Cognitive Communication Disorders

Cognitive-communication disorders are those in which a person has difficulty communicating because of injury to the brain that controls the ability to think. When a child (or adult) has a cognitive-communication disorder, he or she may struggle with memory, organization and problem solving that can make it difficult to properly speak, listen, read, write or interact in social situations.

What causes cognitive-communication disorders?

The cause of a cognitive-communication disorder may be related to biological problems such as abnormalities of brain development or possibly by exposure to toxins during pregnancy, like drugs, alcohol or lead. A genetic factor is sometimes considered a contributing cause in some cases. Other causes can include a traumatic brain injury, stroke and certain neurological conditions.

What are the symptoms of cognitive-communication disorders?

There are many different symptoms when it comes to cognitive-communication disorders and because every child is different, each child may experience symptoms differently.

• Difficulty keeping normal sleep and wake cycles.
• A decline in previously established play and language skills.
• Struggles to pay attention, especially in a distracting environment.
• Memory problems or appear to be forgetful.
• Difficulty to remember information the child has previously learned or memorized, like birthdate, address or parent’s phone number.
• Difficulty organizing themselves at school or to complete a project at home.
• Quick shifts or overall changes in personality.

The symptoms of cognitive-communication disorders may resemble other problems or medical conditions or may even be chalked up by family members as a quirk or typical toddler (or childhood) behavior. It is important to speak with the child’s doctor if there are any concerns about a child’s cognitive, speech or language development, especially if the child experiences a decline in their cognitive and communications skills. Specific cognitive-communication disorders can include:

• Memory problems.
• Learning disorders.
• Attention problems.
• Problems with executive functioning. (Executive functioning is the processes that helps people connect their past experiences with their present action. This process is used for planning, organizing, remembering details and managing time and space.)

Developmental Speech and Language Disorders can also be a result of an injury to the brain or problems with brain development including:

• Articulation disorders occur when a child has difficulties pronouncing certain consonants or vowels correctly (such as the letters “s” and “r”). Children with these disorders leave out, replace or distort the sounds of vowels or consonants that they have difficulty pronouncing. A common type of articulation disorder is a lisp. In many cases, the cause for articulation disorders is unknown and are often not a cause for concern. These disorders are common in young children and most are able to pronounce words correctly by the age of five. Caregivers who note an articulation disorder in a child older than age five should speak with the child’s doctor.
• Sometimes articulation disorders are caused by brain damage or brain disorders. They may also be caused by physical handicaps, such as a cleft palate, hearing loss, or cerebral palsy. In other cases, the condition may be caused by poor coordination of muscles in the mouth or dental problems.
• Fluency disorders, also called rhythm disorders, occur when an individual speaks in an uneven rhythm. Naturally flowing speech moves at an appropriate rate with an easy rhythm and smoothness that is both effortless and automatic and appropriate for the child’s age. Children with fluency disorders may repeat or add words or sounds when talking. They may also pause in the middle of phrases or frequently correct their pronunciation while talking. They may also say certain words longer than normal. The most well-known fluency disorder is stuttering, which is characterized by the repetition or prolonged pronunciation of words or sounds. Learn more about stuttering.
• Vocal disorders occur when there are problems with the quality, pitch, and/or volume of a child’s voice. Vocal disorders can have many different causes ranging from overuse and strain to reflux to brain injury. Learn more about voice disorders.
• Language delay is when a child develops language skills behind schedule. Learn more about the language development milestones.

How are cognitive-communication disorders diagnosed?

Most children with communication disorders are first referred for speech and language evaluations when their delays in communicating are noted. A child psychiatrist is usually consulted, especially when emotional or behavioral problems are also present. A comprehensive evaluation also involves psychometric testing (testing designed to measure logical reasoning abilities, reactions to different situations, and thinking performance; not tests of general knowledge) and psychological testing of cognitive abilities. Depending upon the child’s symptoms, a diagnostic imaging test, like an MRI or CT scan may be ordered.

How are communication disorders treated?

Specific treatment for communication disorders will be determined by the child’s doctor, special education teachers and speech and language and mental health professionals based on:

• The child’s age, overall health and medical history.
• Extent of the disorder.
• Type of disorder.
• Expectations for the course of the disorder.
• The family’s opinion or preference.

The child’s parents, teachers, speech and language pathologists and mental health professionals work together to create a treatment plan based on the child’s needs and test results. Therapists work the patient and family by:

• Finding exercises, tricks and techniques to improve the child’s memory and communication.
• Recommending changes that can be made at home and in the classroom that may help the child with his or her cognitive skills.
• Teaching an alternative form of communication, if necessary, like sign language, a picture communication board, simplified verbal speech or an electronic alternative communication device.
• Teaching memory recall skills like journaling, using a calendar system and other skills that may improve immediate, short term or long term memory.
• Teaching children who experience mood changes how to properly interact with friends and those around them, as well as how to deal with mood swings when they happen.