Acute-Onset Acquired Stuttering Secondary to Concussion: A Case Report

Kelsey Jo Wagner, Karen Hux
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Abstract

Acquired stuttering in young adults can present diagnostic and treatment challenges. This single case report documents the diagnosis of acquired, postconcussive, acute-onset stuttering in an 18-year-old man, describes key elements of a person-centered treatment program conducted via a telerehabilitation platform, and reports documented changes in speech production following intervention. Person-centered care principles, disfluency education, strategies for managing stuttering episodes, and a home program were treatment components. Using the Overall Assessment of the Speaker's Experience of Stuttering (OASES) and speech sample analyses, documentation of initial status and changes over time came from initial, 3-month, 6-month, and follow-up evaluations. Initial OASES scores were consistent with moderate–severe impact for General Information, moderate impact to Daily Communication, and mild–moderate impact with respect to Speaker's Reactions, Quality of Life, and Overall Assessment. The initial speech sample analysis revealed severely disrupted speech production with disfluencies occurring on 60.47% of syllables. In contrast, the 6-month assessment revealed mild or mild–moderate OASES impact scores and disfluencies on 1.78% of syllables. Performance during a follow-up evaluation held 3 months following treatment termination confirmed maintenance of fluent speech production both when reading and engaging in conversation. Clear differentiation between neurogenic and functional contributions to acute-onset, acquired stuttering is not always possible. In some cases, a combination of precipitating factors may be evident. Regardless, presenting traditional fluency management strategies within a framework of person-centered care can be an effective treatment approach. https://doi.org/10.23641/asha.25463968
继发于脑震荡的急性获得性口吃:病例报告
青少年获得性口吃会给诊断和治疗带来挑战。本病例报告记录了对一名 18 岁男子后天获得性、震荡后急性发作口吃的诊断,描述了通过远程康复平台开展的以人为本的治疗计划的关键要素,并报告了干预后言语表达的变化。 以人为本的护理原则、不流利教育、口吃发作管理策略和家庭计划是治疗的组成部分。通过口吃患者口吃体验总体评估(OASES)和言语样本分析,最初、3 个月、6 个月和随访评估记录了患者的初始状态和随时间推移发生的变化。 最初的 OASES 评分显示,口吃对一般信息的影响为中度-重度,对日常交流的影响为中度,而对说话者的反应、生活质量和总体评估的影响为轻度-中度。最初的语音样本分析表明,患者的语音表达受到严重干扰,60.47%的音节出现不流畅现象。相比之下,6 个月的评估显示,OASES 影响评分为轻度或轻度-中度,1.78% 的音节出现不流畅。治疗终止后 3 个月的随访评估结果证实,患者在阅读和交谈时都能保持流畅的语言表达。 对于急性发作的后天口吃,并不总是能够明确区分神经源性和功能性因素。在某些情况下,可能会出现多种诱发因素。无论如何,在以人为本的护理框架内采用传统的流利性管理策略是一种有效的治疗方法。https://doi.org/10.23641/asha.25463968。
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