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Speech and Language Diagnoses Explained

speech diagnoses

A diagnosis can be confusing, affirming, and emotional all at the same time. One can be given at a pediatrician's office, school IEP meeting, or in a speech clinic. We're here to break down the meaning of a diagnosis, how it comes to be, and common diagnoses someone might see in our speech and language reports.

What is a diagnosis?

A diagnosis is the term given to describe a child’s current primary area of need.

How does someone get a speech and language diagnosis?

A speech and language diagnosis is given after an evaluation if data supports it. As speech-language pathologists, we use parent and/or teacher reports, standardized testing, and our clinical experience when diagnosing any child.

Can a speech diagnosis change?

Yes! As a child grows, their communication strengths and areas of difficulty can change. When a child is under three years of age, it is common to see an expressive and or receptive language delay as their current diagnosis. These diagnoses are most appropriate because we might not have enough information about their speech sounds just yet. As they pass ages three through five, their diagnosis may change to a phonological disorder as their speech sound production skills develop. Or, they might lose their diagnosis altogether!

What are some of the most common speech diagnoses?

Phonological Disorder

Phonological disorder is the broad name for an articulation, phonological or speech sound production delay or disorder. A child may be diagnosed under this name if they do not have a certain sound, are substituting a sound with another, or if they are not yet producing the sound correctly. Depending on the child’s age and several other factors, certain sounds or patterns will be chosen as their speech goal targets, while other sounds can wait.

Expressive Language Delay/Disorder

An expressive language delay or disorder is used to describe difficulties expressing thoughts and ideas. It’s helpful to think of expressive language as how someone uses language. This includes vocabulary, grammatical concepts, sentence organization and storytelling. Goals you might see which fall under the expressive language umbrella include using regular and irregular past tense verbs, pronouns and adjectives appropriately in conversation.

Mixed Expressive-Receptive Language Delay/Disorder

A mixed receptive-expressive language delay or disorder covers both an expressive delay (as covered above) and a receptive language delay. Receptive language is a child’s understanding of language. This includes understanding of basic concepts, following directions, and answering questions.

Fluency Disorder

A fluency disorder is also known by some as a stutter. A fluency disorder can include stuttering or disfluent moments such as prolongations (i.e. stretched sounds), repetitions (i.e. repeated sounds, syllables, or words), and blocks (i.e. getting physically “stuck” on a word or sound).

Voice Disorder

A voice disorder is an umbrella term which identifies abnormal vocal quality (i.e. raspy, gravely), loudness, and/or pitch. Speech therapy might be recommended for children who use a consistently loud voice and have started or have the potential to damage their vocal chords.

A note on diagnoses SLPs can’t diagnose:

Autism Spectrum Disorder (ASD), central auditory processing disorder (CAPD) and dyslexia are diagnoses an SLP can’t diagnose, but can co-occur with speech and language diagnosis.

Parent and Caregiver Resources


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