Study Guide: Child Onset Fluency Disorder 

 Within this group of disorders, some are resolvable with appropriate and timely interventions, either pharmacological or nonpharmacological, while other disorders are chronic and need to be managed throughout the lifespan.(Comprehensive Essay Example on Child Onset Fluency Disorder)

For this Assignment, you will develop a study guide for an assigned disorder and share it with your colleagues. In sum, these study guides will be a powerful tool in preparing for your certification exam.(Comprehensive Essay Example on Child Onset Fluency Disorder)

RESOURCES

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources. (Comprehensive Essay Example on Child Onset Fluency Disorder)

WEEKLY RESOURCES

TO PREPARE

• Your Instructor will assign you to a specific neurodevelopmental disorder from the DSM-5-TR.
• Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder.(Comprehensive Essay Example on Child Onset Fluency Disorder)

THE ASSIGNMENT

Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5-TR but also supported by at least three other scholarly resources.(Comprehensive Essay Example on Child Onset Fluency Disorder)

Areas of importance you should address, but are not limited to, are:

• Signs and symptoms according to the DSM-5-TR
• Differential diagnoses
• Incidence
• Development and course
• Prognosis
• Considerations related to culture, gender, age
• Pharmacological treatments, including any side effects
• Nonpharmacological treatments
• Diagnostics and labs
• Comorbidities
• Legal and ethical considerations
• Pertinent patient education considerations

BY DAY 7 OF WEEK 8

You will need to submit your Assignment to two places: the Week 8 Study Guide discussion forum as an attachment and the Week 8 Assignment submission link. Although no responses are required in the discussion forum, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study.(Comprehensive Essay Example on Child Onset Fluency Disorder)

Access the Study Guide Forum (or click the Next button).

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area. (Comprehensive Essay Example on Child Onset Fluency Disorder)

1. To submit your completed assignment, save your Assignment as WK8Assgn+last name+first initial.
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.

Rubric

NRNP_6665_Week8_Assignment_Rubric

NRNP_6665_Week8_Assignment_Rubric

CriteriaRatingsPts

This criterion is linked to a Learning OutcomeCreate a study guide, in outline form with references, for your assigned disorder. Incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards.

30 to >26.0 pts

Excellent

The response is in a well-organized and detailed outline form. Informative and well-designed visual elements are incorporated….Followed directions correctly by uploading assignment to Gradebook and submitted to the discussion forum area.(Comprehensive Essay Example on Child Onset Fluency Disorder)

26 to >23.0 pts

Good

The response is in an organized and detailed outline form. Appropriate visual elements are incorporated….Partially followed directions by uploading assignment to Gradebook but did not submit to the discussion forum area.

23 to >20.0 pts

Fair

The response is in outline form, with some inaccuracies or details missing. Visual elements are somewhat vague or inaccurate….Partially followed directions by submitting to the discussion forum area but did not upload assignment to Gradebook.

20 to >0 pts

Poor

The response is unorganized, not in outline form, or is missing. Visual elements are inaccurate or missing….Did not follow directions as did not submit to discussion forum area and did not upload assignment to gradebook per late policy.(Comprehensive Essay Example on Child Onset Fluency Disorder)

30 pts

This criterion is linked to a Learning OutcomeContent areas of importance you should address, but are not limited to, are:• Signs and symptoms according to the DSM-5-TR• Differential diagnoses• Incidence• Development and course• Prognosis• Considerations related to culture, gender, age• Pharmacological treatments, including any side effects• Nonpharmacological treatments• Diagnostics and labs• Comorbidities• Legal and ethical considerations• Pertinent patient education considerations(Comprehensive Essay Example on Child Onset Fluency Disorder)

50 to >44.0 pts

Excellent

The response throughly addresses all required content areas.

44 to >39.0 pts

Good

The response adequately addresses all required content areas. Minor details may be missing.

39 to >34.0 pts

Fair

The response addresses all required content areas, with some inaccuracies or vagueness. No more than one or two content areas are missing.

34 to >0 pts

Poor

The response vaguely or inaccurately addresses the required content areas. Or, three or more content areas are missing.

50 pts

This criterion is linked to a Learning OutcomeSupport your guide with references to the DSM-5-TR and at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines. Be sure they are current (no more than 5 years old).(Comprehensive Essay Example on Child Onset Fluency Disorder)

10 to >8.0 pts

Excellent

The response is supported by the DSM-5 and at least three current, evidence-based resources from the literature.

8 to >7.0 pts

Good

The response provides at least three current, evidence-based resources from the literature that appropriately support the assessment and diagnosis of the patient in the assigned case study.(Comprehensive Essay Example on Child Onset Fluency Disorder)

7 to >6.0 pts

Fair

Three evidence-based resources are provided to support assessment and diagnosis of the patient in the assigned case study, but they may only provide vague or weak justification.(Comprehensive Essay Example on Child Onset Fluency Disorder)

6 to >0 pts

Poor

Two or fewer resources are provided to support assessment and diagnosis decisions. The resources may not be current or evidence based.

10 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation(Comprehensive Essay Example on Child Onset Fluency Disorder)

5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors

4 to >3.5 pts

Good

Contains one or two grammar, spelling, and punctuation errors

3.5 to >3.0 pts

Fair

Contains several (three or four) grammar, spelling, and punctuation errors

3 to >0 pts

Poor

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

5 pts

This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The guide follows correct APA format for parenthetical/narrative in-text citations and reference list.(Comprehensive Essay Example on Child Onset Fluency Disorder)

5 to >4.0 pts

Excellent

Uses correct APA format with no errors

4 to >3.5 pts

Good

Contains one or two APA format errors

3.5 to >3.0 pts

Fair

Contains several (three or four) APA format errors

3 to >0 pts

Poor

Contains many (five or more) APA format errors

5 pts

Total Points: 100

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Comprehensive Essay Example on Child Onset Fluency Disorder

Child Onset Fluency Disorder (COFD) is a communication disorder that affects the timing and flow of speech. The consequent speech disturbance is inappropriate for an individual’s developmental age. This is a study guide to the condition.  (Comprehensive Essay Example on Child Onset Fluency Disorder)

Individuals with COFD experience the following symptoms (American Psychiatric Association [APA], 2019):                          i.            Syllable and sound repetitions                        ii.            Sound prolongation of vowels and consonants.                      iii.            Broken words.                      iv.            Silent or audible blocking.                        v.            Circumlocutions                      vi.            Excess physical tension when producing words.                    vii.            Repetition of monosyllabic whole-word

Signs and symptoms according to the DSM-5-TR

Differential Diagnoses:

Differential diagnoses for COFD include SMANT:
a)      Sensory deficits	Speech dysfluencies can lead to many sensory deficits, including hearing impairment and speech-motor deficit.
b)      Medication side effects	Stuttering can be a side effect of medication.
c)      Adult-onset dysfluencies	Dysfluencies during or after adolescence is considered adult-onset rather than child-onset fluency disorder(Comprehensive Essay Example on Child Onset Fluency Disorder)
d)     Normal speech dysfluencies	Young children often experience normal dysfluencies such as a phrase or whole-word repetitions, interjections, incomplete phrases, or unfilled pauses that could be confused with child onset fluency disorder.(Comprehensive Essay Example on Child Onset Fluency Disorder)
e)      Tourette’s disorder	Tourette’s disorder can cause repetitive vocalization or vocal tics that can be confused with those associated with COFD.(Comprehensive Essay Example on Child Onset Fluency Disorder)

Incidence

COFD occurs in at least 5 % of all children. COFD occurs between ages 3 and 6; persistence is observed in 1% of adults (Sander & Osborne, 2019).

v  COFD development occurs gradually, and individuals may not be aware of dysfluencies. v  Dysfluencies become more frequent and interfere as the disorder progresses, affecting the utterance of more meaningful words or phrases. v  Avoidance of dysfluencies and emotional responses occurs with awareness of speech difficulty, although about 65-85% of individuals recover from COFD.

Development and course

Prognosis

COFD can be chronic, with periods of partial remission lasting weeks or months. COFD symptoms exacerbate in situations associated with the need to communicate (Boland & Verduin, 2021). 50-80% of individuals with COFD recover spontaneously, while those with chronic symptoms experience impaired peer relationships due to rejections or teasing, leading to academic difficulties and the development of anxiety disorders (Boland & Verduin, 2021). (Comprehensive Essay Example on Child Onset Fluency Disorder)

v  Cultural diversity influences the interpretation and help-seeking behaviors among parents whose children have COFD-related symptoms. v  The age onset of COFD range from 2 to 7 years (APA, 2019). v  80-90% of COFDs occur by age 6 (APA, 2019).

Considerations related to Culture, Gender, and Age

There are no FDA-approved medications for COFD. Studies indicate that dopamine antagonist medications can minimise the severity of COFD (Maguire et al., 2020). v  Aripiprazole, 15 mg per day, has been shown effective in managing COFD in adolescents and adults (Maguire et al., 2020). Aripiprazole causes Akathisia. v  Lurasidone – Has been tried for COFD with less sedation and metabolic side effects (Charoensook & Maguire, 2017).

Pharmacological treatments, including any side effects

Nonpharmacological treatments

v  Lidcombe Program – Parents praise their children when they don’t stutter and request children to self-correct when they stutter (Boland & Verduin, 2021). v  Parent-Child Interaction Therapy (PCIT) – Stressors associated with increased stuttering are identified and used to manage stuttering (Boland & Verduin, 2021) v  Speech Therapy – Encouragements that target modification of  responses to stuttering v  Cognitive behavioral therapy – Identifies processes that exacerbate stuttering and establishes coping strategies (Sander & Osborne, 2019).

Diagnostics and Labs

v  An oral mechanism exam and speech-language test may be performed by a speech and language therapist to ascertain the diagnosis. v  Speech Fluency Assessment – Stuttering severity Instrument and test of childhood stuttering tools can provide information about COFD severity

Comorbidities

Common comorbidities associated with COFD include anxiety disorders, attention-deficit/hyperactivity anxiety disorder, tic disorders, personality disorders, atopic disorders, scholastic skills developmental disorders, Tourette syndrome, mental retardation, chromosomal anomalies, expressive language disorder, and neurodevelopmental disorders (Sommer et al., 2021).

Legal and Ethical Considerations

The following are legal and ethical considerations when dealing with children and adolescents.

v  Autonomy	Parents of minors have the right to steer their children’s medical care.
v  Consent and Assent	Parents assent to treatments and give informed consent for minors.
v  Confidentiality	A practitioner is obliged to uphold the privacy of the client’s information.

Pertinent Patient Education Considerations

v  Coping mechanisms v  How to identify stressors of COFD v  Engage in Syllable-timed speech (STS) v  Nature of speech: Speak slowly

References

American Psychiatric Association (APA). (2019). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publishing(Comprehensive Essay Example on Child Onset Fluency Disorder)

Charoensook, J., & Maguire, G. A. (2017). A case series on the effectiveness of lurasidone in patients with stuttering. , 29, 3, 29(3), 191-194. https://pubmed.ncbi.nlm.nih.gov/28738099/   

Disla de Jesus, V., Liem, A., Borra, D., & Appel, J. M. (2022). Who’s the Boss? Ethical Dilemmas in the Treatment of Children and Adolescents. Focus, 20(2), 215-219. https://doi.org/10.1176/appi.focus.20210037

Maguire, G. A., Nguyen, D. L., Simonson, K. C., & Kurz, T. L. (2020). The pharmacologic treatment of stuttering and its neuropharmacologic basis. Frontiers in Neuroscience, 14, 158. https://doi.org/10.3389%2Ffnins.2020.00158

Sander, R. W., & Osborne, C. A. (2019). Stuttering: understanding and treating a common disability. American Family Physician, 100(9), 556-560. Available at: https://www.aafp.org/pubs/afp/issues/2019/1101/p556.html  (Accessed 18 January 2023)(Comprehensive Essay Example on Child Onset Fluency Disorder)

Sommer, M., Waltersbacher, A., Schlotmann, A., Schröder, H., & Strzelczyk, A. (2021). Prevalence and therapy rates for stuttering, cluttering, and developmental disorders of speech and language: evaluation of german health insurance data. Frontiers in Human Neuroscience, 15, 645292. https://doi.org/10.3389%2Ffnhum.2021.645292(Comprehensive Essay Example on Child Onset Fluency Disorder)

Boland, R., & Verduin, M. (2021). Kaplan & Sadock’s Concise Textbook of Clinical Psychiatry. Lippincott Williams & Wilkins.