ERIC Identifier: ED321504
Publication Date: 1990-00-00
Source: ERIC Clearinghouse on Handicapped and Gifted Children
Children with Communication Disorders. ERIC Digest
#E470 (Revised #419).
The term COMMUNICATION DISORDERS encompasses a wide variety of problems
in language, speech, and hearing. Speech and language impairments include
articulation problems, voice disorders, fluency problems (such as stuttering),
aphasia (difficulty in using words, usually as a result of a brain injury),
and delays in speech and/or language. Speech and language delays may be
due to many factors, including environmental factors or hearing loss.
Hearing impairments include partial hearing and deafness. Deafness may
be defined as a loss sufficient to make auditory communication difficult
or impossible without amplification. There are four types of hearing loss.
Conductive hearing losses are caused by diseases or obstructions in the
outer or middle ear and can usually be helped with a hearing aid. Sensorineural
losses result from damage to the sensory hair cells of the inner ear or
the nerves that supply it and may not respond to the use of a hearing aid.
Mixed hearing losses are those in which the problem occurs both in the
outer or middle ear and in the inner ear. A central hearing loss results
from damage to the nerves or brain.
Many communication disorders result from other conditions such as learning
disabilities, cerebral palsy, mental retardation, or cleft lip or cleft
HOW MANY CHILDREN HAVE COMMUNICATION DISORDERS?
The overall estimate for speech and language disorders is widely agreed
to be 5% of school-aged children. This figure includes voice disorders
(3%) and stuttering (1%). The incidence of elementary school children who
exhibit delayed phonological (articulation) development is 2% to 3%, although
the percentage decreases steadily with age.
Estimates of hearing impairments vary considerably, with one widely
accepted figure of 5% representing the portion of school-aged children
with hearing levels outside the normal range. Of this number, 10% to 20%
require some type of special education. Approximately one-third of students
who are deaf attend residential schools. Two-thirds attend day programs
in schools for students who are deaf or day classes located in regular
schools. The remainder are mainstreamed into regular school programs.
WHAT ARE SOME CHARACTERISTICS OF CHILDREN WITH COMMUNICATION DISORDERS?
A child with speech or language delays may present a variety of characteristics
including the inability to follow directions, slow and incomprehensible
speech, and pronounced difficulties in syntax and articulation. SYNTAX
refers to the order of words in a sentence, and ARTICULATION refers to
the manner in which sounds are formed. Articulation disorders are characterized
by the substitution of one sound for another or the omission or distortion
of certain sounds.
Stuttering or dysfluency is a disorder of speech flow that most often
appears between the ages of 3 and 4 years and may progress from a sporadic
to a chronic problem. Stuttering may spontaneously disappear by early adolescence,
but speech and language therapy should be considered.
Typical voice disorders include hoarseness, breathiness, or sudden breaks
in loudness or pitch. Voice disorders are frequently combined with other
speech problems to form a complex communication disorder.
A child with a possible hearing problem may appear to strain to hear,
ask to have questions repeated before giving the right answer, demonstrate
speech inaccuracies (especially dropping the beginnings and endings of
words), or exhibit confusion during discussion. Detection and diagnosis
of hearing impairment have become very sophisticated. It is possible to
detect the presence of hearing loss and evaluate its severity in a newborn
Students who speak dialects different from standard English may have
communication problems that represent either language differences or, in
more severe instances, language disorders.
WHAT ARE THE EDUCATIONAL IMPLICATIONS OF COMMUNICATION DISORDERS?
Many speech problems are developmental rather than physiological, and
as such they respond to remedial instruction. Language experiences are
central to a young child's development. In the past, children with communication
disorders were routinely removed from the regular class for individual
speech and language therapy. This is still the case in severe instances,
but the trend is toward keeping the child in the mainstream as much as
possible. In order to accomplish this goal, teamwork among the teacher,
speech and language therapist, audiologist, and parents is essential. Speech
improvement and correction are blended into the regular classroom curriculum
and the child's natural environment.
Amplification may be extremely valuable for the child with a hearing
impairment. Students whose hearing is not completely restored by hearing
aids or other means of amplification have unique communication needs. Children
who are deaf are not automatically exposed to the enormous amounts of language
stimulation experienced by hearing children in their early years. For deaf
children, early, consistent, and conscious use of visible communication
modes such as sign language, finger spelling, and cued speech and/or amplification
and aural/oral training can help reduce this language delay. Some educators
advocate a strict oral approach in which the child is required to use as
much speech as possible, while others favor the use of sign language and
finger spelling combined with speech, an approach known as TOTAL COMMUNICATION.
There is increasing consensus that whatever system works best for the individual
should be used.
Many children with hearing impairments can be served in the regular
classroom with support services. In addition to amplification, instructional
aids such as captioned films and high interest/low vocabulary reading materials
are helpful. For most children with hearing impairments, language acquisition
and development are significantly delayed, sometimes leading to an erroneously
low estimate of intelligence.
Students whose physical problems are so severe that they interfere with
or completely inhibit communication can frequently take advantage of technological
advances that allow the individual to make his or her needs and wants known,
perhaps for the first time.
Adams, J. W. (1988). You and Your Hearing-Impaired Child: A Self-Instructional
Guide for Parents. Washington, DC: Gallaudet University Press.
Freeman, R. D., Carbin, C. F., & Boese, R. J. (1981). Can't Your
Child Hear? A Guide for Those Who Care about Deaf Children. Baltimore:
University Park Press.
Grant, J. (1987). The Hearing Impaired: Birth to Six. Boston: Little,
Hixon, T. J., Shribers, L. D., & Saxman, J. H. (Eds.). (1980). Introduction
to Communication Disorders. Englewood Cliffs, NJ: Prentice-Hall.
King, R. R. & Sommers, R. K. (1986). Talking Tots: Normal and Impaired
Communication Development of Preschool Children. Danville, IL: Interstate
Printers and Publishers.
Luterman, D. (1987). Deafness in the Family. Boston: Little, Brown.
Miller, A. L. (1980). Hearing Loss, Hearing Aids, and Your Child. Springfield,
IL: Charles C Thomas.
Moores, D. F. (1987). Educating the Deaf: Psychology, Principles, and
Practices (3rd ed.). Boston: Houghton Mifflin.
National Information Center on Deafness, & National Association
of the Deaf. (1987). Deafness: A Fact Sheet. Washington, DC: Author.
Ogden, P., & Lipsett, A. (1982). The Silent Garden: Understanding
the Hearing Impaired Child. New York: St. Martin's.
Oyer, H. J., Crowe, B., & Haas, W. H. (1987). Speech, Language,
and Hearing Disorders: A Guide for the Teacher. Boston: Little, Brown.
Schwartz, S. (Ed.). (1987). Choices in Deafness: A Parent;s Guide. Rockville,
MD: Woodbine House.
Van Hattum, R. J. (Ed.). (1980). Communication Disorders. AN Introduction.
New York: Macmillan.
American Speech/Language and Hearing Association
10801 Rockville Pike, Rockville, MD 20852
National Association of the Deaf
814 Thayer Avenue, Silver Spring, MD 20910
National Information Center on Deafness
Gallaudet University, Washington, DC 20002
Alexander Graham Bell Association for the Deaf, Inc.
3417 Volta Place, NW, Washington, DC 20007
Division for Children with Communication Disorders
The Council for Exceptional Children
1920 Association Drive, Reston, VA 22091 -----
TRACE Research and Development Center
314 Waisman Center
1500 Highland Avenue, Madison, WI 53706