit or associated with a neurological problem or another medical condition, cannot be better explained by another mental health disorder and includes one or more of the following: 1. Sound and syllable repetitions 2. Sound prolongation of consonants &/or vowels 3. Broken words 4. Audible or silent blocking 5. Word substitutions to avoid problematic words 6. Words produced with an excess of physical tension 7. Monosyllabic whole word repetitions (American Psychiatric Association, 2022). Onset and CourseANSWERUsually starts between ages 2-6 Onset can be insidious or sudden Typically starts gradually with repetition of first consonants or first words in a sentence or phrase Approximately 5% of preschoolers are affected Percentage drops to 1% by the end of junior high and remains at that level throughout lifetime (Saad & Kamel, 2019) Risk factorsANSWERMale Familial stuttering Onset of speech dysfluencies more than 6-12 months ago Age at onset older than 3-4 years of age No reduction in severity of stuttering within initial 7-12 months (Saad & Kamel, 2019). Rule out other causes for dysfluenciesANSWERStroke Brain injury Tourette's syndrome Medications (Theophylline, phenothiazine, amitriptyline, neuroleptic drugs, etc) Meningitis Brain cysts or neoplasm Genetic (Specifically mutations in gentes GNPTAB,GNPTG & NAGPA) (Denworth, 2021). DiagnosisANSWERDiagnosis is usually done by a speech-language therapist or a health professional that is trained to test and treat individuals with voice, speech and language disorders. (National Institute on Deafness and other Communication Disorders, 2017). Evalutation will typically include an analysis of the stuttering behaviors, child's speech & language abilities, and the impact the stuttering is having on their life (National Institute on Deafness and other Communication Disorders, 2017). Diagnostic ToolANSWERSSI-4: Stuttering Severity Instrument is a standardized stuttering assessment which covers four areas of speech behavior including frequency, duration, physical concomitants and naturalness of speech. The test can be used for ages 2-adulthood and measures stuttering severity in 20 minutes or less. TOCS: Test of Childhood Stuttering is used by clinicians to identify children who stutter, determine it's severity, and document changes in child's fluency and functioning over time. BAB: Behavior Assessment Battery for School age children who stutter is designed to provide clinicians with a way to reliably measure a child's affective, behavioral and cognitive reactions to their speech. (Bertone, 2021). Effects of stutteringANSWERIncreased social anxiety