Communication disorders

What are communication disorders?

Speech and language disorders refer to problems in communication and related areas such as oral motor function. Delays and disorders can range from simple sound substitution to the inability to understand or use their native language. Such disorders are usually diagnosed in childhood or adolescence, although they may persist into adulthood.

Guidelines
Language disorders:

Persistent difficulties in the acquisition and use of language in all its modalities (i.e. spoken, written, sign language or other) due to deficits in comprehension or production including the following:

1. reduced vocabulary (knowledge and use of words).
2. Limited grammatical structure (ability to place words and word endings together to form sentences based on grammatical and morphological rules).
3. Speech impairment (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation).

Language abilities are markedly and measurably below what is expected for age, resulting in functional limitations in effective communication, social participation, academic achievement or work performance, individually or in any combination.

The onset of symptoms occurs early in the developmental period.

Difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or other medical or neurological condition and are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

 

Phonological Disorders:

Persistent difficulties in phonological production that interfere with speech intelligibility or prevent verbal communication of messages.

The disorder causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, either individually or in any combination.

The onset of symptoms occurs in the early developmental period

Difficulties cannot be attributed to congenital or acquired conditions such as cerebral palsy, cleft palate, hearing loss, head trauma, or other medical or neurological conditions.

 

Childhood-Onset Fluency Disorder (Stuttering):

Disruptions of normal speech fluency and time patterning of speech that are inappropriate for the individual’s age and language skills, persist over time, and are characterized by frequent and noticeable occurrence of one (or more) of the following factors:

  1.  Sound and syllable repetitions.
  2.  Sound prolongations of consonants and vowels.
  3.  Broken words (e.g., pauses within a word).
  4.  Audible or silent blocking (speech arrests, filled or unfilled pauses).
  5.  Circumlocutions (substitution of words to avoid problematic words).
  6.  Words produced with excessive physical tension.

 

Social (Pragmatic) Communication Disorder:

Persistent difficulties in the social use of verbal and nonverbal communication, as manifested by all of the following:

  1. Deficits in using communication for social purposes, such as greeting and sharing information, in a manner appropriate to the social context.
  2. Impairment in the ability to change communication to match the context or the needs of the listener, such as speaking differently in a classroom or on a playground, talking differently to a child or an adult, and avoiding overly formal language.
  3. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when not understood, and using verbal and nonverbal signals to regulate interaction.
  4. Difficulties understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation)

American Psychiatric Association (2014). <em>Diagnostic and Statistical Manual of Mental Disorders</em> (DSM-5), 5th ed. Washington, D.C.: American Psychiatric Association

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