Communication disorder
Overview
A communication disorder is any disorder that affects an individual's ability to comprehend, detect, or apply language and speech to engage in discourse effectively with others. The delays and disorders can range from simple sound substitution to the inability to understand or use one's native language.The child may also struggle with word choice, word order, or sentence structure.
Language Disorder, Speech Sound Disorder, Child-Onset Fluency Disorder (Stuttering), and Social (Pragmatic) Communication Disorder
Language disorder is the difficulty understanding or using correct words in context. They may also have difficulty getting others to understand what they mean.A language disorder may cause a person to have a reduced vocabulary and limited sentence structure. They often struggle to form complete meaningful sentences and have trouble grasping the rules of grammar, both in written and speaking form.
Speech Sound Disorder affects an individual to have difficulty making certain sounds. The sounds may be omitted, changed, or distorted. For those affected by SSD, it is common to substitute sounds for other sounds.
Child Onset Fluency refers to a disruption in the natural flow of language, more often known as a stutter. COND will manifest itself in repetition or prolongation of speech. Those who suffer from this disorder may also hesitate before they speak or use monosyllabic repetitive words. For example, they may say something like, "He-he-he-he went that way."
Social Communication Disorder (SCD) doesn't focus on articulation of words, phonics, or order of words, but rather how an individual communicates socially. While a person who has SCD may be able to articulate extremely well, and may have no issues understanding grammar and sentence flow, they may be strongly lacking in proper social communication.
Causes
Communication disorders can be developmental or acquired conditions. Causes include abnormal brain development, exposure to substance abuse or toxins before birth, cleft lip or palate, genetic factors, traumatic brain injuries, neurological disorders, strokes, tumors in the area used for communication.
Symptoms
Language
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, limited ability to form sentences, and limited 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), to grasp normal rules of conversation, or to understand nonliteral meanings of language.
Speech
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). Individuals with voice disorders may have trouble with the way their voices sound, and listeners may have trouble understanding a person 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.
Treatment for communication disorders
Speech therapy
It helps children to learn new vocabulary, organize their thoughts and beliefs and correct grammatical or word errors. Speech therapy techniques are used to improve communication. These include articulation therapy, language intervention activities, and others depending on the type of speech or language disorder.
Speech therapy for adults also begins with assessment to determine your needs and the best treatment. Speech therapy exercises for adults can help you with speech, language, and cognitive communication. Exercises may involve problem solving, memory, and organization, and other activities geared at improving cognitive communication, conversational tactics to improve social communication, breathing exercisesfor resonance, exercises to strengthen oral muscles
Behavior Therapy
Behavior therapy designed to increase children’s use of desirable communication behaviors, decrease their unwanted problem behaviors and use of maladaptive coping strategies and to promote their development of useful interpersonal skills. Changes occur via a program of systematic reward and reinforcement. For example, children may be encouraged to use mnemonic strategies to help them remember facts relevant to their school performance.
Stimulant medication
Some clinicians may also recommend the use of Stimulant Medications as a treatment for any impulsivity or hyperactivity symptoms that may be present. This is a variation on a common intervention typically used for treating ADHD, which you may read about more in our ADHD topic center.
Environmental modification
Environmental Modification can also be an important part of treatment for communication disorders. For example, children with communication disorders can be given extra time during school-based discussions or oral test situations to more adequately formulate responses.
Success rates for communication disorder treatments based on methods like those just described are typically reported to be high, with around 70% of treated children benefiting. Follow-up treatment is sometimes necessary when relapses occur.