The Normal Communication Process Of Children
Disorders impairing a patient’s communication abilities may involve voice, speech, language, hearing, and/or cognition. Recognizing and addressing communication disorders is important; failure to do so may result in isolation, depression, and loss of independence. A voice disorder exists when the voice’s quality, pitch, or volume differs from that of other persons of similar age, culture, and geographic location. Dysphonia is classified as either an organic or a functional disorder of the larynx. Another type of communication problem, dysarthria, encompasses a group of motor speech disorders caused by a disturbance in the neuromuscular control of speech. A second form of motor speech disorder, apraxia, occurs in the presence of significant weakness or incoordination of the muscles of speech production.
Aphasia is a language disorder that results from damage to the areas of the brain responsible for language comprehension and expression, while a cognitive-communicative disorder affects the ability to communicate by impairing the pragmatics, or social rules, of language.
The Normal Communication Process
Communication is a multidimensional dynamic process that allows human beings to interact with their environment. Through communication, people are able to express thoughts, needs, and emotions. Communication is an intricate process that involves cerebration, cognition, hearing, speech production, and motor coordination. Evaluation of a communication disorder includes consideration of all aspects of the normal communication process.
Language is the transformation of thoughts into meaningful symbols communicated by speech, writing, or gestures. Thoughts are organized by the brain, specifically the left hemisphere, and encoded into a sequence according to learned grammatic and linguistic rules. These rules govern the way sounds are organized (phonology), the meaning of words (semantics), how words are formed (morphology), how words are combined into phrases (syntax), and the use of language in context (pragmatics).
Speech involves the coordinated motor activity of muscles involved in respiration, phonation, resonance, and articulation. The entire system is modulated by central and peripheral innervation, including with cranial nerves V, X, XI, and XII, as well as with the phrenic and intercostal nerves.
Respiratory muscles, specifically the muscles associated with expiration, must generate enough air pressure to provide adequate breath support to make speech audible. The diaphragm is the main muscle of expiration; however, the abdominal and intercostal muscles help to control the force and length of exhalation for speech.
Phonatory muscles of the larynx generate vibratory energy during vocal cord approximation to produce sound.  Vocal pitch and intensity are modified by subglottic air pressure, tension of the vocal cords, and position of the larynx. Articulatory muscles within the pharynx, mouth, and nose form the tone of the sound. The coordinated action of these muscles produces speech. By altering the shape of the vocal tract, we are capable of producing a tremendous range of sounds.
Sound waves are transformed by the auditory system into neural input for the speaker and the listener. The outer ear detects sound-pressure waves in the air and converts them into mechanical vibrations in the middle and inner ear. The cochlea then transforms these mechanical vibrations into vibrations in fluid, which act on the nerve endings of the eighth cranial nerve. Thus, the process of communication begins and ends in the brain