Communication disorders affect nearly 1 in 10 people, and almost 6 million children have a speech or language disorder.

If you, your child, or someone you know, has been diagnosed with a communication disorder you likely have some questions. Frankly, navigating the world of communication disorders can be pretty confusing.

This guide will help answer some of the most pressing questions associated with the disorders, common symptoms, and common treatments.

WHAT IS A COMMUNICATION DISORDER?

A communication disorder means that a person has difficulty with speech, communication, language, or some combination of those. This can manifest in word articulation, written language, or understanding and participating in verbal and nonverbal communication.

Communication disorders affect a wide variety of people for a wide variety of reasons. For children, diagnosis may come after a parent or teacher notices that a child’s speech development is noticeably delayed in comparison to their peers.

Like many disorders, symptoms can range from mild to very severe. It can be as limited as a slight stutter or as severe as the inability to use speech or language to communicate.

WHAT ARE THE TYPES OF COMMUNICATION DISORDERS?

In 2013, mental health experts released the DSM-5 – Diagnostic and Statistical Manual of Mental Disorders (5). In it, they categorized communication disorders to help smooth the diagnostic process so individuals could receive the necessary services they required.

According to DSM-5, there are four main types of Communication Disorders: Language Disorder, Speech Sound Disorder, Child-Onset Fluency Disorder (Stuttering), and Social (Pragmatic) Communication Disorder.

LANGUAGE DISORDER

People with a language disorder will often have 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.

Often language disabilities are diagnosed at a young age when children’s language abilities are substantially lower than their age expectations. The symptoms for language disorder begin in early development.

According to DSM-5, Language Disorder is not related to hearing loss, motor dysfunction, intellectual disability, global developmental delay, or other medical or neurological conditions.

SPEECH SOUND DISORDER

Those who are affected by Speech Sound Disorder (SSD) have a 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.

As with Language Disorders, SSD is often identified when parents or teachers notice a slowness in the development of a child’s speech. Onset usually occurs in the early development period of a child, and is not an acquired or congenital condition. SSD can affect a person or child’s ability to learn, write, read, and spell.

Speech Sound Disorder can be divided into two categories: Articulation and Phonological.

ARTICULATION

Those who struggle with articulation have a difficult time making specific speech sounds. This is at a phonetic level, and it is sometimes related to a deficiency in their articulators (vocal organs). In other words, children who struggle with articulation may do so because of a motor issue, or because two articulators (for instance the way the tongue meets the palate) don’t meet correctly to produce the proper sound. However, not all children or adults who struggle with Articulation do so because of motor issues.

There are four major symptoms associated with Articulation Disorders.

• Distortion of sound – Distortion sounds are often associated with individuals who have a lisp. For instance, saying a “th” sound instead of an “s” sound.
• Substitution – An example of this would be using the letter “w” instead of the letter “r”.
• Omission – Omission refers to the times that people leave out part of a word. For example, instead of saying, “That’s mine!”, they may say, “‘at’s ‘ine.”
• Additional sounds – Additional sounds may be added to words as in “doguh” instead of “dog.”

PHONOLOGICAL

Phonological has to do with language at the mind’s level. While Articulation is at a phonetic level, Phonological is at a phonemic level. Phonological Disorder is described as a pattern of sound errors. Children with phonological issues struggle to acquire a phonological system, or in other words, they struggle to organize the pattern of sounds in the brain.

Children or adults who have Phonological issues will sometimes create sounds in the wrong part of their mouth. For example, they may use “back sounds” (sounds that would ordinarily be produced in the back of the mouth), in the front of the mouth. Letters like “k” and “g” may be replaced with front sound letters “t” and “d.”

CHILDHOOD-ONSET FLUENCY DISORDER

Childhood-Onset Fluency Disorder (COND) 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.”

Those who suffer from COND often experience anxiety about speaking either in conversation or in front of crowds. Symptoms are not constant and may not be present in all situations. For instance, a person may be able to read out loud or sing without symptoms being present. Unfortunately, the symptoms can flare up if the speaker feels anxious, stressed, or self-conscious.

SOCIAL COMMUNICATION DISORDER

Unlike some of the other disorders, 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.

SCD is the most recent diagnostic code added to the communication disorders listed in DSM-5. It has strong similarities to Autism Spectrum Disorder, but a person can be diagnosed with SCD without also being diagnosed with ASD.

In short, Social Communication Disorder revolves around pragmatics and social understanding. Pragmatics refers to using language in the right context. For example, language is used differently when a person is speaking to their best friend versus a stranger, or their boss. Not recognizing the need to change the way they speak to different people in different contexts may be a sign that someone has this disorder.

Another sign of SCD is having difficulty in following rules of conversation or not understanding things that haven’t been said explicitly. People with SCD may struggle to notice subtle parts of conversation or to pick up on non-verbal communications. They may also have a difficult time keeping conversations flowing, or responding to the thoughts and ideas of others.