Communication Disorders

Claire Zachik, Zoya Popivker, D.O., Roma Vasa, M.D., Rebecca Landa, Ph.D., CCC-SLP
Communication Disorders is a topic covered in the Johns Hopkins Psychiatry Guide.

To view the entire topic, please or purchase a subscription.

Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine. Johns Hopkins Guide App for iOS, iPhone, iPad, and Android included. Explore these free sample topics:

Johns Hopkins Guides

-- The first section of this topic is shown below --


  • A communication disorder is a neurodevelopmental disorder characterized by impairments in sending, receiving, processing, or comprehending verbal, nonverbal, or graphic language, speech, and/or communication.
  • Communication disorders may be developmental or acquired (secondary to trauma or neurological disorder).
  • Language is one of five major streams of development, within which developmental milestone acquisition occurs at a specific rate in an orderly and sequential manner[1].
  • See Table Language and Social Milestones for language and social milestones in a typically developing child.
    • Deviation from these milestones may signal the presence of a communication disorder
    • For further developmental information, please see the American Academy of Pediatrics’ Bright Futures (…) or the CDC’s Milestones (…)
Language and Social Milestones


Language Milestone

Social/Adaptive Milestone

Birth through 6 months

Alerts to sound, Coos (musical long vowel sounds), Orients to voice, Babbles, Responds to name

Pays attention to faces, Reaches for familiar people and objects, Differentiates strangers, Social smile

9 months

Says "mama, dada" indiscriminately, Gestures, Waves bye-bye, Understands "no"

Starts exploring environment; Copies sounds and gestures of others; Plays gesture games (pat-a-cake); Initiates bids for interaction, actions, or objects

12 months

May use 2 words other than "mama, dada" or proper nouns for communicative purposes, Follows 1-step command with gesture such as “give the bottle”

Comes when called by someone nearby, Cooperates with dressing

15 - 18 months

Uses 4-10 words consistently and communicatively, Follows familiar 1-step commands without gesture, Mature jargoning (with intelligible words), Understands the label for 5 body parts

Uses spoon and cup, Points to share attention/enjoyment with another person, Plays in company of other children

24 months

50% of speech is intelligible, Uses pronouns (I, you, me) appropriately, Follows 2-step commands, At least 50-word vocabulary, 2-word phrases

Parallel play

3 years

75% of speech is intelligible, Uses a minimum of 250 words, Phrase speech is established with 3- or more-word sentences produced communicatively, Uses plurals and other grammatical markers such as "ing" (e.g., "throwing"), Uses pronouns, Repeats 2 digits

Shares toys; Takes turns; Plays well with others in 1:1 and group settings; Can state full name, age, gender

4 years

Speech is mostly intelligible, Knows colors, Recites song or poem from memory, Asks questions

More creative with make-believe play, Moves back and forth between what is real and what is make-believe, Plays cooperatively with a group of children

5 years

Prints first name, Asks meanings of words

Plays competitive games, Abides by rules, Likes to help in household tasks

  • Communication disorders fall into a number of separate diagnoses (language disorder, speech sound disorder, childhood-onset dluency disorder, social communication disorder) and are classified under the Neurodevelopmental Disorders section of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)[2].

-- To view the remaining sections of this topic, please or purchase a subscription --

Last updated: September 3, 2017