The following disorders may be diagnosed under the DSM-5 category of “communication disorders.”

Language Disorder

Language abilities are substantially below those expected for the child’s age, resulting in limited communication, social participation, academic achievement, and/or occupational performance. The child has persistent difficulties in learning and using language due to shortcomings in comprehension or speaking, including:

• Reduced vocabulary
• Limited sentence structure
• Impairments in discourse or ability to have a conversation

Language difficulties become evident during early childhood and are not due to hearing or other sensory impairment, motor dysfunction, or another medical or neurological condition.  In addition, the diagnosis of language disorder is given when the problem cannot be better explained by intellectual disability or global developmental delay.

Speech Sound Disorder

A diagnosis of “speech sound disorder” is given when a child has persistent difficulty with speaking that interferes with speech intelligibility or prevents verbal communication. The problem limits the child’s effectiveness in any of the following areas: social participation, academic achievement, or occupational performance. Symptoms begin in early childhood and the speech 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.

Stuttering / Childhood-Onset Fluency Disorder

A diagnosis of stuttering, clinically referred to as “childhood-onset fluency disorder,” is given when a child has disturbances in the normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills. The problem begins in early childhood and persists over time and is characterized by one or more of the following:

• Sounds and syllable repetitions
• Sound prolongations of consonants as well as vowels.
• Broken words (e.g., pauses within a word)
• Audible or silent blocking (filled or unfilled pauses in speech)
• Circumlocutions (word substitutions to avoid problematic words
• Words spoken with an excess of physical tension
• Monosyllable whole-word repetitions (e.g., “I-I-I-I see her.”)

The problem causes anxiety about speaking or limitations in any of the following areas: effective communication, social participation, academic or occupational performance. The diagnosis of stuttering is given when the difficulty speaking is not attributable to a speech-motor or sensory deficit, dysfluency associated with neurological injury (e.g., stroke, tumor, trauma) or another medical condition, and is not better explained by another mental disorder.

Social Communication Disorder

A diagnosis of “social communication disorder” is given when a child has persistent difficulties in verbal and nonverbal communication as shown by all of the following:

• Lacks social communication behaviors, such as greeting and sharing information, in a manner that is appropriate for the social context.
• Lacks ability to change communication to match the context or needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, and avoiding use of overly formal language.
• Has difficulty 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 social interaction.
• Has difficulty understanding what is not explicitly stated or ambiguous meanings of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).

For a diagnosis of social communication disorder, the symptoms cannot be attributable to another medical or neurological condition or to lacking abilities in word structure and grammar. Also, the behavior cannot be better explained by autism spectrum disorder, intellectual disability, global developmental delay, or another mental disorder.

Unspecified Communication Disorder

A diagnosis of “unspecified communication disorder” is given to patients with symptoms characteristic of a communication disorder that cause significant distress or impairment in social, occupations, or other important areas of functioning. However, the symptoms do not meet the full criteria for a communication disorder diagnosis or for any other neurodevelopmental disorder.