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Communication is a two-way process. We use it to express what we want to say and to understand what other people want to tell us. It can therefore break down when neurological disorders cause difficulties in expressing messages, receiving messages or both. To understand why expressing and receiving messages can go wrong we need to think about how we acquired these abilities.

All the means of human communication are possible because of the amazing capacities of the human brain. We are born with a nervous system that allows us to learn to communicate in the first few years of life. Difficulties can arise when something damages or disrupts the parts of our nervous system that allowed us to acquire that ability to communicate.

Language can become disordered when parts of the brain that store words and organise sentences become damaged or disrupted. This disorder is known as aphasia or dysphasia.

Speech can become affected when the parts of the nervous system which control the muscles that physically enable us to speak become damaged and can no longer make those muscles work as strongly, quickly and fluently as they need to. This disorder is known as dysarthria.

In the following descriptions of communication disorders, reference will be made to the World Health Organisation’s classification of impairment, disability and handicap. Examples of how these relate to communication disorders are as follows.

Impairment a disruption of the normal language-processing or speechproduction system e.g. difficulty with finding the right words or with reading sentences, reduced spelling ability, reduced ability to pronounce words clearly.

Disability refers to the communication difficulty experienced e.g. in talking on the phone, reading the paper, writing to people.

Handicap problems which are serious enough to restrict a person in terms of lifestyle and their role within the community e.g. inability to return to work, inability to help children with homework.