As a child, having a communicative disorder can be a harrowing experience. There are chaotic and disheartening feelings of inadequacy, participation anxiety and missing out.
In this post, we will go touch on some communicative disorders to promote awareness and encourage early treatment. Let’s begin.
DEFINITION OF A DISORDER
Any condition that differs from the average case or norm is a disorder. The same applies to a communicative disorder. A good benchmark to go by is school performance in the areas of speaking, reading and writing.
Aphasia affects the expression or reception of language or both. It is caused by damage to certain brain areas.
Wernicke’s aphasia typically shows up as made-up words. But the grammar is usually correct. For example, “Pratnos are Smazzy.”
If the condition is less severe, then the person can be trained to avoid using made-up words even if such words pop in their heads.
In more severe cases, the treatment is simply non-language communication.
Broca’s aphasia shows up as grammatical deficiences/errors. Technically, the problem concerns function words. To give you a simple example, a letter from a Broca’s aphasic may read like so:
“My father… er… came…. He… went… Came… of the morning… me… and… cat… the him… play.. “
There are also comprehension problems when there is unusual syntax. For example, “The lion ate her” is fine. But “she ate the lion” is difficult to understand.
Global aphasia is a combination of Broca’s and Wernick’s aphasia. Finally, anomic aphasia is a disorder of word retrieval. In simple words, they will have a lot trouble finding the right word for a description.
Autism is not, strictly speaking, a communicative disorder. It is actually an interaction disorder. An autistic person will either miss or misinterpret interaction cues. These cues span both verbal and non-verbal interactions.
As far as communication is concerned, there will be trouble understanding communicative intentions. There will also be a failure to develop functional speech. The speech will be there, and may even have good grammar and meaning. But, it will seem out of context or serving no meaningful function in the situation. Another type of communicative dysfunction observed in autistic individuals is inappropriate antics and inappropriate emotions to go along with a verbal utterance.
Austistic individuals also exhibit echolalia (word/phrase/sentence repetitions) sometimes with a lag of several hours from the time that the word/phrase/sentence first came up.
Autism must be dealt with medically. It involves abnormalities in several brain areas including the frontal lobe, parietal lobe, brain stem, cerebellum, corpus collasum, basal ganglia, amygdala and hippocampus.
The term learning disability is self-explanatory. Some common forms are as follows:
Dyslexia is a disorder involving language building units, such as individual letters, numbers, sounds and shapes.
It can be visual in which the child would be unable to copy from a visual source, without somehow jumbling/reversing the letters/numbers.
It can also be auditory in which the child struggles with sounds such as “t’s” and “c’s” and thus misregisters and forgets words. Also, they might have trouble finding the right words/sounds while speaking.
Primary dyslexia is due to damage to the left side of the cerebral cortex. It does not change with age. It also shows a significant degree of heredity.
On the other hand, developmental or secondary dyslexia is thought to be caused by hormonal changes. It does change with age.
The sooner dyslexia is treated, the better the outcome. But it is never “too late” to begin recovery.
This is a disorder related to writing. It mainly comes from impaired fine motor control (holding a pencil, for instance). It is a communicative problem in that it compromises expressions and interpretations of written communication.
Alzheimer’s disease is a progressive brain disorder related to memory. It affects communicative ability.
Sounds (phonics) and grammar (syntax) remain mostly intact.
But meaning of sentences (semantics) and practical aspects of communication (pragmatics) such as intentions, functions, context etc significantly deteriorate.
The damage is in and around the cortical areas of the brain.
SLI (Specific Language Impairement)
The term specific is telling. Most of the communication is normal, but there is a very specific problem. Usually, the following forms of specific deficits/disorders are seen:
- Poor vocabulary
- Difficulty word finding
- Difficulty learning new words
- Use of short sentences, and trouble with longer sentences.
- Difficulty with tenses like “He eat” rather than “He eats”
- Difficulty with rapid and complex communication (talking too fast, varying sentence structure too much, switching between communicative themes and purposes too often etc).
In about 50 % of SLI cases, the child goes on to develop some degree of dyslexia.
Dyspraxia is seen as a person badly or completely missing the point of a communication. It comes from sensory/motor delays and disruptions. For example, as a person is listening to you, they may momentarily stop sensing the sound, or they may suddenly focus too much on tapping the table.
Outcomes of dyspraxia include poor word and concept retention, error-ridden and incoherent speaking, reading and writing, communicative clutter and visible emotional distress during communication.
Treatment includes occupational therapy which involves using the context of everyday activities to develop cuing skills (signs that a particular communicative input or output is required at that instance) and body language skills (to supplement verbal communication).
Speech disorders are different from language disorders in one key aspect. They are concerned mainly with sounds (vocals) and utterances (verbals) whereas language disorders are concerned with phonetics (sounds), syntax (grammar), semantics (meaning) and pragamtics (practical functions such as intentions, emotions etc).
Some common speech disorders to look out for are as follows:
There are 4 factors to consider in voice disorders:
- Volume – How loud it is
- Pitch – how grating or soothing the utterance is.
- Quality – Is the sound full-bodied or weak in tone?
- Rate – How fast is he/she speaking?
Voice disorders can isolate children depending on culture. For example, if a male adolescent doesn’t “speak like a man” a female child “does speak like a man.”
Treatment involves vocal training and self-acceptance therapy.
These can be phonetic (concerning basic sounds of the lanuage units) or phonemic (concerning distinctions where sounds have more than one application).
There can also be an articulation disorder which is about speaking clearly. There may be adding, omitting, substitution and distortion of sounds at inappopriate/incorrect instances. This can happen due to unusual structural features of the mouth or damage to the nervous system.
Treatment involves pronunciation training.
Fluency is characterized by correct, smooth and well-timed application and transition of words during a communication.
Disorders of fluency usually involve:
- Problems with social cues (these children are often mishandled and so do not express themselves normally in social settings).
- Neurological and motor problems.
Treatment is specific to the person concerned.
With apraxia, the following problems are seen:
- Lack of consistency (in pronunciation and clarity).
- Lack of correctness in sound and verbage.
- Dysprosody – Incorrect cadence (emphasis), rythm (flow), timing (no pause during commas for example) and intonation (rise and fall of voice during speaking).
Tony stark, the fictional Marvel character, does not have dysprosody. He just speaks fast because things compute in his head at a quicker rate. He also has good intonation and rythm.
Dysprosody is different. The most telling aspect is speech incomprehensibility due to lack of voice modulation, poor flow, mumbling pronunciations and incomplete utterances.
This disorder happens due to a degree of paralysis in speech structures. Treatment involves articulation therapy, kinesthetic therapy (using body animations to cue and support verbal functions). In cases where improvement is slow, computer-synthesized speech may be used, like in the case of Stephen Hawkings.
In the post, we went over the telltale signs of some common communicative disorders. These disorders cause deep-rooted depression and anxiety, if they’re not treated early. Thus, it is important for parents to recognize them and bring them to the attention of a medical professional as soon as possible.
Thank you for reading.