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Speech, Language and Communication - Neurodiversity Hub Wirral

Language

Language involves using words (spoken, signed, symbols) and sentences to understand, think about and use information. We use language to share in interactions and engage with others.

Comprehension of language is also known as ‘receptive language’: this is ‘input’. This is the ability to understand meaning, instructions, concepts and make sense of the information we receive. This includes understanding of abstract language, such as being able to answer questions and the ability to infer what may happen and why.

Expressive language involves how we communicate using words, phrases and sentences: this is ‘output’. This can include spoken words, signs such as British Sign Language and Makaton, written words and picture symbols.

Children and young people may also use non-verbal communication and behaviour to express themselves.

Social Communication Skills 

Social communication means using language and non-verbal signals to connect with others. This includes: 

  • Taking turns in conversation 

  • Staying on topic 

  • Fixing misunderstandings when communication breaks down 

 

Speech 

Speech is the use of sounds to form words. Children develop speech sounds over time, usually completing this by age 6. However, this can vary widely. 

  • Some children develop speech sounds later than others. 

  • Some follow a different pattern, which may not be typical. 

  • It can be hard to understand children while they are still learning speech sounds. 

  • Older children and young adults may also have speech sound difficulties. 

  • Childhood Apraxia of Speech (CAS) is a speech disorder. It affects how a child or young person plans and makes the movements needed to speak. It was once called Developmental Verbal Dyspraxia (DVD). 

    Children and young people with CAS: 

    • May struggle to say sounds clearly 

    • May say the same word differently each time 

    • May find spontaneous speech easier than repeating words 

    • May look like they are trying hard to speak, moving their lips, jaw, or tongue 

    They often need support from a speech and language therapist. About 1 in 1,000 children are estimated to have CAS. 

  • Stammering can include: 

    • Repeating whole words or syllables 

    • Stretching out sounds 

    • Blocking (when a word gets stuck) 

    Other signs may include: 

    • Facial tension 

    • Extra body movements 

    • Changes in breathing 

    Children and young people may: 

    • Avoid speaking 

    • Change the words they use 

    • Experience stammering that varies from day to day 

    Stammering can be mild or severe. The severity does not predict whether it will continue into adulthood. 

    Stammering is neurodevelopmental, often starting when children are learning language. It can run in families—about 60% of people who stammer have a relative who also stammers. Each child or young person will have a unique mix of factors. Importantly, parents do not cause stammering. 

  • Selective mutism is when a child or young person feels very anxious about speaking or using non-verbal communication in certain places. They may not respond to questions or speak in settings like school, nursery, or college. 

    This is not about being shy—it’s linked to high levels of anxiety. Support and understanding are key. 

    Selective Mutism

    Selective mutism can happen in places like school, nursery, or even at home—especially when a new person or adult is present. 

    It’s important to remember that a child or young person with selective mutism wants to speak and connect with others. But anxiety can make this very hard. 

    They may: 

    • Use body gestures 

    • Whisper to familiar people 

    • Communicate only in certain situations 

    How to Help

    • Offer other ways to communicate. This can reduce pressure to speak. 

    • Older children may prefer to write things down—but only if that feels easier for them. 

    • Younger children may benefit from pictures or symbols to choose a nursery rhyme, activity, or snack. 

    • Reduce pressure to speak. Create a safe, calm space where they feel supported and understood. 

    • Get professional support. A speech and language therapist or other trained professional can offer strategies and training to help. 

       

  • Developmental Language Disorder (DLD) is when a child has ongoing difficulties with language that continue past age five. It affects about 7% of children—that’s 2 in every class of 30. 

    What Causes DLD?

    • DLD is neurodevelopmental. 

    • It may have a genetic link, but no single gene causes it. 

    • There is no test for DLD. 

    • It is not caused by hearing loss, autism, brain injury, or by parents not talking to their children. 

    How DLD Affects Communication

    Children and young people with DLD may: 

    • Struggle to use sounds, words, and sentences to express meaning 

    • Have trouble understanding language (receptive language) 

    • Appear not to listen, seem uninterested, or act out—when in fact, they are struggling to understand 

    These difficulties can continue into adolescence and adulthood. 

    Children with other conditions may also have language disorders. These are not called DLD, but the support they need is often similar.