NCLIP

Communication Disorders

3 min read

Communication Disorders

Key Points

  • Communication disorders are persistent difficulties in speech and/or language development that impair participation.
  • DSM-5 groups include language, speech sound, child-onset fluency, social communication, and unspecified communication disorders.
  • Early recognition and speech-language referral improve outcomes and reduce downstream social distress.
  • Nursing care emphasizes family-centered, culturally responsive collaboration with school and therapy teams.

Pathophysiology

communication-disorders arise from varied neurodevelopmental, sensory, neurologic, or psychosocial pathways. Children may struggle with expressive output, receptive understanding, articulation, fluency, or social-pragmatic use of language.

Risk factors include family history, developmental differences, hearing problems, brain injury, and coexisting conditions such as attention-deficit-hyperactivity-disorder or autism-spectrum-disorder.

Classification

  • Language disorder: Deficits in learning and using spoken, written, or signed language.
  • Speech sound/fluency disorders: Articulation or stuttering patterns that impair communication.
  • Social communication disorder: Impaired use of verbal/nonverbal communication in social contexts.

Nursing Assessment

NCLEX Focus

Compare current communication abilities with developmental expectations and functional impact.

  • Assess developmental milestones, family concerns, and onset pattern of communication changes.
  • Assess expressive and receptive language in home, school, and peer contexts.
  • Assess associated hearing, neurologic, behavioral, and emotional symptoms.
  • Assess social participation, bullying exposure, and self-esteem impact.
  • Assess family understanding of available services and school-based rights/supports.

Nursing Interventions

  • Encourage prompt referral to speech-language pathology for formal assessment.
  • Teach caregivers simple language-modeling and home-practice strategies.
  • Support school collaboration for IEP/504 accommodations and communication plans.
  • Use respectful, patient communication and include the child directly in care encounters.
  • Reinforce strengths-based approaches to reduce shame and withdrawal.

Stigma and Isolation

Unaddressed communication barriers can increase social anxiety, school avoidance, and behavioral dysregulation.

Pharmacology

There is no routine medication that treats communication disorders directly. Pharmacologic therapy may address comorbid anxiety, mood, or attention symptoms when present.

Nurses monitor communication function and psychosocial outcomes while coordinating nonpharmacologic therapy continuity.

Clinical Judgment Application

Clinical Scenario

A child with persistent stuttering avoids class discussion, has increasing peer conflict, and reports fear of speaking at school.

Recognize Cues: Ongoing fluency difficulty with escalating social impairment. Analyze Cues: Communication disorder is affecting emotional and academic function. Prioritize Hypotheses: Prioritize referral, school supports, and anxiety prevention. Generate Solutions: Coordinate speech-language services and school accommodations. Take Action: Begin family coaching and strengths-based communication plan. Evaluate Outcomes: Better classroom participation and reduced social distress.

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