Stuttering Disorder in Children

Communication and Learning Disorders
1) Describe your first experience with childhood-onset fluency disorder (Experiences you had with the first person you diagnosed/first time you heard your child had childhood-onset fluency disorder/first time you remember your childhood-onset fluency disorder being a problem).
Childhood-onset fluency disorder is also referred to as stuttering. John was having trouble pronouncing some of his words. While this had begun when he was younger, it had prolonged past the normal speech developmental period. When John was speaking one could see he was anxious and he was less comfortable with his speech. John kept on repeating syllables, prolonging the vocalization of vowels, and consonants, substituting words in order to avoid problematic words, and he would get frustrated when he tried to speak. He also had shortness of breath when he was speaking and this affected his speech. He would find it hard to complete sentences or express himself.
2) How did you have to alter your everyday routine/routine of your child/suggestions you gave your patient and their family to help cope with _________________?
Parents need to understand that the symptoms might come and go. The symptoms might come depending on the task that the child is required to complete. During oral reading, it is likely that the symptoms might not be present (Mash & Wolfe, 2015). However, in casual conversation with another person, the symptoms might be present. Understanding the symptoms trigger is beneficial to the parents, and the child to understand how to cope with the disorder. Supporting John is vital as this will allow him to develop his speech further. The parents should be aware that the disorder might be rectified but there is a need for assistance to be offered to the child. The child might get frustrated as they attempt to speak and the parent should give them time to complete their sentence.
3) What were some of the initial symptoms you noticed/your family noticed that your child/your patient/you may have had with ______________________, or some kind of issue?
The symptoms that John showed were he kept on repeating some sounds and syllables, pausing within words, and sometimes he would have filled or unfilled pauses in his speech. Broken words mostly occurred with words that were hard for him speak out and one could see that he was trying hard to say the word (Palumbo, Mody, Klykylo, McDougle, & Guenther, 2015). When he found it hard to speak out some words, he would opt to omit them from his speech. This was an attempt to evade problematic words. At times he would substitute the problematic words with other words. John would demonstrate physical tension when he tried to speak. Shortness of breath was evident and he would at times try to speak too fast.
4) How did your child/your patients/you act compared to their peers that did not have _____________________?
As compared to other children of his age, John would get anxious and find it difficult to complete his sentences. One can see that he knows what he wants to say, however, he is finding it hard to say it. John was struggling to continue speaking and his speech was not as fluent as compared to that of his peers. The child could also develop a limitation of social participation. Since John is not able to communicate fluently, he does find it hard to make friends or interact with his peers. There is an impact on a child's academic performance. Anxiety is developed when John is requested to speak or to take part in any activity that requires him to effectively communicate.
5) What was used to treat or what was recommended to alleviate some of the effects of your child’s/your patient’s/your ______________________?
A majority of children do outgrow stuttering and this makes it hard to determine if therapy should be used. Sometimes therapy could be an interference and might result in further speech developmental issues (Mash & Wolfe, 2015). For the case of John, therapy was seen as the most appropriate intervention. It was recommended because John had frequent syllable and sound repetitions. The parents were also taught and advised to be speaking to John slowly and to make use of short and simple sentences. This will remove the speaking pressure that John experiences. Joh could also benefit from positive reinforcements for when he speaks without stuttering and negative reinforcements when he does. This is some form of conditioning that will allow him to practice speaking without stuttering.
6) Were non-medication alternatives suggested? Why or why not?
There is no medication alternative for treating childhood-onset fluency disorder. This is because the disorder is speech based and this does not require any medications to rectify or treat. Therapy and speech training are the best methods that should be used to treat the disorder. Since this is for children, it is quite easy for the child to learn how to speak and to gain confidence in speaking if they undergo therapy and training. Encouraging the child to slow down their speech is beneficial and it will offer them the needed assistance when they are speaking (Mash & Wolfe, 2015). Treatment strategies are not only aimed for the child but also the parents and other relatives. Speaking to the child slowly allows that to also learn how to slow down their speech. This also reduces the pressure that the child might feel that they need to speak as fast as others, which results in the stuttering.
7) How did the medication affect your child/your patients/you? (If no medication was prescribed or taken, why?)
There was no medication that was prescribed or taken for this disorder. This is because the disorder cannot be treated with medication. Instead, it requires therapy and speech training. Considering that the disorder has been discovered for a child, there are high chances that they could recover. Therapy is aimed at offering the child the confidence they need to speak without getting anxious. Anxiety before speaking is what causes stuttering. Speech therapy or training is aimed at teaching the child to slow down their speaking speed. It has been shown that slowing down the rate of speaking for the child is effective in reducing and eliminating the child's stuttering. With therapy, the child will learn how to speak and to improve upon their communication skills (Mash & Wolfe, 2015). Allowing them to gain the ability to speak without stuttering.
8) What are some of the causes of ______________________?
Genetics has been identified as the leading cause of stuttering in children. Stuttering tends to run in the family and it is genetically inherited. The belief that stuttering is caused by emotional problems is wrong and there is no evidence that supports this claim. The disorder is mainly passed from the father and not from the mother (Mash & Wolfe, 2015). Genetics has been found to account for about 70 percent of all the incidences of stuttering. The other factors that cause stuttering are parental mental illness or premature birth. Abnormal development in the speech centers of the brain is what results in stuttering. There is some evidence that demonstrates that the disorder could also be caused by abnormalities in speech motor control.
9) Was the school helpful in accommodating your child/your patient/you with your __________________________?
The school was willing to accommodate the child once they understood the special needs of the child. Having understood that the child will eventually outgrow the stuttering the school was willing to offer the necessary accommodation to the child. While the school did not have a dedicated teacher, the available teachers were willing to assist John to learn and gain confidence while speaking. John's classmates were also encouraged to speak slowly in order for him to also slow down his speech. The teachers ensured that they spoke and taught slowly so that John could be accommodated and they also made use of simple short sentences. This way John would learn and understand what was being taught and he would not struggle to keep up with the other children's speech speed.
10) How has your child’s/your patient’s/your ____________________ affected adulthood?
Since this disorder was discovered when John was still young, the likelihood of it affecting his adulthood is minimal. If the recommendations made to the parents for therapy and slowly speaking to him are followed, then John will most likely overcome his speaking anxiety and he will slow down his speech. This will assist him to overcome his stuttering and he will be able to speak fluently in a conversation. The symptoms that John experiences are due to him not being able to speak or getting anxious when he needs to speak. Stuttering can be rectified if it is discovered early and this will be the case for John. This means that John's adulthood will be free of stuttering. Undergoing speech therapy is quite effective and allows the child to gain confidence when speaking while at the same time learning how to speak slowly.
11) Additional information/questions. Note: What you ask will be determined by the course of the interview. Blank is not sufficient.
Parents should be observant of their children as they grow. Stuttering is a normal thing for children who are learning to speak and this should clear after they are over 2 years old. However, in case the stuttering continues the parent should seek the advice of a trained professional. This will ensure that they are able to handle the condition while still early and the child can undergo therapy early. There are other instances where the child could have muscle tightening and they are visibly struggling to speak. This should be a cause for concern for the parent. Looking out for these signs especially if the family has relatives who stutter too is vital. Genetic predisposition has been shown to be the likely cause of stuttering for children and if there is any family history of stuttering then it is vital that children are closely observed for any tell-tale signs of the condition.
Critical Thinking Reflection Summary
Childhood-onset fluency disorder is a genetic disorder that is mostly passed from the father to the children. It has been established that mothers do not significantly contribute to the development of childhood-onset fluency disorder (Mash & Wolfe, 2015). The disorder is also referred to as stuttering. It is characterized by the disturbance in the timing and flow of speech that is considered appropriate for a child of a certain age. Stuttering involves the repetition or prolongation of certain speech sounds, long pauses in speech, hesitation before and during speaking, and monosyllabic whole word repetitions. According to Palumbo et al. (2015) the condition is mostly accompanied by anxiety regarding speaking and it can place limitations on the child's comfort when they have to participate in social and academic environments. With time the child will develop fearful anticipation of speaking in front of others and they will attempt to avoid such speech situations. The child could also avoid speaking on the phone or in front of the class. Stuttering might be accompanied by motor movements like tremors of the lips and face, tics, and eye blinks. A child who stutters knows what they want to say, but they find it hard to say it. While it might be okay for children younger than 2 years to stutter in the speech as this is the normal learning part. Any stuttering that goes past 2 years should be considered to be a disorder. Stuttering occurs in young children since their speech and language abilities are not fully developed.
A majority of the symptoms for childhood-onset fluency disorder will develop between the ages of 2 and 7 (Mash & Wolfe, 2015). About 80 percent of the cases will develop by the time the child is 6 years old. Stuttering becomes a disorder when it starts affecting the child and it is persistent over time. When stuttering begins to cause distress then it should be considered a disorder. The symptoms are repeating some sounds and syllables, pausing within words, and sometimes filled or unfilled pauses in the child's speech. The child could also substitute words in order for them to avoid the problematic words.
Treatment for the disorder is mainly via therapy. There are no medications that can be prescribed to the child to assist in curing the disorder. Therapy is aimed at giving the child the confidence they need to be able to speak in front of others. Since the child is finding it hard to speak fluently, they tend to want to speak fast and finish what they have to say. This causes them to stutter and pause while they speak. With therapy, the child can be taught how to slow down their speaking speed to allow them to focus on what they have to say. This way the child will gain confidence and they will not be getting anxious about speaking. Parents are advised to be speaking slowly to the child. This will allow the child to learn how to speak slowly and they can adjust to the parent’s method of speaking. The use of short simple sentences is also recommended. Using simple sentences makes it easy for the child to communicate and learn how to use short sentences in his or her conversation.
With an accommodative school, the child can recover fully and they can gain their speech confidence. All the school need is to ensure that the teachers understand the needs of the child and to know how they can offer assistance to the child. This way the child will develop effective communication skills and they can improve their school work and social conversation. Other children should be encouraged to speak slowly when speaking with the stuttering child. This will encourage the child to slow down his or her speaking speed.


References
Mash, E. J., & Wolfe, D. A. (2015). Abnormal Child Psychology. Boston, MA: Cengage Learning.
Palumbo, M. L., Mody, M., Klykylo, W. M., McDougle, C. J., & Guenther, F. H. (2015). Neurodevelopmental Disorders: Communication Disorders. Psychiatry, 1, 706-721.