Differentiating between a communication disorder and a typical developmental variation in preschool children primarily hinges on the severity, persistence, and pervasiveness of any observed impairments NICE NG72. A communication disorder, as part of a broader category of developmental problems and disorders, is characterised by impairments of personal, social, academic, or occupational functioning NICE NG72. The term 'disorder' applies if the condition is severe, persistent, and pervasive enough to meet the criteria for a disorder in the International statistical classification of diseases and related health problems (ICD) or the Diagnostic and statistical manual of mental disorders (DSM) NICE NG72.
Typical developmental variations, in contrast, would not meet these criteria for severity, persistence, and pervasiveness, nor would they typically lead to significant impairments in functioning that warrant a formal diagnosis NICE NG72.
For children, particularly those born preterm, there is an increased risk of speech, language, and communication problems and disorders NICE NG72. Independent risk factors for language disorder include grade 3 or 4 intraventricular haemorrhage, cystic periventricular leukomalacia, and male sex NICE NG72.
Identification of developmental problems and disorders, including communication disorders, involves enhanced developmental surveillance, which is the active monitoring of a child's development at set times using specific tools NICE NG72. If concerns arise, a multidisciplinary team, which includes speech and language therapists, would be involved in further assessment and support NICE NG72.