Communication disorders affect a person’s ability to detect, receive, process, and comprehend the concepts or symbols necessary for communication.
The communication process enables a person to pass on information, express their ideas and feelings, and understand other people’s thoughts, emotions, and ideas.
The American Speech-Language-Hearing Association (ASHA) estimates that about 5–10% of Americans have communication disorders.
This article discusses communication disorders in more detail, including the types, causes, symptoms, and treatment.
Communication disorders are a group of conditions involving problems with receiving, processing, sending, and comprehending various forms of information and communication, including:
- graphic language
They can result from any condition that affects hearing, speech, and language to the extent that it can disrupt a person’s ability to communicate properly. A communication disorder can manifest early in a child’s development, or a medical condition can cause it to develop at an older age.
It can be a stand-alone condition or co-occur with other communication and developmental disorders.
The severity of communication disorders can range from mild to profound.
The ASHA classifies communication disorders into four groups:
Speech disorders affect a person’s ability to articulate speech sounds. These conditions can affect fluency, meaning the rate, rhythm, and flow of speech, or voice, meaning the pitch, volume, or length of speech.
Language disorders impair a person’s ability to comprehend or use spoken, written, or other symbol systems.
They may involve problems with:
- Phonology: This term refers to the sounds that make up language systems and the rules governing sound combinations.
- Morphology: Morphology describes the structure and construction of words.
- Syntax: People who have difficulties with syntax may make errors relating to the relationship, order, and combination of words in sentences.
- Language content: This term refers to the meaning of words and sentences, or semantics.
- Language function: Language function means using and understanding language based on interactional context and beyond its literal meaning.
Hearing disorders result from an impaired sensitivity of the auditory system. They involve difficulties detecting, recognizing, discriminating, comprehending, and perceiving auditory information.
A person with a hearing disorder may be deaf or have partial hearing loss.
Central auditory processing disorder (CAPD)
According to the ASHA, CAPD results from problems in processing auditory information in the brain area responsible for interpreting auditory signals.
These problems are not due to an intellectual impairment or hearing sensitivity problems of the ear.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies communication disorders into four categories:
- Language disorder: A person has difficulty acquiring and using spoken, written, or sign language or other language modalities.
- Speech sound disorder: These disorders involve difficulty producing speech sounds, which can make sounds challenging to understand or prevent effective communication.
- Child-onset fluency disorder (stuttering): This term refers to speech flow and fluency problems that are not appropriate for a child’s age.
- Social (pragmatic) communication disorder: A person has trouble understanding and using verbal and nonverbal communication for social purposes.
Most communication disorders have an unknown cause, but they may be developmental or acquired. Possible causes include:
- exposure to toxins and substances while in the womb
- traumatic brain injuries or tumors in the brain area responsible for communication
- stroke and other neurological disorders
- structural impairments, such as cleft lip or cleft palate
- vocal cord injury due to misuse and abuse
- viral disease
These disorders may also be genetic. A 2015 case study found that some genetic variants may make specific individuals susceptible to communication disorders.
The type of communication disorder will determine the possible symptoms:
Speech disorder symptoms
Symptoms of speech disorders include:
- repeating words, vowels, or sounds
- difficulty making sounds, even when the person knows what they want to say
- elongating or stretching words
- adding, omitting, or substituting words or sounds
- jerky head movements or excessive blinking while talking
- frequently pausing while talking
Language disorder symptoms
Symptoms of language disorders include:
- overusing fillers such as “um” and “uh” because of the inability to recall words
- knowing and using fewer words than their peers
- trouble understanding concepts and ideas
- difficulty learning new words
- problems using words and forming sentences to explain or describe something
- saying words in the wrong order
- difficulty understanding instructions and answering questions
Hearing disorder symptoms
Symptoms of hearing disorders include:
- being behind their peers in terms of oral communication
- asking others to repeat what they said in a slower, clearer manner
- talking louder than is typical
- muffled speech and other sounds
- withdrawal from social settings and conversations
- difficulty understanding words, especially in noisy environments
CAPD disorder symptoms
Symptoms of CAPD include:
- difficulty localizing sounds
- difficulty understanding words that people say too fast or against a noisy background
- problems understanding and following rapid speech
- difficulty learning songs
- lack of musical and singing skills
- difficulty learning a new language
- problems paying attention
- getting easily distracted
Communication disorders are common in children. Nearly
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Certain conditions put a person at risk of communication disorders such as aphasia, apraxia, and dysarthria. The National Aphasia Association notes that 25–40% of people who have experienced a stroke will have aphasia.
A 2021 study also found that a more severe traumatic brain injury puts a person at a higher risk of receiving a communication disorder diagnosis.
A doctor will need to perform a physical exam to diagnose communication disorders. This exam will involve examining a person’s mouth, ears, and nose. If the doctor suspects a communication disorder, they will work with other specialists, such as neurologists and speech-language pathologists, to make an accurate diagnosis.
Common tests include:
- hearing tests
- neurological exam
- nasopharyngolaryngoscopy, which uses a flexible fiber-optic tube with a camera to view the voice box
- psychometric testing to assess thinking performance and logical reasoning abilities
- psychological testing to assess cognitive abilities
- psychiatric evaluation, if emotional and behavioral problems are also present
- speech and language assessments
- imaging tests, such as an MRI or CT scan
Doctors may also compare a child’s language with age and communication milestones and checklists.
The treatment for communication disorders involves working with a speech-language pathologist. The specific approach will depend on the type and severity of the communication disorder. Therapy might take place in a one-on-one or group setting.
A speech-language pathologist will work with the rehabilitation team, including a physical and occupational therapist, to address other relevant skills before or in parallel with speech therapy sessions. Underlying causes, such as infections, will also require treatment.
Treatment often involves the entire family, other healthcare professionals, and teachers for a highly individualized approach.
Depending on the goal, a speech-language pathologist may remediate and promote skills or teach alternative forms of communication, such as augmentative and alternative communication (AAC) or sign language.
Communication disorders are a variety of disorders that affect any aspect of communication. They can occur at any age, and there are various possible causes, although the cause is often unknown.
Communication disorders commonly appear in children in the early phase of their development, whereas adults often acquire communication disorders from other conditions, such as stroke or brain injury.
The best way to treat communication disorders in children is through early intervention. Early detection and treatment can help address the child’s developmental needs and prevent further delays.