Rare and Complex Communication Disorders

What is a Speech and Language Disorder?

A child’s communication is considered delayed when the child is noticeably behind his/her peers in the acquisition of speech and/or language skills. Sometimes a child will have greater receptive (understanding) than expressive (speaking) language skills, but this is not always the case.

Speech disorders refer to difficulties producing speech sounds or problems with voice quality. This might be characterized by an interruption in the flow or rhythm of speech, such as stuttering (dysfluency), problems with the way sounds are formed (articulation or phonological disorders), or difficulties with the pitch, volume or quality of the voice. There may be a combination of several problems. People with speech disorders have trouble using some speech sounds, which can also be a symptom of a delay.

A language disorder is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary, and inability to follow directions. One, or a combination, of these characteristics may occur in children who are affected by language learning disabilities or developmental language delay. Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate.

How is it manifested?

A child with speech or language delays may present a variety of characteristics, including the inability to follow directions, slow and incomprehensible speech, or pronounced difficulties in syntax and articulation. SYNTAX refers to the order of words in a sentence, and ARTICULATION refers to the manner in which sounds are formed. Articulation disorders are characterized by the substitution of one sound for another, or the omission, or distortion, of certain sounds.

Stuttering, or dysfluency, is a disorder of speech flow that most often appears between the ages of 3 and 4 years and may progress from a sporadic to a chronic problem. Stuttering may spontaneously disappear by early adolescence, but speech and language therapy should be considered.

Typical voice disorders include hoarseness, breathiness, or sudden breaks in loudness or pitch. Voice disorders are frequently combined with other speech problems to form a complex communication disorder.

Who is affected?

The overall estimate for speech and language disorders is widely agreed to be 5% of school-aged children. This figure includes voice disorders (3%) and stuttering (1%). The incidence in elementary school children who exhibit delayed articulation (phonological) development is 2% to 3%, although the percentage decreases steadily with age.

How is it diagnosed or detected?

Speech-language pathologists (speech therapists) diagnose and treat or remediate communication disorders in children.

Developmental paediatricians and paediatric neurologists will also sometimes diagnose a speech or language disorder and refer the child to a speech-language pathologist for treatment.