Social (Pragmatic) Communication Disorder 47
cover from the dysfluency, with severity of fl uency disorder at age 8 years predicting re-
covery or persistence into adolescence and beyond.
Risk and Prognostic Factors
Genetic and physiological. The risk of stuttering among first-degree biological rela-
tives of individuals wi th childhood-onset fluency disorder  is more than three times the
risk in the general population.
Functional Consequences of 
Childhood-Onset Fluency Disorder (Stuttering)
In addition to being features of the condit ion, stress and anxiety can exacerbate dysflu-
ency. Impairment of social function ing may result from this anxiety.
Differential Diagnosis
Sensory deficits. Dysfluencies of speech may be associated with a hearing impairment
or other sensory deficit or a sp eech-motor deficit. When the speech dysfluencies are in ex-
cess of those usually associated with these problems, a diagnosis of childhood-onset flu-
ency disorder may be made.
Normal speech dysfluencies. The disorder must be distinguished from normal dysflu-
encies that occur frequently in young children, which include whole-word or phrase rep-
etitions (e.g., “I want, I want ice cream”), incomplete phrases, in terjections, unfilled
pauses, and parenthetical remarks. If these difficulties increase in frequency or complexity
as the child grows older, a diagnosis of child hood-onset fluency diso rder is appropriate.
Medication side effects. Stuttering may occur as a side effect of medication and may be
detected by a temporal relationship with exposure to the medication.
Adult-onset dysfluencies. If onset of dysfluencies is during  or after adolescence, it is an