Many children have speech or language disorders—including difficulty with word articulation, written language, and interacting with the social rules of verbal and nonverbal communication. Early intervention is the key to successful treatment.
Communication disorders involve persistent problems related to language and speech.
Language competence involves two main elements, according to the book Speech and Language Disorders in Children: production, or "the ability to encode one's ideas into language forms and symbols," and comprehension, "the ability to understand the meanings that others have expressed using language." Speech refers specifically to sound produced orally.
It is estimated that nearly one in 10 American children has some type of communication disorder.
The DSM-5 organizes communication disorders into the following categories:
- Language Disorder
- Speech Sound Disorder
- Childhood-Onset Fluency Disorder (Stuttering)
- Social (Pragmatic) Communication Disorder
- Unspecified Communication Disorder
Language Disorder, as defined by the DSM-5, is marked by "persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production." Such deficits include limited vocabulary, ability to form sentences, and capacity to use language to communicate relative to what is expected for one's age.
Social (Pragmatic) Communication Disorder involves "difficulties in the social use of verbal and nonverbal communication," such as a lack of ability to alter communication to fit particular contexts (e.g., a classroom), grasping normal rules of conversation, or understanding nonliteral meanings of language.
One category of speech disorder is dysfluency. Childhood-onset fluency disorder (formerly referred to as stuttering) is characterized by a disruption in the flow of speech and includes repetitions of speech sounds, hesitations before and during speaking, and/or prolongations of speech sounds.
Articulation difficulties are commonly found in people who have speech disorders. The term refers to problems forming and combining sounds, usually by omitting, distorting, or substituting them.
Voice disorders include 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 this speech pathology.
Auditory Processing (Hearing)
Central auditory processing disorder, as described by the International Statistical Classification of Diseases and Related Health Problems (ICD), is "characterized by impairment of the auditory processing, resulting in deficiencies in the recognition and interpretation of sounds by the brain." This disorder is not included in the DSM-5.
Some causes of communication problems include hearing loss, neurological disorders, brain injury, vocal cord injury, autism, intellectual disability, drug abuse, physical impairments such as cleft lip or palate, emotional or psychiatric disorders, and developmental disorders. Yet the DSM-5 generally separates distinct medical and neurological conditions from communication disorders. Frequently, the cause of a communication disorder unknown.
The best way to approach treatment for a communication disorder is to focus on prevention and early intervention.
Parents should be aware of the typical age their child should be reaching each developmental milestone. "The first 3 years of life, when the brain is developing and maturing, is the most intensive period for acquiring speech and language skills," according to the National Institute on Deafness and Other Communication Disorders. By 4 to 6 months, a baby typically babbles in a manner that resembles speech, using a variety of sounds, and responds to changes in voice tone. After one year, it is normal for a child to, for example, understand some simple words for items, to communicate with physical gestures, and to use one or two words. From ages 1 to 2 and beyond, children regularly pick up new words and begin to use more than one word together.
If you have concerns about your child's speech or language development, you should talk to your family doctor, who may refer you to a speech-language pathologist trained to treat communication disorders. Treatment may involve interactive, communication-based activities for parent and child and, potentially, group or individual therapy.
- American Psychiatric Association, Diagnostic and Statistical Manual, Fifth Edition
- Speech and Communication Disorders, US National Library of Medicine, NIH
- National Institute on Deafness and Other Communication Disorders
- The American Speech-Language-Hearing Association
- National Center for Health Statistics
Last reviewed 02/15/2019