Definitions and Descriptions of Communication Disorders

According to Justice (2006), “Individuals are normal and effective communicators when they are
able to formulate, transmit, receive, and comprehend information from other individuals
successfully. A communication Disorder or impairment is present when a person has significant
difficulty in one or more of these aspects of communication when compared with other people
sharing the same language, dialect and culture.”

Language Disorders

Language is a formal communication system that is shared by its users. Although we can
communicate without language, language facilitates our communication by making it more
effective. In order for language to be most effective, its users must all use the same symbols (i.e.
words having the same meanings) and the same rules to connect the symbols. (i.e. putting the word
in the right order to convey the intended meaning ). When people are effective language users,
they can clearly share their thoughts with other people.

An individual may have generally good speaking ability yet have a language problem. For
example, an elementary school student may have a language disorder if he has a difficult time
finding and using the right word or combination of words; using words in the right order; or using
correct words, phrases, or sentences at the right time. Your ability to understand his individual
words may be fine but you may still have a difficult time comprehending what he is trying to say.

Experts usually divide language disorders into three major categories. These are disorders
of (1) form, (2) content (also called semantics), and (3) use (also called pragmatics) (Justice, 2006;
Owens, Metz, &

(1) Form Disorders

In Language, form is defined by three aspects; the sounds used to make words and words parts
(phonology), and the rules for constructing words and parts of words (morphology), and the rules
for connecting the words together (syntax).

The sounds of the language are referred to as its phonology, and the phonological
components are called phonemes. Phonemes are the smallest unit of sound that can affect word

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meaning. The word “mat” has three phonemes: the “m” sound, the “a” sound and the “t” sound.
Most English speakers can both produce and comprehend these sounds when they are linked
together (m-a-t) to conjure an image of an item lying on the floor to wipe our feet or on a table to
put a plate on. The meaning changes, however, if we change just one phoneme. For example,
“mat” can become “sat,” “met” or “map” by changing the first, last or middle phoneme,
respectively, and any of these changes would change the meaning of the word.

A person who has a phonological disorder may not have developed an adequate mental
representation of the phoneme or may not be able to adequately produce some phonemes with
enough distinction from other phonemes. Usually children go through their early development
with many errors in developing and using correct phonemes- for example, saying “ovah deyah”
for over “there” or “dats mine” for “that’s mine.” Phonological disorders such as these usually
disappear as the child grow older, but not always. Speech disorders called articulation disorders
sometimes occur as a product of phonological disorders.

Another language form disorder occurs when an individual doesn’t use the correct internal
structure of words, instead using the meaningful components of word, which are called
“morphemes,” erroneously. For example “walk” work is a morpheme and so is “-s,””-ed,” and “-
ing.” When we attach any of these three morphemes to the first one “Walk,” we ae using them to
change word meaning. Like the person who can articulate the appropriate phoneme, a person
difficulty using the correct morpheme to convey what she intends would also have a language form
disorder.

Finally, form disorders can include syntax disorders. Language syntax consists of the rules
used by a speaker to conduct words appropriately so that the listener can accurately comprehend
what the speaker intends. For example, In English, if we are talking about someone doing
something, like “The girl threw the Frisbee,” we must put words in a certain order so that all
knowledgeable English users will agree about the meaning of the statement. If we don’t arrange
the words correctly, the listener may not comprehend what the speaker is trying to say. Although
we could also say, “The Frisbee was thrown by the girl” (using the passive voice instead of active
voice), we would not say “The Frisbee threw girl” or “Girl the Frisbee threw.” We were to do so,
this would be evidence of an English syntax problem.

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 You can see that if someone has difficulty producing acceptable language form, either
using the correct sound (phonology), word parts (morphology) or word arrangements (syntax) or
maybe combinations of these, he would likely have a significant problem in effective language
usage. In such case, intervention might be necessary to help the individual improve his language
form.

(2) Content Disorders

We call the second major type of disorder content disorder, which is also called a semantic
disorder. The semantics of a language are the rules that dictate the meanings applied to specific
words or word combinations. For example, if a person consistently uses words or phrases that are
not meaningful to other people who use the same language, or uses words or phrases that are not
valid for the situation, the person is experiencing a content or semantics problem.

Language content is often affected by life and learning experiences. Some children who grow
up in a very impoverished environments and, as a result, lack many opportunities for exploring an
array of social and literary condition may have limited language content. As a result, you may find
that they often have difficulty the right words to express themselves or they may use the words
that are inappropriate for their communication needs. Individuals who have trouble finding the
right words who have a hard time understanding or using more abstract language, or who have a
vocabulary that is inadequately developed for their age are considered to have a language content
disorder.

(3) Use Disorders

The real value of language is its potential to allow us to communicate more precisely than if
we did not have it. So an important component of a person’s language is the adequacy with which
she can use the language, that is, how well she can apply language skills when communicating
with others in daily social situations.

Language use disorders, which are also referred to as disorders in pragmatics are
characterized by individuals who do not use language that is appropriate for their current social
context. A child who has a problem in pragmatics might have difficulties initiating conversations,
taking turns with partners, engaging in extensive dialogues, or engaging in wide range of other

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language uses in specific situations (greeting, making requests or commenting). This person may
have adequate language form and content but be deficient when using language for social purpose.

Manifestations of Language Disorders

Although we presented the different language disorders as discrete conditions, different

type of disorders often occur together. In fact, children ay exhibit combinations of language form,
content and use disorders, sometimes even with all three of disorders occurring together. When
this happens, the child is said to have a diffused language disorder. What’s more, the language
disorder displayed by the child can change overtime. Changes can occur because of maturation,
speech-language intervention, or educational experiences. Additionally, a child may experience a
particular type of language disorder at one time and another disorder at another time.

Speech Disorders

Speech relies on the coordinated use of four building blocks: respiration, voice, articulation and
fluency.

 Respiration. An essential need for speaking is being able to produce enough air pressure
from our lungs. Our breathing, or respiration produces a consistent and even breath stream
that provides the power for speech. Just as the air is used to produce sound in a pipe organ,
it is the basic ingredient necessary for people to speak.
 Voice. As we exhale, voice is used to create sound and to vary the sound in volume, pitch
and resonance. We use our larynx and oral and nasal cavities to modify the sounds we
produce.
 Articulation. The sounds are further refined into phonemes through articulation.
Articulation is conducted by using our mouth parts, including our lips, tongue, teeth, jaws,
and soft palate. These are referred to as the articulators.

Speech production

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 Justice (2006) provides this simple description to help us comprehend the complex process
of speech:

To better understand the processes involved with speech, say the word “eat” slowly and
deliberately and think about the processes as you do so. You will see that the speech process begins
with intake of a breath of air, which is then exhaled; this is the basic fuel, needed for all speech.
The exhalation travels up from the lungs through the windpipe (trachea) and over the vocal chords,
which begin to vibrate and create the “eeee” sound. This “eeee” sound is then into the oral cavity,
which is open and marked by a big toothy smile. With the lips pulled wide. Notice the upper and
lower jaws are held fairly close together, but are not closed. The tongue sits low in the mouth, with
the tip tucked behind the lower row of teeth and the middle rounded up on the sides To touch the
upper teeth. Once the “eeee” sound is in the oral cavity, a brief “ea” escapes and then the tongues
comes quickly. Up behind the teeth to produce the “t” sound following the “ea” (p. 16)

When you understand that this is the process required for producing a single word, you
have a good idea of what we mean when we say that speech is an extremely complex activity.

Phonological and Articulation Disorders

If speech is to be an effective way to produce language, a speaker must generate speech

sounds (specifically, phonemes) that a listener can understand and attach meaning to. Phonological
(knowledge of sounds) and articulation (production of sounds) disorders impair a person’s ability
to clearly create speech sounds. Instead of producing standard speech sounds, the speaker produces
sounds that include distortions, substitutions, omissions, or additions. A distortion occurs when a
nonstandard phoneme, like a lisp, is produced. A substitution is when one phoneme is replaced
with another, such as “shair” for “chair”." An omission is the deletion of a phoneme, such as saying
“chai" for “chair,” and an addition is when an extra phoneme is added such as “chuh air” for “chair”
(Owens et al., 2003).

As we mentioned earlier, one type of form disorder was called a phonological disorder: As
we explained, a phonological disorder is a language disorder that occurs when an individual has a
faulty perceptual representation of a particular phoneme. This means that, although the person has
the physical ability to produce the correct phoneme, he constantly produces an incorrect phoneme.
The problem is attributed to having an inadequate mental representation of this aspect of the in”,

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guage sound. An example would be a person who can distinguish between a “ch” sound and a “sh”
sound but doesn’t make a distinction between the two sounds when speaking (Davis & Bedore,
2010).

Phonological disorders (a perceptual problem) produce what sounds like an articulation

disorder that is actually a speech production problem. However, articulation problems can also be
attributed to structural problems, such as a cleft palate, or faulty control of the articulators, such as
incorrect placement of the tongue in relation to the teeth to produce an “r" sound. A common
example of an articulation problem would be the child who says “wed" instead or “red." In such a
case we might say that the child simply has not had enough experience to correctly form the desired
speech sound.

In some cases phonological disorders and articulation disorders can both occur. Davis and
Bedore (2010) offered an example of a child who had a history of chronic otitis media (middle ear
infection) that led to a mild hearing loss. Because of the hearing loss, the child may not have been
able to develop a correct mental representation of some speech sounds, which would lead to a
phonological disorder. At the same time, the child would not be able to monitor his own speech
sounds and thus might not know whether the sounds are correct.

Fluency Disorders

Although less frequent than phonological or articulation disorders, fluency disorders are
typically much more noticeable. The most common fluency disorder, and the one with which you
are likely to be most familiar, is stuttering. Stuttering can draw a great deal of attention to the
speaker and often causes much stress. Because it is often affected by environmental and
circumstantial conditions, teachers can play an important role in creating conditions to reduce the
likelihood that a child will stutter.

Stuttering has been defined by using descriptions and explanations of the condition. Descriptive
definitions usually note that stuttering consists of producing an abnormally high number of sound
and syllable repetitions, prolongations, or blocks. Explanatory definitions try to address the
question “Why does the person stutter?’ and tend to Speculate that stuttering occurs due to
psychological or neurological conditions. In fact, the true cause of stuttering is unknown.

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 Shapiro (1999) offered this definition: "stuttering refers to individualized and involuntary
interruptions in the forward flow of speech and learned reactions there to interacting with and
generating associated thoughts and feelings about one’s speech, oneself as a communicator, and
the communication world in which we live.” He further noted, “Stuttering occurs within the
context of communication systems, thus affecting and being affected by all persons who
communicate with the person who stutters“ (p. 14).

When you observe the person who stutters, you will typically see both primary, or core,
behaviors and secondary behaviors. The primary behaviors are the speech characteristics that we
normally think of as stuttering-that is, the repetitions, prolongations, and blocks. The secondary
behaviors are the person's reaction to stuttering as she tries to deal with the uncomfortable
verbalizations avoid them altogether. Commonly you will see the person doing thing like blinking
her eyes, opening her jaws, pulsing her lips, substituting easier words for those that are more
difficult, or inserting “uh” before a difficult word (Byrd & Gillam, 2010).

Stuttering behavior demonstrates a great deal of variability. In other words, if you carefully
observe peOple who stutter, you will see that they do not do so in [he same way (Byrd & Gillam,
2010). Generally, however, we know that different circumstances tend to increase the probability
that a person who stutters will stutter. Usually this happens when the person tries to put more
pressure on himself to be fluent. For example, talking on the phone, trying to communicate briefly
or quickly (e.g. giving your name or ordering in a restaurant), or speaking to an authority figure
(eg, a teacher or a principal) are all situations when stuttering is more likely to occur.

In contrast, in some conditions a person who stutters is less likely to stutter some of these
include during choral reading, when speaking in a low volume, when speaking slowly, when
speaking in a rhythmical way, and when singing. In fact, as Shapiro (1999) points out, most people
who stutter do so only 15% to 20% of the time they speak. He suggests that, by focusing on
conditions related to fluent speech, therapists and others in the students’ communication
environment (e.g., teachers) can be more successful in increasing effective speaking.

Voice Disorders

One of the key human characteristics that distinguishes us from each other is our voice.
Like facial features and bodily shapes, we know each other by how we sound. Before you see your

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friend coming up behind you in the hall, you know who it is when she calls your name or yells for
you to wait a minute.

Our unique voices are a result of the physical components that allow us to produce them.
The voice begins as air is pushed out of our lungs. It then passes into our larynx and through the
larynx’s two vocal folds (or vocal chords). By vibrating our vocal folds as the air from our lungs
passes through them, we begin to create our voice. The voice is further modified as it passes
through the pharynx (or throat) and then into the oral and nasal cavity where it is given resonation
(lustice, 2006).

One of the most salient variations in our voices is that which exists between mature males
and females. But as you know, there are many, many more variations. This, of course, is why we
can distinguish each other by our voices. The interaction of three vocal characteristics creates our
unique voice: frequency, intensity, and phonatory quality. Frequency (or pitch) refers to how high
or low our voice is. It is controlled by the physical characteristics of our vocal folds. Vocal folds
that are longer and thicker produce lower sounds, whereas those with greater tension produce
higher sounds. Intensity describes how loudly or softly we normally speak and can be reported in
terms of decibels (dB). We produce more intense or louder speech by forcing more air over the
vocal folds as they increase in their resistance. When the folds open suddenly and widely, they
produce a louder sound. As we all know, we can control our loudness, but it is also true that every
person has a base-line loudness level. This is what you typically hear during normal conversation.
The third determinant of voice, phonatory quality, is a little more difficult to explain; but we know
it varies a lot between people, and we usually can easily describe it. Typically, this voice
characteristic is described as mellow, velvety, rich, harmonious whispery, harsh, and so on
(Justice, 2006).

Voice disorders occur when a person’s, pitch, loudness, or phonatory quality differs
significantly from others with the same gender, age, ethnicity, and cultural background. In other
words, when compared to one’s peers, the person with a voice disorder will have an unusually
high or low-pitched voice, one that is too soft or too loud, or one that has unusual phonatory
qualities. In order to be considered a “disorder,” the condition of the voice has to be different
enough to draw attention to the person or to adversely affect performance in school, at home, or in
the community.

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 Voice experts use a variety of terms to describe a person’s voice, but the most commonly
used are harsh or strained voice, a breathy voice, and a hoarse voice (Dalston & Marquardt, 2010).
A harsh voice sounds like the voice of a person who is very angry but is trying to control his
temper. The person may appear to be making a great deal of effort to speak, and her neck and jaw
might appear tense. A breathy voice sounds like a partial whisper or a confidential voice. It is
caused by an excessive amount of air escaping through the vocal folds, which are separated too
much to vibrate appropriately. A hoarse voice is a combination of harshness and breathiness and
is caused when the vocal folds have an irregular vibration. The irregular vibration is caused when
the two folds have a different mass (Dalston 8: Marquardt, 2010; Justice, 2006).

Voice disorders can result from several reasons, including vocal abuse, neurological or
psychological conditions, or the surgical removal of the larynx. Among the children and
adolescents you are likely to encounter as a teacher, the most common Voice problem will be due
to vocal abuse.

COMMON MISUSES OF AND ABUSES OF THE VOICE

Yelling and Screaming Alcohol Use
Hard glottal attack Speaking During Menstrual Cycle
Abusive Singing Excessive Speaking
Hydration Concerns Inadequate Breath Support
Speaking Over Noise Laughing Hard
Coughing/ Throat Clearing Aspirin (Drugs)
Grunting in Exercise Cheerleading, Aerobics Instruction, Pep Clubs
Calling at a Distance Making Toy/ Animal Noises
Inappropriate Pitch Athletic Activity
Excessive Talking with Allergy or Upper Intense Personality
Respiratory Infection
Muscular Tension Arguing
Smoking Factor
Source: From Clinical Management of Voice Disoders (4th Ed.), by G.L. Case, 2002, Austin, TX:
Prof-Ed. Copyright 2002 by Prof-Ed. Adapted by the authors with permission

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 Vocal abuse leads to the development of vocal nodules. Nodules are small tissue
formations on the vocal folds that are somewhat like calluses. They often develop because of
misuse of the voice such as screaming or loud talking (Dalston & Marquardt, 2010). Justice (2006)
notes, however, that nodules can also develop, because of physiological problems like
gastroesophageal reflux, low blood circulation, dehydration, and laryngeal tension.

Motor Speech Disorders

All of our day-to-day actions require us to use our muscles so we can move or act as we
desire. When we make these movements, we are exercising our motor skills. Mo tor skills and
specific movements originate within the neurological system, including our central and peripheral
nervous systems. Even though we do not consciously realize it, to make even a relatively simple
movement such as flicking a finger or kicking a ball, we must first go through a neurologically
based programming and planning process (sort of like “get ready . . . set”) and then execute the
movement (“go!”).

The activities involved in speaking, which we have described as the building blocks of
speech, are the most complex motor movements that a person undertakes, requiring well-
coordinated movements of very small muscles in order to produce speech sounds. Because these
movement have a neurological origin, when neurological insult or trauma occurs, one or more of
the building blocks of speech may be adversely affected (Maas & Robin, 2006).

Manifestation of Speech Disorders

Speech disorders, especially phonological/articulation disorders and fluency disor« ders,

usually originate during the early years of life. Sometimes they disappear, and sometimes they
continue. Stuttering is a good example. As we have said, the cause of stuttering is not known. What
is known, however, is that at some point in their lives, usually during the early childhood years,
many individuals will stutter, perhaps as much as 5% of the population. In about 80% of these
cases, the stuttering disappears, either as a result of normal development or because of therapeutic
intervention. This leaves about 1% of the population who will stutter at any given time.

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 In terms of relative frequency most children who have speech disorders have phonological
or articulation disorders. During the school years, these students comprise the largest proportion
of the SLP’s case load.

The occurrence of both speech and language disorders tends to be higher among students
with other disabilities. A defining characteristic of children with autism is their weak
communication skills. Individuals with intellectual disabilities also have a relatively high
incidence of language and speech disorders, with the number of cases of communication disorders
directly related to the severity of the intellectual disabilities. Speech and/or language disabilities
also occur with higher than-average frequency among individuals with other disabilities, including
learning disabilities, emotional/behavioral disabilities, traumatic brain injury, and physical
disabilities.

COMMUNILATION DIFFERENCES VERSUS COMMUNICATION DISORDERS

Before we continue with other issues in this chapter, it is critical that you understand that
not all people who communicate differently from you are exhibiting communication disorders. In
many cases you may be seeing a communication difference rather than a communication disorder.
What’s the difference?

Our Speech and language characteristics are very much products of our culture, and our
culture reflects our communication characteristics. This is extremely important to note in a society
as diverse as the United States. For example, verbal communication generally differs among
people who have grown up in the mountains of western North Carolina, people from Baltimore,
and people who are natives of Houston. In different regions of our country, vocabulary differs,
idioms vary, and speech is often distinguishable by dialects. Southern White people often sound
different from northern White people, who often sound different from African American people,
who often sound different from Hispanic people, and so on and so on. In the most extreme cases
of communication differences, people have little or no knowledge or experience with the
predominant language, which greatly impairs their ability to communicate effectively.

(We can also give different words from different Filipino dialects and compare their
meaning  )

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 Do such people have a communication disorder? Most often the answer is no. Usually, it
is more correct to say that they have a different form of communication. This is not a small matter.
Many children have been inappropriately placed in Special education programs because of their
language differences. It is critical, therefore, that we recognize that not all uncommon
communication patterns are communication disorders.

To establish that a student has a communication disorder as opposed to a communication

difference, the student must have a discrepancy between her verbal communication and the
communication of others who have the same culture, language, and dialect. To differentiate
communication differenced and communication disorders Justice (2006) notes that the latter is
present only when the person’s communication ability is

 Outside the norms of the person’s language or cultural group

 Considered by members of that group to be disordered
 Interferes with communication within the language or cultural group.

Reference:

Rosenberg, M., Westling, D., & McLesley, J. (2011) Special Education for Today’s Teachers (An
Introduction).USA. Pearson Education Inc.

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