Communication skills and disorders


Communication skills are the skills needed to use language (spoken, written, signed, or otherwise communicated) to interact with others, and communication disorders are problems related to the development of these skills.


Language employs symbols—words, gestures, or spoken sounds—to represent objects and ideas. Communication of language begins with spoken sounds combined with gestures, relying on two different types of skills. Children first acquire the skills to receive communications, that is, the ability to listen and understand what they hear (supported by accompanying gestures). Next, they will begin experimenting with expressing themselves through speaking and gesturing. Speaking will begin as repetitive syllables, followed by words, phrases, and sentences. Later, children will acquire the skills of reading and writing—the written forms of communication. Although milestones are discussed for development of these skills, many children begin speaking significantly earlier or later than the milestone date. Parents should refrain from attaching too much significance to either deviation from the average. When a child's deviation from the average does cause the parents concern, they may contact a pediatrician or other professional for advice.

Spoken language problems are referred to by a number of labels, including language delay, language disability, or a specific type of language disability. In general, experts distinguish between those people who seem to be slow in developing spoken language (language delay) and those who seem to have difficulty achieving a milestone of spoken language (language disorders). Language disorders include stuttering ; articulation disorders, such as substituting one sound for another (tandy for candy), omitting a sound (canny for candy), or distorting a sound (shlip for sip); and voice disorders, such as inappropriate pitch, volume, or quality. Causes can be related to hearing, nerve/muscle disorders, head injury, viral diseases, mental retardation , drug abuse, or cleft lip or palate.

The Diagnostic and Statistical Manual of Mental Disorders (also known as the DSM-IV-TR ), published by the American Psychiatric Association, lists the following disorders as communication disorders:

  • Expressive language disorder: Disorder characterized by impairment in expressive language development.
  • Mixed receptive-expressive language disorder : Impairment in both receptive and expressive language development. The affected child has a more difficult time understanding and expressing language as compared to peers.
  • Phonological disorder : Inability to use expected speech sounds appropriate for the child's age and dialect.
  • Stuttering: Unexpected disturbances in the normal patterns and flow of speech.
  • Communication disorder not otherwise specified: This may be diagnosed when a child has an irregularity in speech or a difficulty (in voice or pitch, etc.) but the child's symptoms do not exactly match any of the specific categories of impairment that the DSM recognizes.

See also Speech-language pathology



American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth edition, text revised. Washington DC: American Psychiatric Association, 2000.

Cowley, Geoffrey. "The Language Explosion." Newsweek 129 (Spring-Summer 1997).


American Speech-Language-Hearing Association. 10801 Rockville Pike, Rockville, MD, 20852. (800) 638-8255. <> .

National Institute on Deafness and Other Communication Disorders. National Institutes of Health, Bethesda, MD, 20892. <> .

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