Stuttering in Children: Review and Referral Criteria
DOI:
https://doi.org/10.20344/amp.18909Keywords:
Child, Childhood-Onset Fluency Disorder, Speech Disorders, StutteringAbstract
Stuttering is a speech fluency disorder, in which people know perfectly well the message they want to convey, even though their speech is characterized by changes in rhythm, repetitions, prolongations, pauses and blocks, and may also be associated with states of anxiety or emotional tension. Up to one in every six children, typically between two and five years old, experience a period of transitory speech disfluency, with usual spontaneous recovery before reaching school age, with a prevalence rate of stuttering of up to 1% of the adult population, and a higher incidence rate in males (4:1). In Portugal, it is estimated that stuttering affects around 100 thousand people, acquiring importance due to its frequency and association with lower self-esteem, anxiety and social isolation, with negative impact on people’s ability to communicate and on their well-being and social interactions. The aim of this article is to highlight the complexity of the diagnostic and therapeutic approach of stuttering in pediatrics, with a particular focus on differentiating between normal speech disfluencies and childhood-onset fluency disorder (stuttering) and referral criteria, in order to raise awareness and facilitate early detection of these cases.
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References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington DC: APA; 2013.
American Psychiatric Association. Manual Diagnóstico e Estatísticos das Perturbações Mentais DSM-5. Vol 1. 5a ed. Lisboa: Climepsi Editores; 2013.
World Health Organization. The ICD-10 international classification of mental and behavioural disorders. 10th ed. Geneva: WHO; 1993.
Centro de Terminologias Clínicas. Catálogo Português ICD-10-CM / PCS. v7.0. Lisboa: CTC; 2023.
World Health Organization. The ICD 11 international statistical classification of diseases and related health problems. 11th ed. Geneva: WHO; 2020.
Yaruss JS. Early childhood stuttering therapy: a practical approach. 2020:1-14.
Alm PA. Stuttering, emotions, and heart rate during anticipatory anxiety: a critical review. J Fluency Disord. 2004;29:123-33.
Yairi E, Ambrose N. Epidemiology of stuttering: 21st century advances. J Fluency Disord. 2013;38:66-87.
Ashurst JV, Wasson MN. Developmental and persistent developmental stuttering: an overview for primary care physicians. J Am Osteopath Assoc. 2011;111:576-80.
Pertijs MA, Oonk LC, Beer de JJ, Bunschoten EM, Bast EJ, Ormondt van J, et al. Clinical guideline stuttering in children, adolescents and adults. Woerden: Dutch Association for Stuttering Therapy; 2014.
Felsenfeld S. Progress and needs in the genetics of stuttering. J Fluency Disord. 1996;21:77-103.
Alm PA. Stuttering and the basal ganglia circuits: a critical review of possible relations. J Commun Disord. 2004;37:325-69.
Chang SE, Guenther FH. Involvement of the cortico-basal gangliathalamocortical loop. Front Psychol. 2020;10:3088.
Chow HM, Chang S. White matter developmental trajectories associated with persistence and recovery of childhood stuttering. 2017;3359:3345-59.
Raza MH, Amjad R, Riazuddin S, Drayna D. Studies in a consanguineous family reveal a novel locus for stuttering on chromosome 16q. Hum Genet. 2012;131:311-3.
Rautakoski P, Hannus T, Simberg S, Sandnabba NK, Santtila P. Genetic and environmental effects on stuttering: a twin study from Finland. J Fluency Disord. 2012;37:202-10.
Frigerio-Domingues C, Drayna D. Genetic contributions to stuttering: the current evidence. 2017;5:95-102.
Smith A, Weber C. Childhood stuttering: where are we and where are we going? Semin Speech Lang. 2017;37:291-7.
Tseng CJ, Froudist-walsh S, Kroll J, Karolis V, Brittain PJ, Palamin N, et al. Verbal fluency is affected by altered brain lateralization in adults who were born very preterm. eNeuro. 2018;6:1-16.
Alm PA. Streptococcal infection as a major historical cause of stuttering: data, mechanisms, and current Importance. Front Hum Neurosci. 2020;14:1-20.
Merlo S, Briley PM. Sleep problems in children who stutter : evidence from population data. J Commun Disord. 2019;82:105935.
Trenque T, Claustre G, Herlem E, Djerada Z, Trenque A, Morel A, et al. Methylphenidate and stuttering. Br J Clin Pharmacol. 2019;85:2634-7.
Prasse JE, Kikano GE. Stuttering: an overview. Am Fam Physician. 2008;77:1271-6.
Shenker RC. Multilingual children who stutter: clinical issues. J Fluency Disord. 2011;36:186-93.
National Institute of Health. NIDCD Fact Sheet | Voice, Speech, and Language. Stuttering. Maryland; NIH: 2016.
Riley GD. SSI-4: Stuttering Severity Instrument. 4th ed. Austin: PRO-ED; 2009.
Yaruss JS, Quesal RW. Overall assessment of the speaker’s experience of stuttering (OASES): documenting multiple outcomes in stuttering treatment. 2006;31:90-115.
Choo AL, Smith SA, Li H. Associations between stuttering, comorbid conditions and executive function in children : a population ‑ based study. BMC Psychol. 2020:1-19.
Guitar B, Conture EG. The child who stutters: to the pediatrician. 6th ed. Memphis: Stuttering Foundation of America; 2021.
Onslow M, O’Brian S. Management of childhood stuttering. J Paediatr Child Health. 2013;49:112-5.
Winters KL, Byrd CT. Pediatrician referral practices for children who stutter. Am J Speech-Language Pathol. 2020;29:1404-22.
Perez HR, Stoeckle JH. Stuttering: clinical and research update. Can Fam Physician. 2016;62:479-84.
Donaghy M, Smith K. Management options for pediatric patients who stutter: current challenges and future directions. Pediatr Heal Med Ther. 2016;7:71-7.
Boyd A, Dworzynski K, Howell P. Pharmacological agents for developmental stuttering in children and adolescents: a systematic review. J Clin Psychopharmacol. 2011;31:740-4.
Stuttering Foundation of America. Physician’s checklist for referral. [cited 2022 Nov 08]. Available from: https://www.stutteringhelp.org/checklist-referral.
Stuttering Foundation of America. Questions for parents. [cited 2022 Nov 08]. Available from: https://www.stutteringhelp.org/questionsparents.
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