Communication Disorders

Communication disorders include problems related to speech, language and auditory processing. Communication disorders may range from simple sound repetitions such as stuttering to occasional misarticulation of words to complete inability to use speech and language for communications (aphasia).

Some causes of communication disorders include hearing loss, neurological disorders, brain injury, mental retardation, drug abuse, physical impairments such as cleft lip or palate, emotional or psychiatric disorders, and developmental disorders. Frequently, however, the cause is unknown. It is estimated that one in every 10 Americans, across all ages, races and genders, has experienced or lived with some type of communication disorder (including speech, language and hearing disorders). Nearly 6 million children under the age of 18 have a speech or language disorder.

About Speech

Speech is produced by precise, coordinated muscle actions in the head, neck, chest, and abdomen. Speech development is a gradual process that requires years of practice. During speech development, one learns how to regulate these muscles to produce intelligible speech. It is estimated that by the first grade, 5 percent of children have noticeable speech disorders, the majority of which have no known cause.

One category of speech disorder is dysfluency.

Stuttering is, perhaps, the most serious dysfluency. Stuttering is characterized by a disruption in the flow of speech. It includes repetitions of speech sounds, hesitations before and during speaking and, or, prolongations of speech sounds. There are over 15 million individuals who stutter in the world. Most stutterers first exhibit dysfluency at an early age, and stuttering occurs most frequently in children between the ages of 2 and 6, during language development. One child in 30 goes through a period of stuttering that can last six months or longer.

Articulation difficulties constitute the most numerous of all speech disorders. The term refers to difficulties with the way sounds are formed and strung together ("wabbit" for "rabbit"), omitting a sound ("han" for "hand"), or distorting a sound ("sip for ship")

Voice disorders, another type of speech disorder, relate to difficulties with the quality, pitch and loudness of the voice (prosody). People with voice disorders may have trouble with the way their voices sound. Listeners may have trouble understanding someone with a speech pathology.

Voice is generated by airflow from the lungs as the vocal folds are brought close together. The vocal folds vibrate when air is pushed past them with sufficient pressure. Without normal vibration of the vocal folds in the larynx (voice box), the sound of speech is absent. To produce a whisper, the vocal folds need to be partially separated. It is estimated that 7.5 million people in the United States have difficulties using their voices. Many people who have acquired normal speaking skills become communicatively impaired when their vocal apparatus fails. This can occur if the nerves controlling the functions of the larynx are impaired as a result of an accident, a surgical procedure or a viral infection.

It is important to distinguish between a difficulty in articulation of words and aphasia (a problem with the production of language).

About Language

Language is the expression of human communication through which knowledge, beliefs and behavior can be experienced, explained and shared. A language disorder is the impairment or deviant development of expression and, or, comprehension of words in context. The disorder may involve the form of language, the content of language and, or, the function of language as a communication tool. It is estimated that between 6 and 8 million individuals in the United States have some form of language impairment. Disorders of language affect children and adults differently. For children who do not use language normally from birth, or who acquire the impairment in childhood, the disorder occurs in the context of a language system that is not fully developed or acquired. Many adults acquire disorders of language because of stroke, head injury, dementia or brain tumors. Language disorders are also found in adults who failed to develop normal language because of childhood autism, hearing impairment or other congenital or acquired disorders of brain development.

About Auditory Processing (Hearing)

Auditory processing is the term used to describe what happens in your brain when it recognizes and interprets the sounds around you. Humans hear energy, which we recognize as sound when it travels through the ear and is changed into electrical impulses that can be interpreted by the brain. The "disorder" part of auditory processing disorder (APD) means that something is adversely affecting the processing or interpretation of information.

Children with APD often do not recognize subtle differences between sounds in words, even though the sounds themselves are loud and clear. For example, the request "Tell me how a couch and a chair are alike" may sound to a child with APD like "Tell me how a cow and a chair are alike." It can even be understood by the child as "Tell me how a cow and a hair are alike." These kinds of problems are more likely to occur when a person with APD is in a noisy environment or when he or she is listening to complex information.

APD goes by many other names. Sometimes it is referred to as central auditory processing disorder (CAPD). Other common names are auditory perception problem, auditory comprehension deficit, central auditory dysfunction, central deafness and so-called "word deafness."

Children with APD typically have normal hearing and intelligence.

Communication Disorders. Last reviewed 12/31/1969
  • Journal of Communication Disorders
  • Speech and Communication Disorders, US National Library of Medicine, NIH
  • Speech and Language Impairment Fact Sheet 11
  • National Institute on Deafness and Other Communication Disorders
  • The American Speech-Language-Hearing Association