[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Behavioral science](https://durgical.com/en/behavioral-science/) › [Other mental disorders](https://durgical.com/en/behavioral-science/areas/disorders/) › Communication disorders: language, speech sound, stuttering and social communication

# Communication disorders: language, speech sound, stuttering and social communication

- Disorder

Problems understanding or using words, making speech sounds, speaking smoothly, or using language socially. Hearing is always checked first.

Updated Nov 13, 2026

## Key points

- Any child with delayed or unclear speech needs a hearing assessment, because hearing loss, for example from otitis media, can interfere with language development.
- Language disorder is a problem with words, grammar and discourse (understanding, expressing or both); speech sound disorder is a problem with producing sounds clearly.
- Stuttering usually starts between ages 2 and 6, is two to three times more common in boys, and about three in four children recover.
- Social (pragmatic) communication disorder: trouble using language socially without restricted, repetitive behaviors; if those behaviors are present, think autism.
- Not saying at least 2 words by the first birthday needs evaluation, and a loss of language skills may call for an evaluation for autism.
- Learning more than one language does not cause developmental language disorder, which affects every language a child speaks.

## What it is

DSM-5 groups four neurodevelopmental communication disorders: language disorder, speech sound disorder, childhood-onset fluency disorder (stuttering) and social (pragmatic) communication disorder. Together, communication disorders affect about 8 in 100 children and start in early childhood. Language disorder can also affect reading and writing, and identifying and treating it early is ideal.

## Key facts

- Developmental language disorder affects about 1 in 14 kindergarten children, is not explained by hearing loss or autism, and often follows a history of late talking.
- Stuttering shows as repeated sounds, syllables or words, stretched sounds and blocks; rapid eye blinks or lip tremors can accompany it.
- Singing, reading or speaking in unison can briefly reduce stuttering, while speaking before a group or on the telephone can make it worse.
- Factors used to predict whether stuttering will persist include a family history, stuttering for 6 months or more, and other speech or language problems.
- Structural causes such as cleft palate produce a nasal voice and usually need surgery as well as speech therapy.

## Telling the communication problems apart

| Condition | Core problem | Distinguishing clue |
| --- | --- | --- |
| [Hearing loss](https://durgical.com/en/conditions/hearing-loss/) | Child cannot hear speech well enough to learn it | Abnormal hearing test; may follow otitis media |
| Language disorder | Vocabulary, sentence building and understanding are behind age | Not explained by hearing loss or autism |
| Speech sound disorder | Sounds are left out, swapped or distorted | Language content is normal; only intelligibility suffers |
| [Structural speech problem (cleft palate)](https://durgical.com/en/conditions/cleft-lip-and-palate/) | Hypernasal voice | Cleft palate or another structural problem; needs surgery plus therapy |
| Childhood-onset fluency disorder (stuttering) | Repetitions, prolongations and blocks | Knows what to say but the flow breaks; anxiety about speaking |
| Social (pragmatic) communication disorder | Trouble with greetings, turn-taking, adapting to the listener and non-literal meaning | No restricted interests or repetitive behaviors |
| [Autism spectrum disorder](https://durgical.com/en/conditions/autism-spectrum-disorder/) | Social communication deficits | Restricted, repetitive behaviors and interests are also present |

## Clinical notes

- Refer to a speech-language pathologist when a language problem is suspected and check hearing; identifying and treating children early is ideal.
- For young children who stutter, therapy often teaches parents ways to support their child's fluent speech.
- Older children and adults learn techniques such as speaking more slowly and regulating breathing, and therapy also addresses anxiety about speaking.
- No medicine is approved for stuttering; parents can help by speaking in a slightly slowed, relaxed way and by not finishing the child's sentences.
- Watch children with language disorder for reading and writing difficulties, which it can also cause, and support them at school.

## Memory aid

Hear first, then sort by question: What is said (language), How it sounds (speech sound), How it flows (fluency), What it is for (social use).

## Test yourself

Think of the answer, then tap the question to see it.

## What must be tested in every child with a speech or language delay?

Hearing, because hearing loss, for example from otitis media, can interfere with language development.

## How does social (pragmatic) communication disorder differ from autism?

Both involve trouble using language socially, but social communication disorder lacks the restricted, repetitive behaviors and interests required for autism.

## At what age does developmental stuttering usually begin, and how often does it resolve?

Usually between ages 2 and 6; about three in four children recover.

## Which features raise the risk that stuttering will persist?

A family history of stuttering, stuttering that lasts 6 months or more, and other speech or language problems.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/behavioral-science/communication-disorders-language-speech-sound-stuttering-and-social-communicatio/)

## Elsewhere in DurgiPedia

- [Hearing loss in children and language development](https://durgical.com/en/ent/hearing-loss-in-children-and-language-development/)
- [Newborn hearing screening in Colombia](https://durgical.com/en/ent/newborn-hearing-screening-in-colombia/)
- [The cerebral cortex and language](https://durgical.com/en/physiology/the-cerebral-cortex-and-language/)
- [Pediatric history: perinatal, growth, development and vaccines](https://durgical.com/en/clinical-exam/pediatric-history-perinatal-growth-development-and-vaccines/)

## Connections

## Related 5

- [Language development and speech red flags](https://durgical.com/en/behavioral-science/language-development-and-speech-red-flags/)
- [Selective mutism](https://durgical.com/en/behavioral-science/selective-mutism/)
- [Specific learning disorder (dyslexia, dyscalculia)](https://durgical.com/en/behavioral-science/specific-learning-disorder/)
- [Intellectual disability](https://durgical.com/en/behavioral-science/intellectual-disability/)
- [Assessing children and adolescents in mental health](https://durgical.com/en/behavioral-science/assessing-children-and-adolescents-in-mental-health/)

## Related conditions 4

- [Autism spectrum disorder (ASD)](https://durgical.com/en/conditions/autism-spectrum-disorder/)
- [Hearing loss (conductive and sensorineural, including sudden hearing loss)](https://durgical.com/en/conditions/hearing-loss/)
- [Cleft lip and palate](https://durgical.com/en/conditions/cleft-lip-and-palate/)
- [Attention-deficit/hyperactivity disorder (ADHD)](https://durgical.com/en/conditions/attention-deficit-hyperactivity-disorder/)

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Educational content on behavior and the clinical relationship; not a diagnostic or treatment guide and no substitute for assessment by a health professional. If you or someone near you is at risk, seek help now from an emergency service or a mental-health helpline.

Sources: [Communication Disorders in Children](https://www.msdmanuals.com/professional/pediatrics/miscellaneous-ear-nose-and-throat-disorders-in-children/communication-disorders-in-children) (MSD Manual Professional Edition, 2025); [What Is Stuttering? Diagnosis & Treatment](https://www.nidcd.nih.gov/health/stuttering) (National Institute on Deafness and Other Communication Disorders (NIDCD), 2017); [Developmental Language Disorder](https://www.nidcd.nih.gov/health/developmental-language-disorder) (National Institute on Deafness and Other Communication Disorders (NIDCD), 2023); [Social (pragmatic) communication disorder: a research review of this new DSM-5 diagnostic category](https://pmc.ncbi.nlm.nih.gov/articles/PMC4258293/) (Journal of Neurodevelopmental Disorders (PubMed Central), 2014).

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Source: https://durgical.com/en/behavioral-science/communication-disorders-language-speech-sound-stuttering-and-social-communicatio/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/behavioral-science/communication-disorders-language-speech-sound-stuttering-and-social-communicatio/