Childhood-Onset Fluency Disorder occurs by age 6 for 80-90% of affected individuals, with age at onset ranging from 2 to 7 years. The onset can be gradual or more sudden. Typically, however, dysfluencies start gradually, with repetition of initial consonants, first words of a phrase, or long words. As the child becomes more aware of the speech difficulty, they may develop mechanisms for avoiding the dysfluencies and emotional responses. 

Development and Course of Childhood-Onset Fluency Disorder 

Stress and anxiety can exacerbate dysfluency. Impairment of social functioning may result from this anxiety. Moreover, negative communication attitudes may be a functional consequence of stuttering starting in the preschool years and increasing with age. 

Functional Consequences of Childhood-Onset Fluency Disorder

1. Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual's age and language skills persist over time. 
2. The disturbance causes anxiety about speaking or limitations in effective communication, social participation, or academic and occupational performance
3. The onset of symptoms is in the early developmental period
4. The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological damage (i.e., stroke, tumor, trauma), or another medical condition and is not better explained by another mental disorder

[DSM-5-TR] Diagnostic Criteria of Childhood-Onset Fluency Disorder

Associated features of Childhood-Onset Fluency Disorder may include:
- a child attempting to avoid dysfluencies by linguistic mechanisms (e.g., altering the rate of speech, avoiding certain words or sounds)
- a child may avoid certain speech situations (e.g., telephoning or public speaking)
- a child may exhibit motor movements (e.g., eye blinks, tics, tremors of the lips or face, jerking of the head, breathing movements, fist clenching). 

Associated Features of Childhood-Onset Fluency Disorder

- Risk factors of Childhood-Onset Fluency Disorder include genetic and physiological factors 
- Although stuttering can be life-long, approximately 65-85% of children recover from the dysfluency, with severity of fluency disorder at age 8 years predicting recovery or persistence into adolescence and beyond 

Risk and Prognostic Factors of Childhood-Onset Fluency Disorder 

Differential diagnoses of Childhood-Onset Fluency Disorder include: 
- Sensory deficits
- Normal speech dysfunctions
- Specific learning disorder, with impairment in reading
- Bilingualism
- Medication side effects
- Adult-onset dysfluencies
- Tourette's disorder

Differential Diagnoses to Childhood-Onset Fluency Disorder

Childhood-Onset Fluency Disorder can co-occur with other disorders, such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, intellectual developmental disorder (intellectual disability), language disorder to specific learning disorder, seizure disorders, social anxiety disorder, speech sound disorder, and other developmental disorders.

Comorbid Diagnoses to Childhood-Onset Fluency Disorder

This includes the intersection of connections and/or research related to Childhood-Onset Fluency Disorder (Stuttering) as a general category in other fields of study and research. Such fields include:
- TBD

Note: Add subjects as needed.

Interdisciplinary Connections & Research Related to Childhood-Onset Fluency Disorder (Stuttering)

A type of communication disorder that is characterized by significant disruptions of the normal fluency and motor production of speech. 

University of Illinois at Chicago

The DSM-5-TR separates Communication Disorders into the following specific disorders:
- Language Disorder
- Speech Sound Disorder
- Childhood-Onset Fluency Disorder (Stuttering)
- Social (Pragmatic) Communication Disorder
- Unspecified Communication Disorder


[DSM-5-TR] List of Communication Disorders

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed., Text revision). https://doi.org/10.1176/appi.books.9780890425596

DSM-5-TR

A type of communication disorder defined by difficulties in the acquisition and use of language due to deficits in the comprehension or production of vocabulary, grammar, sentence structure, and discourse.

Language Disorder

Child-hood-Onset Fluency Disorder (Stuttering)

A type of communication disorder that is characterized by continuous difficulty with using verbal and nonverbal language for social intentions.

Social (Pragmatic) Communication Disorder

"Speech sound disorders" (SSD) is an umbrella term which refers to any communication disorder defined by persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages. 

The condition is marked by developmentally inappropriate errors in speech production, due to impairments in articulation and phonological processing which arise from a variety of limitations related to perception, speech motor, and/or linguistic processes. 

SSD can be subdivided into two primary groups: 1) articulation disorders (also known as phonetic disorders) and 2) phonological disorders. 

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