Language Difficulties, Clinical Assessment of

The terms language, speech, and communication are used interchangeably by most people. When children or adults are seen by a speech-language pathologist (SLP), however, each of these terms refers to specific behaviors that are assessed and treated differently.

Language is a symbolic code organized by rule-governed combinations that are socially shared. Children learn to use this symbolic code by being part of families and communities. This learning process continues when children go to school and learn to read and write and formally study language. Most children have no difficulty learning the code. They quickly and easily recombine words to talk with others (which can be likened to building structures with a Lego set). However, approximately 10% of all children have difficulty learning some aspect of the language code. In addition, some adults have had an experience, for example, a stroke or head trauma, that resulted in specific language impairment.

Speech is the spoken production of language. It is an oral neuromuscular process that shapes the sounds particular to each national language and allows verbal transmission of thoughts and ideas between people. The mouth's structures and muscles shape the sounds, but the sounds being shaped are particular to specific symbolic language codes.

Communication, the most comprehensive of the three terms, involves the exchange of information between people. This exchange can be nonverbal, such as when the body, space, and eye gaze are used to convey information. It can be vocal, such as when those who are hearing impaired or using electronic equipment add their pitched voice, grunts, and so forth to the messages they are sending. It can be verbal, such as when information is exchanged by speaking to one another. Language is integral to communication because this symbol system is used to encode information and ideas. Therefore, while language need not be spoken, it is a pivotal aspect of communication.

Language, speech, and communication typically co-occur in everyday life. When considering atypical development or disease, injury, or illness that affects language, each person must be assessed and possibly treated differently. A life-span perspective about language assessment follows.