Communication Disorder: Incapacitates the Ability

Shams Al Galib discusses the communication disorder and ability

Communication disorder is one kind of disorder that destroys the ability to share information. For communication disorder, a person loses the ability to hearing the sound, realizing, speaking, and so s/he faces an obstacle in verbal, non-verbal, and graphical communication. It is a disorder when you do not understand instruction properly and fail to express your feelings of the mind. In a developing country like Bangladesh, communication disorder is not a familiar disease; however, it is quite common in developed countries.

Definition of communication disorder

As a human being, persons express their feelings, emotion, need, wish, desire through communication. But there are a lot of persons in every society who have the disorder in communicating ability. Inability to receive, realizing and expressing information through verbal, non-verbal or graphical ways are called communication disorder. A person with this disorder feels an obstacle to communicating with others. S/he feels hard to understand and express instruction or any information.

In verbal communication, s/he feels hard to choose words, word sequences in sentence formation while speaking. For that reason, a person with a communication disorder tries to hide him/herself from others. So, s/he became lonely in society. In general, communication disorder has many types: Speech disorder, Receptive language disorder, Expressive language disorder, mixed receptive-expressive language disorder, Social communication disorder, stuttering in childhood etc. Communication disorder becomes visible when a person feels difficulties in hearing, application of language or while speaking. The level of communication disorder might be mild to severe.

How communication disorder affects life?

This disorder can occur in two ways. One is developmental delays or other diseases, and another one is genetically acquired when s/he may acquire communication disorder from their parents through the gene. Therefore, any children of affected parents can be affected by a communication disorder.

A child may affect by it because of Autism spectrum Disease, developmental delays, immaturity of hearing/speech related organs such as vocal cord, cleft-lip etc. A mature person may affect by it because of hearing loss, memory loss, significant psychological injury, retardation of nerve etc. However, a person of any age may have communication disorder through massive brain injury or any type of disease of the brain.

Symptoms

Communication disorder has some common symptoms. When a person carries these kinds of symptoms, s/he might be identified as a disordered communication person and needs further assessment to ensure his disorder. The specialist must do further assessment. Some symptoms are:

1. A child with such disorder usually does not talk with anyone. S/he tries not to answer any question or instruction. Usually, a 1.5/2-year aged child starts to speak. At first, one or two words and then it speaks fluently. In most common cases, a child with a communication disorder does not speak though other children at the same age do.

2. A person with a Communication disorder has to face many types of problems while speaking or spelling words. Specifically, s/he feels hard to pronounce words. Though s/he pronounces a word, his/her word is defective. For this reason, the listener does not understand his/her speech.

3. Usually, a mature person pronounces about 140-160 words per minute. But those who have disabilities in communication cannot pronounce at that speed. S/he speaks slower than average. For slower speed, speech became monotonous to the listener.

4. Some person repeats a word while speaking. For example, instead of ‘I eat rice,’ s/he will pronounce I eat eat rice/I eat rice rice/ I I eat rice or something like that. S/he does this fault involuntary. It is also considered the significant symptoms.

5. This disorder is not only a disease for speaking difficulties. Speaking difficulties or disability to speak is just a part of communication disorder. Another important part of communication disorder is a disability to listen to. S/he frequently asks others to speak more slowly, clearly and loudly. He may bow his head to the speaker to listen clearly.

6. Another symptom is common for all types of such disorders. A person with a communication disorder cannot maintain the sequence of the word in a sentence. S/he speaks part by part. A mature person can speak childishly. S/he feels an obstacle to selecting words while speaking.

7. A communication disorder is related to the ability to speak, listening and realizing. Hence, s/he feels hard to communicate verbally with others. A person with a communication disability who feels hard to listen fails to understand speech fully and, at last, fails to express the feelings of his/her mind.

8. Another important sign of communication disorder: s/he fails to understand any command or instruction. Instruction or command may be written, graphical or verbal, but s/he fails to follow it. Most of the time, in multi-instruction, s/he cannot follow without the help of others.

9. A person with a communication disability has another common symptom. As his/her language is defective, s/he tries to use sign/body language instead of verbal language or speaking. A person with a speaking/hearing disability does the same thing to communicate with others.

10. S/he may try to avoid social functions/festivals. It is a familiar symptom of communication disorder. S/he avoids eye contact while speaking and tries to hide him/her from the situation by playing with own hair or anything.

Categories of communication disorder

Communication disorder has several types: Speech disorder, Receptive language disorder, Expressive language disorder, mixed receptive-expressive language disorder, Social communication disorder, stuttering in childhood etc. Some important categories are given below.

Speech disorder

A speech disorder is an abnormality of producing sound caused by the larynx. The affected child cannot speak just because of difficulty in pronouncing sound. The disability of the vocal cord is also included in it. Vague voice, flimsy sound etc. causes a speech disorder. Stuttering, involuntary repetitions break in the sentences, involuntary word pronunciation etc. are also part of it.

Receptive language Disorder

They feel difficulties in realizing any information or any instruction. Most of the time, their language develops very slowly according to their age. S/he can visualize or listen word correctly but fails to realize the meaning of it. His/her vocabulary is too limited and has to feel too many difficulties while learning new word meanings. Most of the time, they do not feel interested in speaking with others. Any instruction, especially they cannot follow verbal instruction properly.

Expressive language Disorder

It’s a kind of difficulty in language expression. In this case, a person has to face difficulties to express his feelings verbally and non-verbally. S/he faces troubles in vocabulary, formatting complex sentence and remembering words. In this stage, s/he may not have the difficulties in pronunciation. For this reason, a person cannot express his feelings properly in school, society, workplace and his/her personal life.

Mixed receptive-expressive language disorder

Sometimes a person with a communication disability may have both speaking and understanding disabilities. It is much more critical than other categories of communication disorder. A person with these types of disability fails to express his feelings of the mind. On the other hand, s/he cannot understand verbal or non-verbal information or instruction. Therefore, children with communication disorders try to avoid interactions with others.

Social communication disorder

A person with a communication disability loses interest in social interaction. S/he cannot distinguish between place, time and person and speaks the same way with teachers and friends. They can speak irrelevant topics while talking to others. Their language developments remain lagging than their ages and fail to communicate verbally with others. He/she can’t maintain appropriate social etiquette and fails to greet others.

Causes of communication disorder

Hearing loss

One of the vital reasons is hearing loss. Any person can lose his/her hearing ability by injury or any kind of disease. For the reason of hearing loss, a person may lose his/her listening ability, and that can create communication disorder. Therefore, he/she loses the ability to speak and listen.

Neurological disorder

A neurological disorder of the brain is also liable to a communication disorder. The brain has several parts for hearing and listening, and these parts control the ability to speak and listen. But traumatic brain injury, stroke or any neurological diseases can hamper hearing, listening or speaking ability. Thus s/he may be affected.

Autism Spectrum Disorder (ASD)

Autism may also be the reason behind communication disorder. Autism is a neurological development disorder. As autism is a familiar disorder, and its sphere is vast, it has been categorized severally from other neurological disorders. Autism can also be another cause of communication disorder.

Cleft-lip

As such disorder is related to the ability to speak, cleft-lip, or any type of disorder of lip might be the reason behind speaking disability. Because a person uses his/her lip while producing sound or speaking. The disorder of lip or cleft affects the ability to speak. It can make his/her speech vague, and s/he fails to speak. 

Psychological abnormality

A person may lose his/her speaking ability for trauma. In this case, he/she may listen but loses the ability to talk, and that can create communication disorder to a person. Effective counseling by counselors, psychiatry or psychologist can improve the condition.

Developmental delay

Every human being has milestones of development with time. Sometimes, proper development can delay for many reasons. Improper development of larynx can make a persons’ speaking defective. The development of hearing organs may harm hearing ability too. Neurological developmental delay of the brain also causes the same things. Therefore, developmental delay is another vital reason for communication disorder. 

Terminology related to a communication disorder

Aphasia

Losing verbal communication ability caused by traumatic brain injury is called Aphasia. It causes difficulties in expressing or realizing language. S/he can format and use complex sentences while speaking or writing. These types of people cannot express their feelings of the mind.

Dysarthria

Communication disorder related to the problems in the larynx is Dysarthria. It occurs for neurological abnormalities in the brain, such as Parkinson’s Disease. The affected person speaks very slowly and feels hard to do. S/he feels difficulties while talking on a mobile phone.

Apraxia

Communication disorder caused by neurological abnormalities is Apraxia.

Dysnomia

This disorder also occurred by memory loss is dysnomia. S/he cannot remind any word instruction, and so s/he cannot follow it. Most of the time, they started talking about irrelevant topics while speaking with others.

Dementia

Dementia is the most horrible category. It occurs with Alzheimer’s disease. In this category, s/he faces problems in attention, memory and personality.

Dyslexia

Dyslexia is reading difficulties. The affected person can read the written test. It is not a lack of motivation or poor schooling, but dyslexia may affect these conditions. S/he cannot read the combination of a different letter. Traumatic brain injury or stroke can occur.

Dysphagia

Dysphagia is not a traditional type of communication disorder. It is a combination of other communication disorders. In this category, s/he cannot eat too with speaking disability. A person with dysphagia has trouble swallowing foods.

Communication disorder and world

A communication disorder is a problem for the whole world. The percentage of communication disorders is not a few at all. But in an undeveloped country, communication disorder isn’t considered any diseases. Special education concept is spreading all over the world; communication disorder is considering a disability nowadays. About 40 million people in the USA have communication disorder. According to the research of IDEA found 24.1% of communication disabled children at the age of 3 to 5 years.  Among affected children, 1.4% receive special education. Some institutions working for communication Disorder:      

1. NIH National Institute on Deafness and Other Communication Disorders
2. American Society for Deaf Children
3. American Speech-Language-Hearing Association
4. Childhood Apraxia of Speech Association 
5. DeafMD.org Foundation
6. Dystonia Medical Research Foundation
7. International Dyslexia Association
8. Laurent Clerc National Deaf Education Center
9. National Aphasia Association
10. National Association of the Deaf
11. National Stuttering Association
12. Stuttering Foundation of America
13. The Autism Society 

Communication disorder and Bangladesh

A communication disorder is a critical problem for every country. A developed country is working to prevent and intervene. However, a country like Bangladesh, it is an unfamiliar topic till now, and we do not find noteworthy research on communication disorder.

Bangladesh Person with Disability Act categorized those types of disabilities that are easily visible (For example, visual impairment, Intellectual disabilities, Physical disabilities etc.). Therefore, communication disorder is not considered as any type of disability until now. We do not have any statistics about the communication-disabled person and their future. We do not have any plan to educate them. But it is good news for us that Bangladesh has started working on communication disorders.

Recently, Dhaka University has started a new department named communication disorder in the year of 2015. Department of Communication disorder started his journey on 1 April 2015. Dr, Hakim Arif is the founder chairperson of the department. It aims to do higher studies in the sector and to organize various projects on communication and speech-related things. For the very first-time department of communication, the disorder has started four years of the undergraduate course in Bangladesh. Though Bangladesh has several institutions for working in deaf/hearing disabilities, the department of communication disorder is only one institution working in this sector.

Identification of Communication Disorder

Communication disorder becomes visible when a person speaks or follows any instructions. In this perspective, communication disorder doesn’t any specific further assessment. If it seems that a person has defective communication skills, he should meet speech and language specialist. Sometimes child psychologists or child specialists can identify defective communication skills. They diagnose communication disorders by considering the developmental milestone of a child. To identify communication disorder, some activities can help:

• Psychological testing of thinking abilities.
• Psychometric test to identify a Childs’ reasoning skills and reactions of different situations.
•  Developmental test of a child according to the milestone and
• Measure defective pronunciation and duration of defective speech while speaking.

Education for the communication disabled children in Bangladesh

In Bangladesh, communication disorder is not a specified disease until now. So, we have no specific educational institutions as developed countries have. In our country, we have several institutions for blind children, physically handicapped autism and some other disabilities. Learning a communication-disabled child is very much hard, and that deserves several strategies of learning.

An affected student in the classroom does not understand teachers’ lectures. As they cannot communicate properly with others, so they feel lonely and try to hide from the classroom. It creates bad effects on their educational career. Sometimes people who have hearing difficulties are treated as hearing impairment person, and they learn with hearing-impaired children. But communication disorder is not only a problem in hearing ability but also its area is vast. A person from other categories of communication disorder remains unprivileged.

The constitution of Bangladesh, article 28, ensures educational rights for all kinds of people of the country. It ensures the educational rights of all types of disabled persons. As communication disorder is a defined disability, ensuring their learning opportunity is their constitutional right. So, it is badly needed to identify the total amount. Then the government should design and implement an effective program for their education.

How should we treat them?

A person with a communication disabled cannot express her feelings. For that reason, they fail to express their feelings of mind, emotion, expectations, needs with others. Imagine your condition when you cannot express your feelings fully and cannot understand others’ speech. A person with a communication disorder loses the rhythm of speech; sometimes, s/he stutters and repeats the same speech. For the defective speech, other people become angry and annoyed while talking with an affected person. A person with this problem tries to hide him/herself from social interaction and always with an inferiority complex.

In our society, if a person stutters or cannot understand too much easy instruction, we laugh at him/her. We must change this culture. We should keep in mind that they do not do that willingly. They try their best to speak properly but fail to do. As other people laugh at for defective speech, s/he feels depressed.

Our co-operative behavior can make an abnormal person’s life beautiful. People should act normal to disabled persons with stuttering, very slow or vague speech. The stuttering, very slow or vague speech should treat as normal. We should never feel annoyed at him/her and encourage him/her to live with us. If s/he fails to understand anything, we should tell that repeatedly with patience. We have to accept disordered communication with people with pleasure in social functions or festivals.  

Teaching strategies for children with a communication disorder

The teacher should maintain eye contact while giving a lecture. When s/he maintains eye contact, especially on disordered communication student, s/he will be able to justify his/her student’s attention. Sometimes for a higher teacher-student ratio, a teacher cannot maintain eye contact. Lecture recording is beneficial for communication disorders affected children. They have to listen to easy instruction more and more to understand fully. The teacher should permit his/her students to use audio or video recorders in the classroom.

If a student needs to use signs or languages, the authority should manage an interpreter in the class. The classroom should be student friendly as much as possible. A child with such tries to hide him/herself from the classroom activities, so the teacher should encourage him/her student to participate in classroom activities and then the affected student will feel free to do. The teacher should be very much patience. Sometimes teachers’ intolerant behavior hampers students’ interest in learning activities. Intolerant behavior of the teacher in the classroom is never accepted.  

The teacher has to be a good listener, and s/he should be careful about the defective speech of the student. S/he should be careful about his or her students’ homework. If a child has such disorder, s/he may not follow instructions. So, the teacher should be careful about it. If s/he finds any abnormalities, s/he should share his/her findings with the guardian. The teacher should encourage every student to talk easily with the teachers. Teachers should not be angry about the question on a very much easy topic from his or her student. If possible, the teacher should repeat his lecture more than two times. As this disorder affected children faces difficulties in the following instruction, we can allow additional time for assignment, exam or any academic activities.

Conclusion

This disorder is like other abnormalities. But in a country like Bangladesh, it is not familiar till now. The rate of the affected person in a developed country is vast. We do not have any statistical data of the affected person in communication disorder, and the total amount of it is unknown till now. Students/person bearing the symptoms of communication disorder is considered as inattentive, dull etc. Communication disorder needs huge research. With the help of others, a communication-disabled person can have a beautiful life; they just need our caring and love.