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Communication Skills and Disorders



The skills needed to use language (spoken, written, signed, or otherwise communicated) to interact with others, and problems related to the development of these skills.

Language employs symbols—words, gestures, or spoken sounds—to represent objects and ideas. Communication of language begins with spoken sounds combined with gestures, relying on two different types of skills. Children first acquire the skills to receive communications, that is, listening to and understanding what they hear (supported by accompanying gestures). Next, they will begin experimenting with expressing themselves through speaking and gesturing. Speaking will begin as repetitive syllables, followed by words, phrases, and sentences. Later, children will acquire the skills of reading and writing, the written forms of communication. Although milestones are discussed for the development of these skills of communication, many children begin speaking significantly earlier or later than the milestone date. Parents should refrain from attaching too much significance to either deviation from the average. When a child's deviation from the average milestones of development cause the parents concern, they may contact a pediatrician or other professional for advice.



Spoken language problems are referred to by a number of labels, including language delay, language disability, or a specific type of language disability. In general, experts distinguish between those people who seem to be slow in developing spoken language (language delay) and those who seem to have difficulty achieving a milestone of spoken language (language disorders). Language disorders include stuttering; articulation disorders, such as substituting one sound for another (tandy for candy), omitting a sound (canny for candy), or distorting a sound (shlip for sip); and voice disorders, such as inappropriate pitch, volume, or quality. Causes can be related to hearing,

COMMUNICATION MILESTONE
Age Milestone
0–12 months
  • Responds to speech by looking at the speaker; responds differently to aspects of speakers voice (such as friendly or angry, male or female).
  • Turns head in direction of sound.•
  • Responds with gestures to greetings such as "hi," "bye-bye," and "up" when these words are accompanied by appropriate gestures by speaker.
  • Stops ongoing activity when told "no," when speaker uses appropriate gesture and tone.
  • May say two or three words by around 12 months of age, although probably not clearly.•
  • Repeats some vowel and consonant sounds (babbles) when alone or spoken to; attempts to imitate sounds.
12–24 months
  • Responds correctly when asked "where?"
  • Understands prepositions on, in, and under; and understands simple phrases (such as "Get the ball.")
  • Says 8–10 words by around age 18 months; by age two, vocabulary will include 20–50 words, mostly describing people, common objects, and events (such as "more" and "all gone").
  • Uses single word plus a gesture to ask for objects.
  • Refers to self by name; uses "my" or "mine."
24–36 months
  • Points to pictures of common objects when they are named.
  • Can identify objects when told their use.
  • Understands questions with "what" and "where" and negatives "no." "not," "can't," and don't."•
  • Responds to simple directions.
  • Selects and looks at picture books; enjoys listening to simple stories, and asks for them to be read aloud again.
  • Joins two vocabulary words together to make a phrase.
  • Can say first and last name.
  • Shows frustration at not being understood.
36–48 months
  • Begins to understand time concepts, such as "today," "later," "tomorrow," and "yesterday."
  • Understands comparisons, such as "big" and "bigger."•
  • Forms sentences with three or more words.
  • Speech is understandable to most strangers, but some sound errors may persists (such as "t" sound for "k" sound).
48–60 months
  • By 48 months, has a vocabulary of over 200 words.
  • Follows two or three unrelated commands in proper order.
  • Understands sequencing of events, for example, "First we have to go to the grocery store, and then we can go to the playground."
  • Ask questions using "when," "how," and why." Talks about causes for things using "because."

nerve/muscle disorders, head injury, viral diseases, mental retardation, drug abuse, or cleft lip or palate.

Further Reading

Bates, Elizabeth, and Jeffrey Elman. "Learning Rediscovered." Science 274, (December 13, 1996): 1849+.

Berko-Gleason, J. The Development of Language. New York: Macmillan, 1993.

Cowley, Geoffrey. "The Language Explosion." Newsweek 129, (Spring-Summer 1997): 16+.

Goodluck, H. Language Acquisition: A Linguistic Introduction. Cambridge, MA: Blackwell Publishers, 1991.

Pinker, S. The Language Instinct. New York: Morrow, 1994.

Further Information

American Speech-Language-Hearing Association. 1801 Rockville Pike, Rockville, MD 20852, voice or TTY (301)897–8682, voice or TTY (800) 638–8255. Email: ircasha.org. www.asha.org. (Publishes brochures, booklets, and fact sheets on speech-language pathology.)

National Institute on Deafness and Other Communication Disorders. National Institutes of Health, Bethesda, MD 20892. Email: webmaster@ms.nih.gov. www.nih.gov/nidcd/.

Additional topics

Psychology EncyclopediaDiseases, Disorders & Mental Conditions