SANDINO, REGINE Dr. Evelyn V.

Pagsanhan

IV-B PSYCH

CHILDHOOD ONSET FLUENCY DISORDER

According to DSM 5:

DIAGNOSTIC CRITERIA: A. Disturbances in normal fluency and time patterning of

speech characterized by 1 or more of the following:

1. Sound and syllable repetitions.

Ex.: The b-b-baby

My p-p-pencil

2. Sound prolongations. (Consonants and vowels)

Ex.: Sssssssometimes I watch horror movies.

I ssssssssaw him yesterday.

3. Broken words.

(Pauses within a word)

Ex.: Pau…ses

My pencil is bro….ken.

4. Audible or silent blocking. (filled or unfilled pauses in speech)

Ex.: I am g-(pause)-oing home.

I have uh 5 pets.

5. Circumlocutions

6. Words produced with an excess of physical tension.

 7. Monosyllabic whole-word repetitions.

Ex.: I-I-I-I want ice cream.

Why-why-why- is he there?

But-but-but but I don’t want cake.

NOTE: Examples are not taken from the DSM 5.

B. The disturbance causes anxiety about speaking or limitations in effective

communication, social participation or academic or occupational performance

individually or in any combination.

C. The onset of symptoms is in the early developmental period.

The disturbance is not attributable to a speech-motor or sensory deficit, dysfluency

associated with neurological insult or another medical condition and not better explained

by another mental disorder.

ASSOCIATED FEATURES:

 Attempt to avoid dysfluencies by linguistic mechanisms.

 Avoiding certain speech situation.

 May be accompanied by motor movements

 Stress and anxiety have been shown to exacerbate dysfluency.

DEVELOPMENT

 Occurs by age 6 for 80%-90% of affected individuals, with age at onset ranging

from 2-7 years.

RISK FACTORS:

 First-degree biological relatives of individuals with childhood onset fluency

disorder is more than three times the risk in general population.

 SOCIAL (PRAGMATIC) COMMUNICATION DISORDER

According to DSM 5:

Diagnostic Criteria:

A: Persistent difficulties in the social use of verbal and nonverbal communication

as manifested by the following:

1. Deficits I using communication for social purposes.

2. Impairment of the ability to change communication to match context or the needs

of the listener.

3. Difficulty following rules of conversation and storytelling.

4. Difficulty understanding what is not explicitly stated.

B. Deficits result in functional limitations in effective communication.

C. Onset of symptoms is in early developmental period.

D. Symptoms are not attributable to another medical condition or neurological condition

or to low abilities in the domain of word structure and grammar and are not better

explained by ASD, intellectual disability or another mental disorder.

ASSOCIATED FEATURES:

 Language impairment

 May avoid social interactions

 ADHD, behavioral problems and SLD are common in affected individuals.

DEVELOPMENT:

 Rare among children younger than 4 years.

RISK AND PROGNOSTIC FACTORS:

Family history of ASD, communication disorders and SLD appears to increase the risk.