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Cognitive communication disorder — Clinical Guidelines

Overview

Cognitive communication disorders encompass impairments in cognitive processes that affect communication abilities, including language production, comprehension, and pragmatic use of language. These disorders can result from various neurological conditions, brain injuries, or developmental issues 1 14 22.

Diagnosis

Comprehensive assessment including standardized language tests, cognitive evaluations, and functional communication analysis 1 4 14.

Identification of specific deficits in areas such as receptive language, expressive language, pragmatic skills, and executive functioning 1 14.

Consideration of differential diagnoses to rule out other communication disorders like functional communication disorders 1.

Management

First-line treatments:

- Speech-language pathology interventions tailored to individual needs, including structured communication therapy and pragmatic language training 1 6 14. - Augmentative and alternative communication (AAC) systems for individuals with severe expressive impairments 2 15.

Adjunctive approaches:

- Family and caregiver involvement in therapy sessions and training to support communication strategies at home 19. - Holistic interventions addressing cognitive, emotional, and social aspects of communication, particularly in residential settings 14.

Special Populations

Pediatrics: Early intervention with evidence-based instructional strategies and AAC support for prelinguistic communication 2 4 9.

Elderly: Focus on maintaining communicative participation through tailored speech therapy and environmental adaptations 19.

Comorbidities: Integrated management addressing coexisting conditions like psychosocial issues or cognitive impairments alongside communication deficits 14 18.

Key Recommendations

Implement individualized speech-language pathology interventions based on comprehensive assessments to address specific cognitive communication deficits (Evidence: Strong 1 6).

Incorporate family and caregiver training to enhance support and carryover of therapeutic strategies at home (Evidence: Moderate 19).

Utilize augmentative and alternative communication systems for individuals with severe expressive communication impairments (Evidence: Moderate 2 15).

Consider holistic approaches that integrate cognitive, emotional, and social components in managing persistent communication difficulties, especially in residential settings (Evidence: Weak 14).

Regularly assess and adapt interventions for pediatric and elderly populations to maintain communicative participation and address developmental or age-related changes (Evidence: Moderate 2 19).

References

1 McKenzie K, Behn N, Rodgers L, Hilari K. Functional communication disorders: a systematic review of interventions to improve outcomes in adults. Disability and rehabilitation 2025. link 2 Snodgrass MR, Meadan H. A boy and his AAC team: building instructional competence across team members. Augmentative and alternative communication (Baltimore, Md. : 1985) 2018. link 3 Snow PC, Woodward MN. Intervening to address communication difficulties in incarcerated youth: A Phase 1 clinical trial. International journal of speech-language pathology 2017. link 4 Washington K, Thomas-Stonell N, Oddson B, McLeod S, Warr-Leeper G, Robertson B et al.. Construct validity of the FOCUS© (Focus on the Outcomes of Communication Under Six): a communicative participation outcome measure for preschool children. Child: care, health and development 2013. link 5 Vinney LA, Grade JD, Connor NP. Feasibility of using a handheld electronic device for the collection of patient reported outcomes data from children. Journal of communication disorders 2012. link 6 Adams C, Lockton E, Gaile J, Earl G, Freed J. Implementation of a manualized communication intervention for school-aged children with pragmatic and social communication needs in a randomized controlled trial: the Social Communication Intervention Project. International journal of language & communication disorders 2012. link 7 McCool S, Stevens IC. Identifying speech, language and communication needs among children and young people in residential care. International journal of language & communication disorders 2011. link 8 Goldblum G. Mark Ylvisaker's influence on scripts, videos, and projects within a South African context. Seminars in speech and language 2010. link 9 Jordaan H. Clinical intervention for bilingual children: an international survey. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) 2008. link 10 Fonseca RP, Parente MA, Côté H, Ska B, Joanette Y. Introducing a communication assessment tool to Brazilian speech therapists: the MAC Battery. Pro-fono : revista de atualizacao cientifica 2008. link 11 McLeod S, McKinnon DH. Prevalence of communication disorders compared with other learning needs in 14,500 primary and secondary school students. International journal of language & communication disorders 2007. link 12 Kummerer SE, Lopez-Reyna NA, Hughes MT. Mexican immigrant mothers' perceptions of their children's communication disabilities, emergent literacy development, and speech-language therapy program. American journal of speech-language pathology 2007. link) 13 Simon SK. What Ruth knew. Nursing 2005. link 14 Nash P, Stengelhofen J, Toombs L, Brown J, Kellow B. An alternative management of older children with persisting communication problems. International journal of language & communication disorders 2001. link 15 Clarke M, McConachie H, Price K, Wood P. Views of young people using augmentative and alternative communication systems. International journal of language & communication disorders 2001. link 16 de Bruin MD, Coerts MJ, Greven AJ. Speech therapy in the management of male-to-female transsexuals. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) 2000. link 17 Simon EW, Whitehair PM, Toll DM. A case study: follow-up assessment of facilitated communication. Journal of autism and developmental disorders 1996. link 18 Prelock PA. Managing the language and learning needs of the communication-impaired preschool child. A proactive approach. Clinics in communication disorders 1993. link 19 Buckwalter KC, Cusack D, Kruckeberg T, Shoemaker A. Family involvement with communication-impaired residents in long-term care settings. Applied nursing research : ANR 1991. link80059-x) 20 Eibel P. Cacolalia. Orthopaedic review 1986. link 21 Defries Z. Case report: the automatic message box as therapeutic aid. Journal of communication disorders 1980. link90028-3) 22 Lubinski R, Jones G. Communication therapy for the young adult. Journal of communication disorders 1979. link90016-9) 23 Prutting CA, Bagshaw N, Goldstein H, Juskowitz S, Umen I. Clinician-child discourse: some preliminary questions. The Journal of speech and hearing disorders 1978. link 24 Haynes WO, Oratio AR. A study of clients' perceptions of therapeutic effectiveness. The Journal of speech and hearing disorders 1978. link

Cognitive communication disorder