- 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.
- 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 (http://brightfutures.aap.org/index.html) or the CDC’s Milestones (http://www.cdc.gov/NCBDDD/actearly/milestones/index.html)
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
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
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
50% of speech is intelligible, Uses pronouns (I, you, me) appropriately, Follows 2-step commands, At least 50-word vocabulary, 2-word phrases
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
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
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).
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