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Early intervention is key for children with communication disorders.

As many as 1 in 12 U.S. children has had a disorder related to voice, speech, and language – and knowing how to tell if your child may need help is the first step.

Difficulties in the development of voice, speech, language, or swallowing abilities may interfere with cognitive, social, and academic development, but speech-language pathologists and other experts can help.

Here’s what to know about the signs and symptoms of common communication disorders in children and when to get help.

What Are Common Communication Disorders in Children?

Children who routinely struggle to communicate with those around them – whether it’s comprehension, physical speech, finding the right words, or formulating grammatically correct sentences – may be experiencing a communication disorder. These can be the result of developmental delays, genetic conditions, a brain injury, or other factors.

The most common of these disorders fall into one of five categories:

• Mixed receptive-expressive language disorder: When a child struggles to speak or understand spoken language, they may have a receptive-expressive language disorder. These may be developmental, appearing when a child is just learning to speak, or acquired and possibly caused by damage to the brain. Finding speech-language therapy with a certified professional as early as possible gives your child the best chance at recovery. Signs of this disorder include repeating words, trouble following simple directions or answering questions, limited speech for a child’s age, or learning/academic difficulties.
• Expressive language disorder: A child with speaking challenges may have an expressive language disorder. People with this type of disorder may struggle to share their thoughts or confirm they understand others’ speech. This happens everywhere, including at home, school, and other social settings. It can create problems at all levels of interaction. Some signs are using excessive “filler” words like “um” when searching for words, using non-descript words like “thing,” having a limited vocabulary, using incorrect grammatical structures, delayed speech in childhood, or avoiding speech altogether. It can cause children to become withdrawn socially. No single cause is linked to expressive language disorder, but difficulties may be genetic, related to autism, or result from brain injury or illness.
• Speech-sound disorders: A child that has trouble producing sounds, words, or phrases clearly and fluently beyond the age when that word or sound is typically learned may have a speech-sound disorder. This can present as difficulty with articulation or a phonological process disorder where a child has a pattern of speech sound errors. It can be related to a neurological impairment, developmental delays, or a physical issue such as cleft lip/palate.
• Childhood-onset fluency disorder: Also known as stuttering, this is characterized by repetition or prolongation of speech sounds, hesitations and long pauses when speaking, or repetition of parts of or whole words. Stuttering can be worsened in stressful situations that prompt nervousness or anxiety. It tends to run in families, and some researchers believe it may be driven by a combination of linguistic, motor, emotional, and brain factors.
• Social communication disorder: This is characterized by routine challenges with the use of verbal and nonverbal language for social interaction. It’s not a problem with speech itself, or with the mechanics of language, but with the “rules” of language within a particular society. Children with this disorder may have trouble reading social cues, body language, or facial expressions, or understanding language pragmatics. They may interrupt during conversations, say things that appear to be “rude” in a particular setting, say off-topic things, or be reluctant to speak at all. This can make it hard for children to connect with others. It often presents alongside other conditions or challenges, including autism.

What Causes Communication Disorders In Children?

In many cases, the exact cause of a child’s communication disorder may not be fully understood, and experts don’t always know if or how they can be prevented.

Disorders may be related to developmental, genetic, physical, neurological, or environmental factors.

Spotting the signs early and working with a speech-language pathologist will give your child the tools they need to recover or learn to live more comfortably with their condition.

Possible causes of communication disorders in children include:

• Developmental delays or differences.
• Learning difficulties or intellectual disability.
• Physical differences, such as a cleft lip/palate, or voice problems.
• Genetic factors.
• Neurological impairments caused by traumatic brain injury, premature birth, or birth trauma.
• Exposure to toxic chemicals or substances during pregnancy or in early childhood.
• Autism.
• Emotional or psychiatric conditions, such as trauma, psychosis, or schizophrenia.
• Sensory deprivation in the form of hearing or vision.

Communication Disorders in Children: Signs

Symptoms vary among children and depend on the type and cause of a particular communication disorder, but here are some of the most common symptoms in younger children:

• Limited, delayed, or no speech consistent with a child’s age.
• Limited vocabulary for a child’s age, or trouble with word retrieval.
• Difficulty understanding simple directions.
• Academic or learning challenges.
• Stuttering.
• Difficulty expressing emotional or physical needs, or thoughts and ideas.
• Trouble interacting with others in social settings, or withdrawing from social situations due to communication challenges.

Next Steps for Your Child

1. Most children with communication disorders will be referred to a speech-language pathologist for diagnosis and treatment, and some may see a child psychiatrist at the same time if there are emotional or behavioral problems to consider.
2. A speech-language pathologist will conduct a full evaluation that may involve speech-sound production, language usage and understanding, and reasoning/thinking skills and situational reactions. After diagnosis, the pathologist will work with you and your child in an individual or group setting to improve your child’s communication skills.
3. Speech-language pathologists in the Division of Audiology and Speech-Language Pathology at UPMC Children’s Hospital of Pittsburgh are experts in evaluating and treating children with a variety of communication disorders.