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Communication Characteristics: Selected Populations With an Intellectual Disability

Population Communication Characteristics

Autism spectrum disorder

Neurologically based, heterogeneous disorder with the core features of impairment of social communication, impairment of language, and presence of restricted, repetitive behaviors, which are present in early childhood.

  • Social communication impairment (e.g., joint attention, social reciprocity, nonverbal and verbal language skills, social interaction, initiation of conversation; APA, 2013).
  • Restricted and repetitive use of language (e.g., echolalia, perseveration; APA, 2013).
  • Delay or absence of spoken communication (Anderson et al., 2007).
  • Difficulty with abstract language (Tager-Flusberg & Caronna, 2007).
  • Difficulty with narrative discourse (Tager-Flusberg, 1995).
  • May have a speech sound disorder (Shriberg, Paul, Black, & van Santen, 2011).
  • May have feeding problems (Twachtman-Reilly, Amaral, & Zebrowski, 2008).

Cerebral palsy

Motor disorder, which may affect speech, language, and swallowing.

Variable difficulties, depending on the area of the brain affected and the severity.

  • Increased risk for language disorders (Pennington, Goldbart, & Marshall, 2005; Richardson & Kertoy, 2006).
  • May have hearing loss (Rosenbaum & Rosenbloom, 2012).
  • Dysarthria is the most common speech disorder (McNeil, 2009)
  • May have childhood apraxia of speech (ASHA, n.d.).
  • Feeding and swallowing may be compromised (Sullivan, 2009).

Down syndrome

Genetic syndrome associated with intellectual impairment, limitations in adaptive skills, and anatomical differences in tongue size (relative macroglossia).

  • Language comprehension is better than production, particularly syntax (Roberts, Price, & Malkin, 2007).
  • Problem with speech intelligibility, which may result from disturbances in voice, articulation, resonance, fluency, or prosody (Kent & Vorperian, 2013).
    • Stuttering is more prevalent (Kumin, 2012).
    • Persistent otitis media; conductive and sensorineural hearing loss is common (Shott, 2006).
    • Morphosyntax is more difficult than semantics (Fidler, Most, & Philofsky, 2009), with variability in vocabulary development (Kumin, Council, & Goodman, 1999).
    • Strengths are present in social and pragmatic skills; however; individual has difficulty with more complex pragmatic skills (e.g., figurative and abstract language, conversation and narrative discourse, and metalinguistics [Kumin, 2010]).

    Fetal alcohol syndrome

    Congenital syndrome resulting from alcohol exposure in utero.

    Leading cause of developmental disabilities in the United States

    • Delayed speech and language acquisition (Church, Eldis, Blakley, & Bawle, 1997).
    • May have hearing loss (Church et al., 1997).
    • Receptive and expressive language problems (Wyper & Rasmussen, 2011).
    • Difficulties with narrative discourse, particularly errors in nominal reference (Thorne, Coggins, Olson, & Astley, 2007).
    • Difficulties with social communication (Coggins, Timler, & Olswang, 2007).

    Fragile X syndrome

    Most common inherited cause of ID.

    Symptoms are more severe for boys than for girls.

    • Delayed speech and language skills, particularly syntax, with relative strengths in vocabulary and language comprehension (Roberts, Chapman, & Warren, 2008).
    • Difficulties with articulation, fluency, and oral motor skills (Roberts, Hennon, & Anderson, 2003); prolonged unintelligible speech, particularly in connected speech (Paul, Cohen, Breg, Watson, & Herman, 1984).
    • Social interaction and pragmatic difficulties similar to those associated with ASD (e.g., staying on topic, taking turns in conversation, echolalia, perseveration; [Abbeduto & Sterling, 2011]).


    Abbeduto, L., & Sterling, A. (2011). Language development and Fragile X syndrome. Perspectives on Language Learning and Education, 18 (3), 87–97.

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    American Speech-Language-Hearing Association. (n.d.). Childhood Apraxia of Speech (Practice Portal). Retrieved from

    Anderson, D. K., Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2007). Patterns of growth in verbal abilities among children with autism spectrum disorder. Journal of Consulting and Clinical Psychology, 75,, 594–604.

    Church, M. W., Eldis, F., Blakley, B. W., & Bawle, E. V. (1997). Hearing, language, speech, vestibular, and dentofacial disorders in fetal alcohol syndrome. Alcoholism, Clinical and Experimental Research, 21, 227–237.

    Coggins, T. E., Timler, G. R., & Olswang, L. B. (2007). A state of double jeopardy: Impact of prenatal alcohol exposure and adverse environments on the social communicative abilities of school-age children with fetal alcohol spectrum disorder. Language, Speech, and Hearing Services in Schools, 38, 117–127.

    Fidler, D., Most, D., & Philofsky, A. (2009). The Down syndrome behavioral phenotype: Taking a developmental approach. Down Syndrome Research and Practice, 12, 37–44,

    Kent, R. D., & Vorperian, H. K. (2013). Speech impairment in Down syndrome: A review. Journal of Speech, Language, and Hearing Research, 56, 178–210.

    Kumin, L. (2010). Social communication skills. Down Syndrome News, 33, 86–89.

    Kumin, L. (2012). Early communication skills for children with Down syndrome: A guide for parents and professionals. Bethesda, MD: Woodbine House.

    Kumin, L., Council, C., & Goodman, M. (1999). Expressive vocabulary in young children with Down syndrome: From research to treatment. Infant-Toddler Intervention: The Transdisciplinary Journal, 9(1), 87–100.

    McNeil, M. R. (2009). Clinical management of sensorimotor speech disorders. New York, NY: Thieme Medical Publishers.

    Paul, R., Cohen, D. J., Breg, W. R., Watson, M., & Herman, S. (1984). Fragile X syndrome: Its relations to speech and language disorders. Journal of Speech & Hearing Disorders, 49, 326–336.

    Pennington, L., Goldbart, J., & Marshall, J. (2005). Direct speech and language therapy for children with cerebral palsy: Findings from a systematic review. Developmental Medicine and Child Neurology, 47(1), 57–63.

    Richardson, K., & Kertoy, M. (2006). Language characteristics of children and youth with cerebral palsy. Hamilton, Ontario, Canada: McMaster University CanChild Resources. Retrieved from

    Roberts, J. E., Chapman, R., & Warren, S. (2008). Speech and language development and intervention in Down syndrome and Fragile X syndrome. Baltimore, MD: Brookes.

    Roberts, J. E., Hennon, E. A., & Anderson, K. (2003, October). Fragile X syndrome and speech and language. The ASHA Leader, 8, pp. 6–7.

    Roberts, J. E., Price, J., & Malkin, C. (2007). Language and communication development in Down syndrome. Mental Retardation and Developmental Disabilities Research Reviews, 13(1), 26–35.

    Rosenbaum, P., & Rosenbloom, L. (2012). Cerebral palsy: From diagnosis to adult life. London, England: Mac Keith Press.

    Shott S. R. (2006). Down syndrome: Common otolaryngologic manifestations. American Journal of Medical Genetics: Part C, Seminars in Medical Genetics, 142, 131–140.

    Shriberg, L. D., Paul, R., Black, L. M., & van Santen, J. P. (2011). The hypothesis of apraxia of speech in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 41, 405–426.

    Sullivan, P. B. (2009). Feeding and nutrition in neurodevelopmental disability: An overview. In P. B. Sullivan (Ed.), Feeding and nutrition in children with neurodevelopmental disability (pp. 8–20). London, England: John Wiley & Sons.

    Tager-Flusberg, H., & Caronna, E. (2007). Language disorders: Autism and other pervasive developmental disorders. Pediatric Clinics of North America, 54, 469–481.

    TagerFlusberg, H. (1995). Once upon a ribbit: Stories narrated by autistic children. British Journal of Developmental Psychology, 13(1), 45–59.

    Thorne, J. C., Coggins, T. E., Olson, H. C., & Astley, S. J. (2007). Exploring the utility of narrative analysis in diagnostic decision making: Picture-bound reference, elaboration, and fetal alcohol spectrum disorders. Journal of Speech, Language, and Hearing Research, 50 , 459–474.

    Twachtman-Reilly, J., Amaral, S. C., & Zebrowski, P. P. (2008). Addressing feeding disorders in children on the autism spectrum in school-based settings: Physiological and behavioral issues. Language, Speech, and Hearing Services in Schools, 39, 261–272.

    Wyper, K. R., & Rasmussen, C. R. (2011). Language impairments in children with fetal alcohol spectrum disorder. Journal of Population Therapeutics and Clinical Pharmacology, 18(2), e364–e376.

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