Communication Disorder is a disorder characterized by the inability to comprehend, send, process, or understand concepts while communicating with others. They usually find it extremely difficult to express themselves through language and speech and have an impaired ability to hear and comprehend messages.
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Understanding Communication Disorders
Communication Disorder impairs the ability to speak and communicate effectively with others. The experts at Mind Help define communication disorders as “a serious impairment in one’s capability to receive, send, process & understand ideas, concepts or symbol systems, whether verbal, non-verbal or graphic”. The disorder can range from simple sound substitution to the inability to understand or use their own native language. A report estimated that one in ten American children suffer from some kind of communication disorders. A child suffering from this disorder may experience several symptoms such as being unable to express themselves, stammering, or stuttering. In this case, it is important to diagnose the type of disorder in order to devise an effective treatment plan. This disorder can range from mild to profound and it may be developmental or acquired. Individuals may also display a combination of communication disorders.
People with these disorders have a reduced vocabulary and limited use of grammar. They also lack the ability to choose words or language that are suitable for expressing their views and opinions that ultimately makes it difficult to develop a conversation. Studies 1 suggested that some people with phonological disorders have difficulties distinguishing and articulating the phonemes that don’t allow them to express their thoughts in a way that others understand. Individuals with language disorders usually have poor academic performance, issues in setting up social relationships or may have difficulties in finding a job. These occur in the early stages of development and are not caused by other conditions such as cleft palate, hearing loss, or cerebral palsy.
If you detect these symptoms in your child it is important to seek medical attention to detect the type of communication disorder and devise a treatment plan.
Categories Of Communication Disorders
The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) laid down communication disorders into five categories:
1. Mixed Receptive Expressive Language Disorders
In this category, the child has different developmental delays and problems in comprehending language and speaking. It is a communication disorder where the receptive and expressive areas of communication are compromised. Patients can be affected in any degree that includes from mild to severe. According to research, 2 2% to 4% of 5-year-olds have mixed receptive expressive language impairments.
2. Expressive Language Disorder
The child has developmental delays and problems in speaking. Children with this condition have difficulty conveying or expressing information in speech, writing, sign language or gesture. The child may experience difficulty with vocabulary, producing complex sentences and remembering words. There may also be abnormalities in articulation. A 2010 study 3 found the prevalence rates for this condition ranges from 6% to 15% of children.
Read More About Expressive Language Disorder Here
3. Speech Sound Disorders
They have a hard time expressing what they want to say, especially past a certain age. Speech sound disorders are usually associated with difficulties in articulation and phonology. However some children may have both articulation and phonological difficulties. Although it is usually found in children, there may be residual errors that persist in adulthood. A report found that the prevalence rate of speech sound disorders is 8% to 9% in young children.
4. Childhood Onset Fluency Disorders
This condition is also known as stuttering. It begins in childhood and can continue throughout their life. Childhood onset fluency disorder is a speech disorder characterized by difficulties with the normal fluency and flow of speech. A review suggested that more than three million (almost one percent) Americans stutter.
Read More About Childhood Here
5. Social Communication Disorders
The child has difficulty using language in social settings because of pragmatics. It occurs due to brain developmental condition. Children with this condition have problems using verbal and non verbal communication methods in social situations. A 2018 study 4 reported that the prevalence of this disorder was 2.64%.
6. Unspecified Communication Disorders
This condition occurs when the symptoms don’t meet the specific criteria for the disorders listed above. It applies to individuals who have clinical presentations in which symptoms of communication disorders are present but don’t meet the diagnostic criteria to categorise it under a specific diagnosis. A scientific review reported that the prevalence of unspecified communication disorder was approximately 9%.
Types Of Communication Disorders
Communication disorders can be divided into two types. They are as follows:
1. Speech Disorders
Speech disorders usually affect an individual’s voice. They are not the same as language disorders and usually affect a person’s ability to produce sounds in order to create words. This disorder can be further subdivided into three categories. They include:
- Articulation disorders: Substituting words where messages are harder to understand.
- Fluency disorders: Communicating in an irregular rate or rhythm speech
- Voice Disorders: This disorder involves having an abnormal pitch, volume, or length of speech.
2. Language Disorders
This disorder affects how an individual uses their speech or writing. It is further classified into five types. They are as follows:
- Phonology Disorder: Disruption in the sounds that make up the language system.
- Morphology Disorder: This involves being unable to structure and construct words.
- Syntax Disorder: This occurs when an individual finds it difficult to form sentences.
- Language Content Disorders: This condition affects semantics i.e. meaning of words and sentences.
- Language Function Disorders: This disorder affects the pragmatics in a person i.e use of socially appropriate messages.
3. Hearing Disorders
This disorder impairs the ability to use speech or language. A person suffering from this disorder may be deaf or has a faint hearing. They cannot use hearing as their main source of communication. People who have difficulty in hearing cant use hearing as a tool of communication. Hearing problems are commonly categorised based on issues in auditory information detection, identification, discrimination, comprehension, and perception. A 2016 study 5 found that the prevalence rate of hearing loss rises steeply with age from 3 percent for the 20-29 years age group to 49 percent among adults for age group 60-69. Hearing impairment may be described as follows:
- Deaf: This condition involves the limited oral communication performance due to their lack of hearing abilities or having an impaired hearing.
- Hard of hearing: This disorder is found to adversely affect a person’s ability to communicate whether it is fluctuating or permanent. This relies on the auditory channel as the primary sensory input for communication.
4. Central Auditory Processing Disorders (CAPD)
This disorder affects how a person analyzes and uses data in auditory signals. It occurs when there is a deficiency in the information processing of audible signals that are attributed to impaired peripheral hearing sensitivity or intellectual impairment. The Central Auditory Processing is responsible for ongoing transmissions, analysis, organization, transformation, elaboration, storage, retrieval, and use of information that are contained in the auditory signals. A 2019 study 6 suggested that adult based research has identified CAPD as a “hidden hearing loss” characterised by difficulty with listening or recognizing speech in the presence of noise despite normal pure tone thresholds.
Symptoms Of Communication Disorders
There are several symptoms that can be seen in an individual suffering from this disorder. They are as follows:
- Repetitive sounds
- Misuse of words
- Being unable to communicate in a way that others can understand
- Unable to comprehend messages
- Disruption in flow of speech
- Articulation difficulties
- Disruptive voice quality such as pitch, or loudness of voice
- Language and speech delays due to hearing loss
Causes Of Communication Disorders
This disorder can develop due to developmental or acquired conditions. A 2010 study 7 examined communication disorders based on two basic principles that states that complex disorders have complex causes which are influenced by a number of separate genes. The second principle stated that behaviorally related disorders were influenced by the same genes. This has allowed researchers to understand the influence of genes in developing communication disorders. However other causes can include:
- Abnormal brain development
- Being exposed to substance abuse or toxins before birth
- Cleft lip or palate
- Genetic factors
- Traumatic brain injuries
- Neurological disorders
- Having a tumor in the area used for communication
Who Is At Risk Of Communication Disorders?
This disorder is more common in children. Research shows that almost 8 percent to 9 percent of children have a speech sound disorder. This rate becomes 5% for children in the first grade. Communication disorders are also common among adults. Almost 7.5 million people have issues using their voices in the United States. Studies suggest that almost 6 to 8 million people suffer from some kind of language problem.
Patients with brain injuries also have a higher risk of developing this disorder. It can also co-occur with other conditions such as aphasia. Studies found that over 1 million people suffer from Aphasia in the United States.
Diagnosis Of Communication Disorders
It is important to seek medical attention in order to arrive at a correct diagnosis. A team of doctors that includes neurologists and speech language pathologists may administer the tests. The common tests include:
- Complete physical examination
- Psychometric tests that examine reasoning and thinking skills
- Speech and language tests
- Magnetic resonance imaging (MRI)
- Computed tomography scan (CT)
- Psychiatric evaluation
Treatment Of Communication Disorders
It can be extremely difficult for a child to express themselves when they suffer from communication disorders. The treatment methods would depend on the kind of disorder, age, general health, and severity of the disorder. A speech language pathologist can help to improve their communication skills with time and practice. The treatment procedure requires a complete team effort. This team may involve parents, teachers, and mental health experts working together to help the child develop their communication skills. Some available treatment therapy options may include:
1. Individual Therapy
Sometimes communication disorders can occur due to psychological conditions such as experiencing a traumatic event or growing up with strict parents. In such cases, individual therapy is adopted to address the mental health issues of the child. This therapy is used to work through the personal issues that the individual might be facing and developing coping strategies that will help them to recover. A 2011 8 study found that treatment with individual therapy showed significant improvements in a duration of 6 months.
2. Group Therapy
Group therapy is a form of psychotherapy wherein one or more psychiatrists work together with a group of people suffering from the same condition. This therapy helps the patient to work on their communication skills and address their concerns effectively to their fellow group members. Several therapeutic treatments such as cognitive behavioral therapy, skills training, etc are used in group therapy. A report 9 studied the efficacy of group therapy in treating patients with chronic aphasia (an acquired communication disorder that causes impairment in either language, reading, writing or listening). It was found that there was significant improvement in patients with scores being maintained at six months follow up. Group therapy was found to be effective in functional communication abilities.
Read More About Group Therapy Here
3. Special Classes
Special education classes may be used in schools or other institutions to help students with communication disorders. These classes help them to work through the academic levels at their own pace with trained professionals. A 2016 review 10 confirmed that special classes and preschool intervention has proven effective since this period marks the transition for children. Recovering from communication disorders is highly influenced by the mode of teaching and learning context. Hence, it is important to select a school that has the facilities based on your child’s special needs.
How To Help A Child With Communication Disorders?
Since children with communication disorders find it difficult to express themselves, it can be a challenge to understand their needs. But there are several things you can do to help your child communicate better. They are as follows:
- Keep all the appointments with the psychologist and speech-language pathologist updated.
- Encourage your child to try their best to communicate with others.
- Talk with the psychologist to learn about the team of people who can help your child to develop their communication skills better.
- Tell your child’s school about their treatment plan so they may work together with your doctor.
- Reach out for support from local community services. Being in contact with other parents in similar situations may be helpful for you and your child.
Is Prevention Possible?
The exact causes of this disorder are still unknown. Hence experts don’t have a clear idea of how to prevent this disorder. Sometimes it can occur due to exposure to toxic substances such as drugs or alcohol. In this case, it is best to avoid the usage of substances during pregnancy to avoid this disorder.
Can Your Child Recover From Communication Disorders?
Recovery depends on the severity and type of disorder. Some people recover from some communication disorders such as stuttering or stammering. In the case of hearing disorders, the doctor may recommend hearing aids to help the patient to communicate in an effective manner. Therapy and working with a speech language pathologist have been proven helpful in some cases.
Communication Disorders At A Glance
- Communication Disorder impairs the ability to speak and communicate effectively with others.
- The disorder can range from simple sound substitution to the inability to understand or use their own native language.
- This disorder can range from mild to profound and it may be developmental or acquired.
- People with these disorders have a reduced vocabulary and limited use of grammar.
- This disorder is more common in children.
- Patients with brain injuries also have a higher risk of developing this disorder.
- The treatment methods would depend on the kind of disorder, age, general health, and severity of the disorder.
- Kirchner, R. Phonetics and phonology: understanding the sounds of speech. NPTEL. https://nptel.ac.in/content/storage2/courses/109106085/downloads/03-%20Phonetics%20and%20Phonology-%20week%203.pdf [↩]
- Assous, A., Borghini, A., Levi-Rueff, M., Rittori, G., Rousselot-Pailley, B., Gosme, C., Zigante, F., Golse, B., Falissard, B., & Robel, L. (2018). Children with mixed developmental language disorder have more insecure patterns of attachment. BMC psychology, 6(1), 54. https://doi.org/10.1186/s40359-018-0268-6 [↩]
- Committee on the Evaluation of the Supplemental Security Income (SSI) Disability Program for Children with Speech Disorders and Language Disorders; Board on the Health of Select Populations; Board on Children, Youth, and Families; Institute of Medicine; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine; Rosenbaum S, Simon P, editors. Speech and Language Disorders in Children: Implications for the Social Security Administration’s Supplemental Security Income Program. Washington (DC): National Academies Press (US); 2016 Apr 6. 2, Childhood Speech and Language Disorders in the General U.S. Population. Available from: https://www.ncbi.nlm.nih.gov/books/NBK356270/ [↩]
- Topal, Z., Demir Samurcu, N., Taskiran, S., Tufan, A. E., & Semerci, B. (2018). Social communication disorder: a narrative review on current insights. Neuropsychiatric disease and treatment, 14, 2039–2046. https://doi.org/10.2147/NDT.S121124 [↩]
- Committee on Accessible and Affordable Hearing Health Care for Adults; Board on Health Sciences Policy; Health and Medicine Division; National Academies of Sciences, Engineering, and Medicine; Blazer DG, Domnitz S, Liverman CT, editors. Hearing Health Care for Adults: Priorities for Improving Access and Affordability. Washington (DC): National Academies Press (US); 2016 Sep 6. 2, Hearing Loss: Extent, Impact, and Research Needs. Available from: https://www.ncbi.nlm.nih.gov/books/NBK385309/[↩]
- Heine, C., & Slone, M. (2019). Case studies of adults with central auditory processing disorder: Shifting the spotlight!. SAGE open medical case reports, 7, 2050313X18823461. https://doi.org/10.1177/2050313X18823461[↩]
- Smith SD, Grigorenko E, Willcutt E, Pennington BF, Olson RK, DeFries JC. Etiologies and molecular mechanisms of communication disorders. J Dev Behav Pediatr. 2010 Sep;31(7):555-63. doi: 10.1097/DBP.0b013e3181ee3d9e. PMID: 20814255; PMCID: PMC2943674.[↩]
- Broomfield, Jan & Dodd, Barbara. (2011). Is speech and language therapy effective for children with speech/language impairment? A report of an RCT. International journal of language & communication disorders / Royal College of Speech & Language Therapists. 46. 628-40. 10.1111/j.1460-6984.2011.00039.x. [↩]
- Cermak, C. (2011). The efficacy of group therapy for adults with chronic aphasia. Poster session presented at: 7th Annual Research Day. [↩]
- Committee on the Evaluation of the Supplemental Security Income (SSI) Disability Program for Children with Speech Disorders and Language Disorders; Board on the Health of Select Populations; Board on Children, Youth, and Families; Institute of Medicine; Division of Behavioral and Social Sciences and Education; National Academies of Sciences, Engineering, and Medicine; Rosenbaum S, Simon P, editors. Speech and Language Disorders in Children: Implications for the Social Security Administration’s Supplemental Security Income Program. Washington (DC): National Academies Press (US); 2016 Apr 6. 3, Treatment and Persistence of Speech and Language Disorders in Children. Available from: https://www.ncbi.nlm.nih.gov/books/NBK356271/?report=classic [↩]