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child:communication:childhood-onset-fluency-disorder [on April 12, 2019]
 child:communication:childhood-onset-fluency-disorder [on May 28, 2019]
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-{{INLINETOC}} 
 ====== Childhood-Onset Fluency Disorder (Stuttering) ====== ====== Childhood-Onset Fluency Disorder (Stuttering) ======
 +{{INLINETOC}}
 ===== Primer ===== ===== Primer =====
 **Childhood-Onset Fluency Disorder** (also known as **Stuttering**) is a disorder characterized by a disturbance in the normal fluency and time patterning of speech that is inappropriate for an individual'​s age. The disorder is characterized by frequent repetitions or prolongations of sounds or syllables. Other speech deficits include: (1) single words that are broken up (e.g. - pauses within a word), (2) audible or silent blocks (i.e. - filled or unfilled pauses in speech), (3) circumlocutions (i.e. -  word substitutions to avoid problematic words), (4) words produced with excess physical tension, and (5) monosyllabic whole-word repetitions (e.g., '​He-he-he-he is here"​). **Childhood-Onset Fluency Disorder** (also known as **Stuttering**) is a disorder characterized by a disturbance in the normal fluency and time patterning of speech that is inappropriate for an individual'​s age. The disorder is characterized by frequent repetitions or prolongations of sounds or syllables. Other speech deficits include: (1) single words that are broken up (e.g. - pauses within a word), (2) audible or silent blocks (i.e. - filled or unfilled pauses in speech), (3) circumlocutions (i.e. -  word substitutions to avoid problematic words), (4) words produced with excess physical tension, and (5) monosyllabic whole-word repetitions (e.g., '​He-he-he-he is here"​).
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 ===== Differential Diagnosis ===== ===== Differential Diagnosis =====
-  * Sensory deficits+  ​* **Sensory deficits**
     * Dysfluencies of speech can be caused by hearing impairment, sensory deficit, or a speech-motor deficit. Only when the speech dysfluencies are in excess of what is expected, should a diagnosis of childhood-onset fluency disorder be made.     * Dysfluencies of speech can be caused by hearing impairment, sensory deficit, or a speech-motor deficit. Only when the speech dysfluencies are in excess of what is expected, should a diagnosis of childhood-onset fluency disorder be made.
-  * Normal speech dysfluencies+  ​* **Normal speech dysfluencies**
     * Normal dysfluencies occur frequently in young children. This includes whole-word or phrase repetitions (e.g. - "I want, I want that toy!"​),​ incomplete phrases, interjections,​ unfilled pauses, and parenthetical remarks. If these difficulties continue to increase in frequency or complexity with age, then childhood-onset fluency disorder is more likely.     * Normal dysfluencies occur frequently in young children. This includes whole-word or phrase repetitions (e.g. - "I want, I want that toy!"​),​ incomplete phrases, interjections,​ unfilled pauses, and parenthetical remarks. If these difficulties continue to increase in frequency or complexity with age, then childhood-onset fluency disorder is more likely.
-  * Medication side effects+  ​* **Medication side effects**
     * Stuttering can occur as a side effect from medications. This should be correlated with a temporal history of exposure to the medication.     * Stuttering can occur as a side effect from medications. This should be correlated with a temporal history of exposure to the medication.
-  * Adult-onset dysfluencies+  ​* **Adult-onset dysfluencies**
     * If the dysfluency begins during or after adolescence,​ it is an diagnosed as adult-onset dysfluency instead. Adult-onset dysfluencies are usually due to a neurological insult, medical conditions, or mental disorders. It is not considered a DSM-5 diagnosis.     * If the dysfluency begins during or after adolescence,​ it is an diagnosed as adult-onset dysfluency instead. Adult-onset dysfluencies are usually due to a neurological insult, medical conditions, or mental disorders. It is not considered a DSM-5 diagnosis.
-  * [[child:​motor:​tic-disorders|Tourette’s disorder]]+  ​* **[[child:​motor:​tic-disorders|Tourette’s disorder]]**
     * The vocal tics and repetitive vocalizations from Tourette'​s disorder should be distinguished from the repetitive sounds of childhood-onset fluency disorder by their nature and timing.     * The vocal tics and repetitive vocalizations from Tourette'​s disorder should be distinguished from the repetitive sounds of childhood-onset fluency disorder by their nature and timing.
 ===== Treatment ===== ===== Treatment =====