Communication breakdown
Any disorder that impairs a person’s capacity to understand, identify, or use language and speech in order to carry out productive conversations with others is considered a communication breakdown.[1] Deficits in both verbal and nonverbal communication styles are included in this.[2] From basic sound replacement to the incapacity to comprehend or utilize one’s own tongue, there are a variety of delays and diseases that might occur.[3] This page discusses diagnosis, learning difficulties, aphasia, sensory impairments, and speech disorders, among other topics. It also covers the DSM-IV and DSM-V.
Diagnosis
The list of behaviors and disorders that fall under the category of communication disorders varies depending on where it comes from. For instance, the Diagnostic Statistical Manual, Fourth Edition (DSM-IV), and the American Speech-Language-Hearing Association have different definitions.[4]
According to Gleason (2001), a speech and language disorder includes issues with oral motor function, communication, and other associated domains. From basic sound replacement to the incapacity to comprehend or utilize one’s own tongue, there are a variety of delays and diseases that might occur.[3] Broadly speaking, speech (comprehension and/or expression) issues that substantially impede an individual’s success and/or quality of life are referred to as communication disorders. It could be useful to understand the operational definition of the organization making the diagnostic or conducting the assessment.[3]
If someone is speaking in a way that blends their native environment with their foreign surroundings, or if they speak more than one language or are perceived as having an accent in their place of residency, they do not have a speech disorder.[5]
The Cincinnati Children’s Health Library (2019) lists the following additional conditions that could raise a person’s risk of developing a communication disorder: [6]
Cleft lip or cleft palate: this condition results in a deformity because the palate and mouth pieces do not fuse together properly during fetal development within the mother. Surgery is frequently used to correct this.
A malformation of a child’s head and facial bones brought on by an early or delayed fusion of the bones is known as a craniofacial anomaly.
When speaking, velopharyngeal insufficiency occurs when the soft palate fails to form a tight adequate seal against the pharynx, resulting in a nasal sound.
When the mouth is closed, dental malocclusion occurs when the upper and lower teeth are not in alignment.
Oral-motor dysfunction is the inability to chew, blow, talk, and do other actions because of a disconnect between the mouth and the brain.
The word “neurological disease/dysfunction” refers to a broad range of neurological conditions, including multiple sclerosis, epilepsy, dementia, and Alzheimer’s disease.
Brain injury is the result of a traumatic event that causes damage to the brain and movement of the brain inside the skull.
The inability to breathe without the assistance of a ventilator machine is known as ventilator reliance.
If treatment is not received, respiratory compromise—a decline in respiratory function—may result in failure or even death.
A surgically made hole in the trachea to help with breathing is called a tracheostomy.
Vocal fold pathology refers to a deviation in the vocal folds’ cartilage.
A child is said to have a developmental delay if their growth—mental or physical—does not progress at the typical rate for kids their age.
Autism is a term used to describe a group of neurological illnesses that cause difficulties with social interaction, communication, sensory processing, and other areas.
Prematurity or traumatic birth refers to an early or complicated delivery that occurs before full term.
Deafness, often known as hearing loss, is a reduction in hearing caused by abnormalities in the auditory system.
DSM-IV
Communication disorders were typically first identified in childhood or adolescence, while they are not just childhood disorders and can continue into adulthood, according to the DSM-IV-TR (no longer in use).[7][Reference in full needed] They could also be present with other illnesses.
Testing and evaluation were used to make the diagnosis, and it was decided whether the results were “substantially below” developmental expectations and whether they “significantly” interfered with social interactions, academic performance, and day-to-day living. It’s possible that this evaluation also revealed whether the trait is delayed or aberrant. Consequently, it was plausible that a person with communication difficulties could not have met the DSM IV-TR’s “substantially below” requirements. Not all communication disorders were included in the DSM diagnosis list; auditory processing disorder, for instance, is not included in the DSM or ICD-10 classification systems.[8] Among the diagnoses classified as communication disorders were the following:
A restricted vocabulary and trouble expressing oneself beyond short words are hallmarks of expressive language disorder. People are better at understanding language than using it; even though they may have a lot to say, they may struggle more than is normal for their developmental stage to organize and recall it.[9]
Mixed receptive-expressive language disorder: difficulty understanding what other people are asking of you.
Stuttering is a speech condition marked by a pause in speaking pattern during which words, syllables, or sounds are repeated or prolonged.
Phonological disorders are disorders of the speech sound that are typified by difficulties producing patterns of phonetic errors (e.g., “dat” for “that”).
Communication disorder NOS (not otherwise specified) is a DSM-IV diagnosis that can be used to classify disorders that don’t fit the precise requirements for the illness mentioned above.
DSM-5
The diagnoses listed above are entirely reworked in the DSM-5 for communication disorders.[11] In order to distinguish these communications disorders from those linked to other diseases (such as autism spectrum disorders) and to underline the disorders’ young start, the diagnoses have been made more inclusive.[12]
Language disorder: The key features of a language disorder are difficulties learning and utilizing the language, which stem from issues with grammar, vocabulary, and sentence construction. Both receptive (knowing language) and expressive (creating language) problems are possible.Speech sound disorder, formerly known as phonological disorder, is a term used to describe individuals who have difficulty pronouncing and articulating words in their native tongue.
Stuttering, or childhood-onset fluency disorder, is characterized by disruptions to speech patterns and regular fluency, which frequently result in the repetition of entire phrases and syllables.[15] May also involve pronouncing words and syllables longer than necessary, pausing inside sentences, and/or eschewing difficult terms in favor of simpler ones that the person can pronounce more easily.[16] This disease impairs social communication, performance in job and/or school environments where communication is crucial, and numerous other communication issues for the individual.
The term “social (pragmatic) communication disorder” refers to a diagnostic that describes challenges with verbal and nonverbal social communication in naturalistic settings, which has an impact on dialogue understanding and the formation of social connections. This diagnosis is distinct from autism spectrum disorder because the latter condition also involves a confined or repetitive pattern of activity.[13] Unspecified communication disorder: this category is used for those who don’t fit all the requirements for a communication disorder but nonetheless exhibit distressing or incapacitating symptoms.
As an example
conditions that could co-occur with the aforementioned conditions, cause difficulties in language and communication, or both include the following examples:
Developmental diseases that interfere with the brain’s normal development of social and communication abilities are known as autism spectrum disorders. These disorders include Asperger disorder, PDDNOS, and autistic disorder.[17]
Speaking and comprehending are affected by expressive language disorder, even in cases when non-verbal intelligence is not delayed.
When there is no delay in non-verbal intelligence, mixed receptive-expressive language disorder affects speaking, understanding, reading, and writing.
Specific language impairment is a language disorder that causes children without hearing loss or other developmental disabilities to take longer to learn language skills. Other names for SLI include developmental dysphasia, language delay, and developmental language disorder.
Limitations of the senses
Blindness: Research is currently being done to determine whether communicative abilities and visual impairment are related in blind youngsters.[19]
Deafness or recurrent ear infections: Hearing loss during language learning might cause issues with spoken language. Children who get ear infections frequently may experience short-term difficulties pronouncing words correctly. Hearing loss is not a sign of a communication issue by itself.
Phobia
The lack of language production or comprehension is known as aphasia. Acute aphasias stemming from brain damage or stroke are distinguished from primary progressive aphasias, which are brought on by progressive diseases like dementia.
Abrupt aphasias
Expressive aphasia, commonly referred to as Broca’s aphasia, is a non-fluent aphasia that is typified by brain injury to the frontal lobe area. Typically, a person with expressive aphasia talks in brief, coherent sentences that require a lot of work to generate. Additionally, a someone with expressive aphasia can understand what others are saying but finds it difficult to reply right away.
Receptive aphasia, sometimes referred to as Wernicke’s aphasia, is a type of fluent aphasia that is defined by injury to the brain’s temporal lobe area. When speaking, an individual with receptive aphasia typically uses extended, meaningless sentences. Individuals with this kind of aphasia typically struggle to grasp what other people are saying and are generally unaware that they are not making sense.
Progressive nonfluent aphasia, or PNFA, is a type of PPA that includes difficulties with articulation and word seeking, impairment in syntax and grammar, reduced speech fluency, and long-term understanding.
A disease known as semantic dementia[23] causes words and phrases to gradually lose their meaning and comprehension due to a decline in semantic recall. Typically, this is indicated by altered behavior, meaningless speech that is fluent, intact syntax and grammar, and trouble identifying objects.
LPA, also referred to as logopenic progressive aphasia[23], is linked to Alzheimer’s disease. Phonological mistakes, anomia, difficulty retrieving and repeating words, and retention of single-word comprehension are the characteristics of this.
Learning impairment
Dyscalculia is a disorder that affects the processes that convey numerical information.
Dyslexia is a reading-related problem.
Dysgraphia is a disability affecting the writing systems
Speech Disorders
Cluttering is a syndrome defined by unusually fast, irregular, or both speech delivery rates.[24] Dysarthria is a condition in which a person’s inability to speak is caused by issues with the muscles that support their speech.[25] Esophageal voice: this condition occurs when a patient swallows or injects air into their esophagus. Typically, patients who are unable to talk with their larynx learn to utilize it. Esophageal voice is produced when the patient pushes air into their esophagus, which causes the air to vibrate a muscle. Patients with esophageal voice frequently can only speak quietly and in short words, and it can be challenging to learn.
lisp, commonly referred to as sigmatism, is a speech handicap.
Speech-sound disorders (SSD) are characterized by impairments in the production of speech sounds. These disorders can vary in severity, ranging from mild articulation problems involving a restricted range of speech sounds to more severe phonologic disorders involving multiple errors in speech-sound production and decreased intelligibility.[26]
stuttering is a speech disorder characterized by repeated sounds, syllables, or words that are longer than usual. Speech breaks due to these issues are referred to as disfluency.
