Moreover, these verbal and nonverbal cues were not developed during childhood, as normally expected. Symptoms of CDs usually lie on a spectrum of severity, in which impairments can be mild or more profound. They also tend to coexist with each other, in which an individual is diagnosed with multiple types of CDs.
Symptoms of Communication Disorders
There are various types of CDs. Although they are different, most share common impairments in verbal and non-verbal communication, displaying difficulties in the following areas:
Language comprehensionSpeechSocial cuesFacial expressionsGestures Emotional perception
Causes of Communication Disorders
There is no definitive cause of CDs; however, genetic factors and things that affect brain development in the early developmental period can play a role.
Diagnosis
For an individual to be diagnosed with a CD they must meet the diagnostic criteria stated in fifth edition of the The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and other mental health classification books. Social (pragmatic) communication disorder (SCD) was the most recent CD included in this diagnostic manual, in an effort to distinguish this isolated communication disorder from the requirement for social communication difficulties and restrictive/repetitive behaviors that are part of the current autism spectrum disorder (ASD) diagnosis.
DSM-5 Diagnostic Criteria for Social Communication Disorder
According to the DSM-5, an individual meets the criteria for SCD if they display the following symptoms: Social issues in verbal and nonverbal communication regarding:
Greetings Transitions in conversations, depending on the setting Social rules during a conversation, like waiting until it’s your turn to speak Comprehending indirect communication
Symptoms have been present since childhood and create difficulties in:
FunctioningCommunication and social engagementAcademic or occupational performanceRelationships
Communication Disorders Are Mostly Diagnosed in Children
CDs can be diagnosed in both adults and children. Most research on social impairment, however, has been performed in toddlers, kids, and adolescents. Once an adult, it can be more difficult to discover and treat, since these impairments are no longer developmental concerns, but social habits that interfere with communication and societal norms.
Types of Communication Disorders
Below are the types of communication disorders listed in the DSM-5:
Social (pragmatic) communication disorderLanguage disorderSpeech-sound disorderChildhood-onset fluency disorderUnspecified communication disorder
Social (Pragmatic) Communication Disorder
Social communication disorder (SCD) or pragmatic coomunication disorder, consists of impairments with verbal and nonverbal communication specifically involved in social interaction. SCD does not impact language comprehension, such as grammar or punctuation. Individuals who have SCD experience difficulties in the following areas of social communication:
Pragmatics, which is interpreting your surroundings to discern the meaning of linguistic context. Conceptualizing sentences that are indirect or nonliteral, such as “metaphors, humor, and aphorisms." Verbal communication due to a lack of understanding of social cues and behaviors, like not always knowing when or how to greet people or interjecting during a conversation before the appropriate time. Nonverbal communication, such as gestures, eye contact, and facial expressions can also be difficult to comprehend for those with SCD. Understanding emotions; those with SCD have trouble expressing their own emotions and understanding the emotional context of a situation.
Language Disorder
Language disorders (LD) consist of difficulties in the acquisition and use of language across different modalities such as spoken, written, or sign language. Individuals will most likely find it challenging to produce content that involves:
SyntaxSemantics Phonology (sound system)Morphology (word system)Pragmatics
Speech Sound Disorders
Speech disorder is a persistent difficulty with producing speech sounds and challenges with articulating words fluently. It causes limitation in effective communication and being understood. To be diagnosed, the symptoms have to interfere with social, academic, or work performance. It needs to have its onset in early development and it can’t be due to medical conditions such as deafness, a cleft palate, or brain injury.
Childhood-onset Fluency Disorder
Childhood-onset fluency disorder is also known as stuttering. It occurs when a child’s speech is impacted in ways that interfere with normal fluency and pattern of speech. It can include:
Interrupted speech (known as speech blocks)Prolonging soundsRepeating sounds or syllables
The disturbance causes anxiety or limitations in social, academic, or work functioning. Although there can be the development of adult-onset fluency disorder, for this specific condition, the onset needs to be in the early developmental period and not due to a medical or neurological condition.
Unspecified Communication Disorder
Unspecified communication disorder applies to children who exhibit some of the symptoms that are characteristic of other CDs. However, children with unspecified communication disorder don’t meet the exact diagnostic criteria of any of the other communication disorders.
Comorbidities
There are instances in which CDs can be present along with other neurodevelopmental disorders. There can also be overlap, such as those with autism spectrum disorder (ASD), who specifically share common challenges with social communication—as do individuals who are diagnosed with SCD. However, there need to be other symptoms present to meet criteria for an ASD disorder. SCD and other communication disorders commonly co-occur with other neurodevelopmental disorders like attention deficit hyperactivity disorder (ADHD).
Assessing Communication Disorders
It can sometimes be challenging to diagnose communication disorders. It can involve different professionals, including pediatricians, audiologists, speech-language pathologists, teachers, and developmental psychologists.
Reports
Since it can often be difficult for clinicians to examine a child’s usual interaction in social settings, reports from parents and teachers are important in the assessment. There are checklist screening tools that both parents and teachers may complete. The clinician may observe and rate the child’s conversational and communication skills.
Observations
Examiners may conduct “structured observations” by creating a setting in which they can provide certain social interaction to observe the child’s responses and reactions. They also observe both verbal and nonverbal communication between the child and adults. They analyze how the child converses, asks questions, and responds to questions. Examiners additionally examine facial expressions, gestures, and eye movements.
Assessments
Clinicians use certain assessment measures to assess different aspects of a child’s communication skills. This may involve asking them to identify and interpret specific factors of stories and express these narratives coherently. These measures explore how the individual interprets indirect or figurative language; such as metaphors, humor, and idioms.
Treatment
Treatment for communication disorders may include speech and language therapy and social skills training. Speech-language therapists can facilitate sessions, in which they work on developing phonology and monopoly language acquisition. This helps individuals expand their speech and written language skills.
A Word From Verywell
If you or your child is displaying signs of a communication disorder, it’s best to speak to a doctor for a possible evaluation. It can be frustrating for an individual or loved one to experience a CD because symptoms may make it hard to express oneself and build relationships. However, there are treatment options available to enhance communication skills and help you feel more comfortable in social situations over time.
