title: Dysfluency in a service member with comorbid diagnoses: a case study.
abstract: OBJECTIVE
  Because of the noted increase in dysfluency among service members returning from Iraq and Afghanistan, this article describes differentiation between the various types of fluency as well as an evaluation and treatment course of a service member returning from war with the comorbid diagnoses of post-traumatic stress disorder, mild traumatic brain injury, and resulting stuttering.
  
  
  METHODS
  The subject of this case study signed a consent on his admission to National Intrepid Center of Excellence (NICoE) for use of any clinical information for research purposes. The patient-centered method of his evaluation and treatment is one standard for NICoE's 4-week treatment program. Fluency data were collected from the patient using observational and standardized assessment (Stuttering Severity Instrument-4). The patient underwent a course of treatment using fluency strategy education and practice to lead to generalization of skills across all communication environments.
  
  
  CONCLUSIONS
  This service member responded favorably following a short course of fluency treatment because of the psychogenic nature of his stuttering, which was a symptom of his psychological health diagnoses. The NICoE patient-centered care model achieved the desired results of fluency and improved overall function in this service member.
authors.affiliation: National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center (WRNMMC), Building 51, 4860 South Palmer Road, Bethesda, MD 20889.
authors.forename: Erin O
authors.initials: EO
authors.lastname: Mattingly
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000150:complications; D003072:Cognition Disorders / Q000150:complications; D006801:Humans; D008297:Male; D008889:Military Personnel; D009326:Naval Medicine; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D013070:Speech Therapy; D013313:Stress Disorders, Post-Traumatic / Q000150:complications; D013342:Stuttering / Q000209:etiology* / Q000628:therapy*; D000067398:War-Related Injuries / Q000150:complications