variety of ways. Children and adults are monitored and evaluated for evidence of possible social, psychological or emotional signs of stress related to their disorder. Some common assessments of this type measure factors including: anxiety (Endler multidimensional anxiety scales (EMAS)), attitudes (personal report of communication apprehension (PRCA)), perceptions of self (self-rating of reactions to speech situations (SSRSS)), quality of life (overall assessment of the speaker's experience of stuttering (OASES)), behaviors (older adult self-report (OASR)), and mental health (composite international diagnostic interview (CIDI)). The SLP will then attempt to combine the information garnered from the client's case study along with the information acquired from the assessments in order to make a final decision regarding the existence of a fluency disorder and determine the best course of treatment for the client. Stuttering can also be diagnosed per the DSM-5 diagnostic codes by clinical psychologists with adequate expertise. The most recent version of the DSM-5 describes this speech disorder as "Childhood-Onset Fluency Disorder (Stuttering)" for developmental stuttering, and "Adult-onset Fluency Disorder". However, the specific rationale for this change from the DSM-IV is ill-documented in the APA's published literature, and is felt by some to promote confusion between the very different terms "fluency" and "disfluency". Normal disfluency Preschool aged children often have difficulties with speech concerning motor planning and execution; this often manifests as disfluencies related to speech development (referred to as normal dysfluency or "other disfluencies"). This type of disfluency is a normal part of speech development and temporarily present in preschool aged children who are learning to speak. These normal disfluencies can present as interjections ("Um"), multisyllable repetitions ("I want I want to do that"), or revised or abandoned utterances ("I want—hey what's that?"). Normal disfluency should be ruled out before diagnosing stuttering. Classification Developmental stuttering (also known as childhood onset fluency disorder) is stuttering that originates when a child is learning to speak and may persist as the child matures into adulthood. Stuttering that persists after the age of seven is classified as persistent stuttering. Other much less common causes of stuttering include neurogenic stuttering (stuttering that occurs secondary to brain damage, such as after a stroke) and psychogenic stuttering (stuttering related to a psychological condition). Other disorders with symptoms resembling stuttering include autism, cluttering, Parkinson's disease, essential tremor, palilalia, spasmodic dysphonia, selective mutism, and social anxiety. Developmental Stuttering is typically a developmental disorder beginning in early childhood and continuing into