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Understanding Communication Disorders

"What does my baby want?"

"My six-month-old is crying and wriggling a lot. I don't understand what he is feeling and needing!!

"My 2-year-old isn't using words yet. He only babbles. What is he trying to say?"

"My 4-year-old doesn't speak clearly and is not using full sentences yet. Is something wrong?"

"My 10-year-old doesn't use language as well as his classmates. His teacher is failing him in Language Arts. Is he being lazy, or does he have a problem?

Communication consists of speech, oral language, writing, and actions such as behaviors. Infants are not born knowing how to communicate, which is as frustrating to them as it is to you. But over the months, you both begin to understand how to communicate with each other.


First, you learn what different sounds mean and the pitches and intensity of crying.

Over the first six months, your infant realizes that the sounds you make have meaning, so he tries to imitate them. He also notices that your facial movements have meaning, such as smiling, sticking your tongue out, and blowing bubbles.

By one year of age, you should notice your child using specific sounds to label you, foods your child likes, any pets you have, and favorite toys. This is the beginning shift from overall communication to the use of speech and language to communicate. Your child frequently points at objects or things he wants and waves bye-bye.

By 18 months of age, your child should be using more of a combination of pointing and sounds that have language meaning. If your child does not appear to learn more words (understanding) or prefers to use gestures rather than words, your child is showing language delays.

You will often bring this up to your child's doctor but get the reassurance that some children develop slower in language because they are more interested in hands-on activities. Or your physician will tell you that older siblings are speaking for him, so he doesn't need to talk. Request a speech therapy referral to address these misconceptions. The longer a child lags behind his peers, the higher the rate of social, behavioral, and academic problems.

If you have problems getting your child's doctor to make a speech/language evaluation, you can contact your state's Early Intervention Program for ages 0-3 years. They also provide other services for children from birth up to age 3, such as physical or occupational therapy. The Centers for Disease Control and Prevention (CDC) has a page with links for each state's early intervention services. If your child needs services after age 3, your local school district will be where you start.

In addition to speech word problems, your child may have issues with pronunciation or fluency. Pronunciation is also called articulation. Most children have problems with pronunciation as they are learning to speak. But by eight years of age, most of these dysfluencies should have been resolved. Children with articulation problems are frequently labeled as having a phonologic disorder. Having a phonological disorder increases their risk of being diagnosed with dyslexia in school since the reading and writing of words require the ability to match the correct sounds to the correct letter or letter groups (words).

A second speech disorder is due to problems with the coordination of oral motor actions with speech sounds. Speech therapists frequently diagnose this developmental verbal apraxia disorder. Your child may sound like he is gargling when speaking. He is challenging to understand, with no muscle or nerve problems found to explain it. Your child will need speech/language assistance as soon as possible. Most times, this doesn't start till two years of age due to many physicians' misconceptions about speech and language development. Your child will not necessarily have any problems understanding words or language but responding in words or sentences.

The third speech sound disorder is stuttering, which is a problem with fluency or rhythm of speech. Your child will make errors that consist of repetitions of sounds and syllables, prolonged sounds of consonants and vowels, and the breaking up of words with pauses between the parts. About 2% of children will develop stuttering, with 65-85% growing out of it. Help from a speech pathologist offers the best chance of the child overcoming it. There have been many well-known people, including President Joe Biden, who have struggled with stuttering. Here is a list of some of them.


According to the dictionary, language is "how humans communicate using words in a structured and conventional way through speech, writing, or gesture." Humans are the only members of the animal species that have language to communicate, although many animals make sounds and gestures.

There are several layers to language:

  • Receptive – understanding what is being communicated
    • Vocabulary – single words
    • Phrase or sentence – series of words to convey more complex meaning
  • Expressive – Being able to communicate with others
    • Vocabulary – single words
    • Phrase or sentence – a series of words having more precise meaning than can be given with a single word

As a baby, your child at first has no words and knows no words. He must rely on your actions to understand what is happening. He watches your face and listens to your voice and other vocalizations, such as lullabies, attempting to connect them to how he feels with you. You watch his face and listen to his sounds, looking for common ground to communicate with him.

Over the first six months, you each get better at communicating with facial and sound gestures. Then your baby begins attempting to repeat the sounds you make to increase your ability to speak to each other. Your baby begins with vocabulary, so the meaning of words, such as "Ma" and "Da," as labels for mother and father. By a year of age, he may be accurately using these initial sounds and soon after will begin to use sounds to label other objects, such as his bottle, a blanket or favorite toy, or even a family pet.

Phrases or sentences come later, between 18 months and two years, as he understands more about the different purposes of words, such as "Me hungry" being different from "Big puppy."

Most children increase their receptive vocabulary first, then their expressive vocabulary (knowing what you mean for bye-bye or bedtime), followed by receptive sentences and then expressive sentences.


You likely don't think about the nonverbal ways your child communicates with you. You may mislabel some of his communication efforts as behavior problems. Examples may be whining, crying, yelling, or plopping down on the ground when he doesn't want to go any further. Your child has a reason for his behavior but may not have the words or feels that you are not listening and taking his words seriously, so he reverts to behavioral communication. Behavioral communication is essential to understand and will be the focus of another article. Basically, the more you understand how to get to the root of his behavior and any emotions fueling it, the better your relationship with your child will be.

What you definitely don't want to say is, "If you are going to cry, I will give you a reason to cry." Your child has a reason, and as his parent, teacher, and protector, you must find out why so that he can grow in his communication skills and ability to regulate his emotions and behavior.

If you are interested in an in-depth look at three factors of children and adolescents that can create positive or negative futures, check out my program, Developing a Calm Classroom.