Communication Disorders

Communication disorders are grouped as the following five diagnoses under the DSM:

  • Language Disorder
  • Speech Sound Disorder (previously Phonological Disorder)
  • Childhood-Onset Fluency Disorder (Stuttering)
  • Social (Pragmatic) Communication Disorder
  • Unspecified Communication Disorder
Criterion A

Persistent difficulties in the acquisition and use of language across modalities (i.e., spoken, written, sign language, or other) due to deficits in comprehension or production that include the following:

  1. Reduced vocabulary (word knowledge and use)
  2. Limited sentence structure (ability to put words and word endings together to form sentences based on the rules of grammar and morphology)
  3. Impairments in discourse (ability to use vocabulary and connect sentences to explain or describe a topic or series of events or have a conversation).
Criterion B

Language abilities are substantially and quantifiably below those expected for age,resulting in functional limitations in effective communication, social participation, academic achievement, or occupational performance, individually or in any combination.

Criterion C

Onset of symptoms is in the early developmental period.

Criterion D

The difficulties are not attributable to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition and are not better explained by intellectual disability or global developmental delay.

Criterion A

Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.

Criterion B

The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in any combination.

Criterion C

Onset of symptoms is in the early developmental period.

Criterion D

The difficulties are not attributable to congenital or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medical or neurological conditions.

Criterion A

Disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills, persist over time, and are characterized by frequent and marked occurrences of 1 (or more) of the following:

  1. Sound and syllable repetitions
  2. Sound prolongations of consonants as well as vowels
  3. Broken words (e.g., pauses within a word)
  4. Audible or silent blocking (filled or unfilled pauses in speech)
  5. Circumlocutions (word substitutions to avoid problematic words)
  6. Words produced with an excess of physical tension
  7. Monosyllabic whole-word repetitions (e.g., “He-he-he-he is over there”)
Criterion B

The disturbance causes anxiety about speaking or limitations ineffective communication, social participation, or academic or occupational performance, individually or in any combination.

Criterion C

The onset of symptoms is in the early developmental period. (Adults are diagnosed as adult-onset fluency disorder.)

Criterion D

The disturbance is not attributable to a speech-motor or sensory deficit, disfluency associated with neurological insult (e.g., stroke, tumour, trauma), or another medical condition and is not better explained by another mental disorder.

Criterion A

Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all 3 of the following:

  1. Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context.
  2. Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talk ing differently to a child than to an adult, and avoiding use of overly formal language.
  3. Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction.
  4. Difficulties understanding wliat is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).
Criterion B

The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination.

Criterion C

The onset of the symptoms is in the early developmental period (but deficits may not become fully manifest until social communication demands exceed limited capacities).

Criterion D

The symptoms are not attributable to another medical or neurological condition or to low abilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability, global developmental delay, or another mental disorder.

This diagnosis applies to presentations in which symptoms characteristic of communication disorder that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for communication disorder or for any of the disorders in the neurodevelopmental disorders diagnostic class. The unspecified communication disorder category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for communication disorder or for a specific neurodevelopmental disorder, and includes presentations in which there is insufficient information to make a more specific diagnosis.