Communication Disorders

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KEY POINTS

• A communication disorder is a problem with language, speech, or hearing. Language disorders include problems with expressing and understanding what is said or written. Speech disorders include trouble saying words or delays in starting to speak. Hearing disorders include not being able to hear certain sounds or not being able to hear anything at all.
• Speech and language therapy, occupational therapy, and physical therapy are helpful. Find out what services are offered through your school district to help children with communication disorders.
• Be patient with your child. Praise your child for his efforts and for any improvement, however small.

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What is a communication disorder?

A communication disorder is a problem with language, speech, or hearing. Communication disorders can affect the way your child talks, how much he understands, and how well he gets along with other people.

Speech disorders include:

• Not being able to say words clearly
• Stuttering
• Trouble using words, usually as a result of a brain injury
• Delays in starting to speak

Language disorders include problems being able to:

• Talk with others and understand what others say
• Solve problems
• Understand what is read
• Express thoughts in writing

Hearing disorders include not being able to hear certain sounds or not being able to hear anything at all.

Millions of children under the age of 18 have a communication disorder. It is most common in boys.

What is the cause?

The cause of communication disorders is not always known.

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way your child thinks, feels, or acts. A child with this disorder may have too little or too much of some of these chemicals.
• Children with this disorder may have physical changes in their brain.
• Exposure to certain chemicals and medicines during pregnancy may increase the risk.
• Communication disorders sometimes run in families.

Communication disorders are more likely if your child has other problems such as:

• Learning disabilities or autism
• Cerebral palsy or muscular dystrophy
• Intellectual disability (previously called mental retardation)
• Cleft lip or cleft palate
• Ear diseases or damage to the nerves or brain

What are the signs of a communication disorder?

Signs may include:

• Not understanding his name and a few words or simple commands by age 1 year
• Not saying words by 14 to 16 months of age
• Having trouble being understood by people outside the family after age 3
• Hesitating or distorting words and meanings after age 5 years
• Being hoarse without having a cold
• Not knowing as many words as other children the same age
• Doing poorly in school
• Straining to hear or often asking to have things repeated
• Dropping the beginnings and endings of words when speaking
• Being confused during conversations
• Not being able to follow directions

Do not wait to see if a problem goes away by itself. Your child may miss many months of helpful therapy.

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child will also have hearing and vision tests.

If your healthcare provider thinks your child may have a communication disorder, your child may need to see a specialist. They can do more testing and advise you about treatment. Your school district may also provide testing services for your child.

How is it treated?

Speech and language therapy, occupational therapy, and physical therapy are helpful. These kinds of therapy can:

• Help your child to understand and use words
• Increase the number of words that your child knows
• Help relax face and mouth muscles by teaching your child breathing and relaxation exercises
• Use sign language, picture boards, or other tools if needed

Children who attend public preschool, elementary school, or secondary school may be eligible for free assistance. The school must develop an Individualized Educational Plan (IEP) for each child who needs special education. This plan includes:

• Educational goals
• Class placement
• A plan to check progress
• Any other special services, such as therapy or transportation

Both the parent and the school must agree to the plan. You may want to visit public schools in your area to see the type of program they offer.

How can I help my child?

• Find out what services are offered through your school district to help children with communication disorders.
• Your child’s therapists can help you learns ways to work with your child at home.
• Look for your child’s strengths. No one knows what your child may be able to do in time, so don’t set your expectations too low. Encourage your child to try new things.
• Be specific when you talk to your child. Tell your child in simple steps what you want him to do. It also helps to show your child how to do something rather than just tell him.
• Be patient with your child. He may not be able to put his needs and feelings into words. Watch your child’s body language for signs that he is upset or that something is wrong.
• Try to avoid putting pressure on your child. Do not say "You can't have it unless you say it first." Praise your child for his efforts and for any improvement, however small.
• Join a support group. Support groups can help by sharing common concerns and solutions to problems with other families in the same situation. You can find these services through your healthcare provider, schools, therapy programs, and local and national support organizations.
• See a mental health professional to help you cope with your stress.