|Disorders usually first diagnosed in
infancy, childhood, or adolescence.
Expressive language disorder (DSM 315.31) is a communication disorder which is characterised by having a
limited vocabulary and grasp of grammar. It is a general language impairment that puts the person onto the level of
a younger person and also a person can be as young as 2 or 3 years old with the disorder.
As well as present speech production, very often, someone will have difficulty remembering things. This memory
problem is only disturbing for speech; non-verbal or non-linguistically based memory will be unimpaired.
Expressive language disorder affects work and schooling in many ways. It is usually treated by specific speech
therapy, and usually cannot be expected to go away on its own.
Care must be taken to distinguish expressive language disorder from other communication disorders, sensory-motor
disturbances, intellectual disability and/or environmental deprivation (see DSM-IV-TR criterion D). These factors
affect a person's speech and writing to certain predictable extents, and with certain differences.
Mixed receptive-expressive language disorder (DSM-IV 315.32) is a communication disorder in which both the
receptive and expressive areas of communication may be affected in any degree, from mild to severe.
If someone is being assessed on the Wechsler Adult Intelligence Scale, for instance, this may show up in relatively
low scores for Information, Vocabulary and Comprehension (perhaps below the 25th percentile). If the person has
difficulty with spatial concepts, such as 'over', 'under', 'here' and 'there', he or she may have arithmetic difficulties,
have difficulty understanding word problems and instructions, or have difficulties using words.
They may also have a more general problem with words or sentences, both understanding and speaking them.
If someone is suspected to have mixed receptive-expressive language disorder, then they can go to a speech
therapist or pathologist, and receive treatment. Most treatments are short term, and rely on accommodations made
in the person's environment, so as to be minimally interfering with work and school functioning.
Speech disorders or speech impediments, as they are also called, are a type of communication disorders
where 'normal' speech is disrupted. This can mean stuttering, lisps, etc. Someone who is totally unable to speak due
to a speech disorder is considered mute.
Stuttering, also known as stammering in the United Kingdom, is a speech disorder in which the flow of speech is
disrupted by involuntary repetitions and prolongations of sounds, syllables, words or phrases; and involuntary silent
pauses or blocks in which the stutterer is unable to produce sounds.
The term stuttering is most commonly associated with involuntary sound repetition, but it also encompasses the
abnormal hesitation or pausing before speech, referred to by stutterers as blocks, and the prolongation of certain
sounds, usually vowels. Much of what constitutes "stuttering" cannot be observed by the listener; this includes such
things as sound and word fears, situational fears, anxiety, tension, self-pity, stress, shame, and a feeling of "loss of
control" during speech. The emotional state of the individual who stutters in response to the stuttering often
constitutes the most difficult aspect of the disorder. The term "stuttering", as popularly used, covers a wide spectrum
of severity: it may encompass individuals with barely perceptible impediments, for whom the disorder is largely
cosmetic, as well as others with extremely severe symptoms, for whom the problem can effectively prevent most oral
Stuttering is generally not a problem with the physical production of speech sounds (see Speech sound disorders,
Voice disorders) or putting thoughts into words (see Dyslexia, Cluttering). Despite popular perceptions to the
contrary, stuttering does not affect and has no bearing on intelligence. Apart from their speech impairment, people
who stutter are normal. Anxiety, low confidence, nervousness, and stress therefore do not cause stuttering,
although they are very often the result of living with a highly stigmatized disability.
The disorder is also variable, which means that in certain situations, such as talking on the telephone, the stuttering
might be more severe or less, depending on the anxiety level connected with that activity. In other situations, such
as singing (as with country music star Mel Tillis or pop singer Gareth Gates) or speaking alone (or reading from a
script, as with actor James Earl Jones), fluency improves. (It is thought that speech production in these situations, as
opposed to normal spontaneous speech, may involve a different neurological function.) Some very mild stutterers,
such as Bob Newhart, have used the disorder to their advantage, although more severe stutterers very often face
serious hurdles in their social and professional lives. Although the exact etiology of stuttering is unknown, both
genetics and neurophysiology are thought to contribute. Although there are many treatments and speech therapy
techniques available that may help increase fluency in some stutterers, there is essentially no "cure" for the disorder
A communication disorder is a disease or condition that partially or totally prevents human communication. The
defect can be in producing, receiving or understanding the communication.
Examples of communication disorders:
* autism -- a developmental defect that affects understanding of emotional communication
* aphasia -- loss of the ability to produce or comprehend language
* learning disability - both speaking and listening components of the definition
* dysnomia - deficit involving word retrieval
* asperger syndrome - areas of social and pragmatic language
* blindness -- a defect of the eye or visual system
* deafness -- a defect of the ear or auditory system
* dyslexia -- a defect of the systems used in reading
* dyscalculia -- a defect of the systems used in communicating numbers
* expressive language disorder -- affects speaking and understanding where there is no delay in non-verbal
* mixed receptive-expressive language disorder -- affects speaking, understanding, reading and writing where there
is no delay in non-verbal intelligence
* speech disorders such as:
o cluttering, a speech organization disorder
o oesophageal voice
o speech sound disorder
o specific language impairment