44 Neurodevelopmental Disorders
Comorbidity
Language disorder is strongly associated with other neurodevelopmental disorders in
terms of specific learning d isorder (literacy and numeracy),  attention-deficit/hyperactiv-
ity disorder, autism spectrum disorder, and developmental coordination disorder. It is
also associated with social (pragmatic) commu nication disorder. A positive family history
of speech or language disorders is often present.
Speech Sound Disorder
Diagnostic Criteria 315.39 (F80.0)
A. Persistent difficulty with speech sound production that interferes with speech intelligi-
bility or prevents verbal communication of messages. 
B. The disturbance causes limitations in effect ive communication that interfere with social
participation, academic achievement, or occupational performance, individually or in
any combination.
C. Onset of symptoms is in the early developmental period.
D. The difficulties are not attributable to congenital or acquired conditions, such as cere-
bral palsy, cleft palate, deafness or hearing loss, traumatic brain injury, or other medi-
cal or neurological conditions. 
Diagnostic Features 
Speech sound production descri bes the clear articulation of  the phonemes (i.e., individual
sounds) that in combination make up spoken words. Speech sound production requires both
the phonological knowledge of speech sounds and the ability to coordinate the movements of
the articulators (i.e., the jaw, tongue, and lips ,) with breathing and vocalizing for speech. Chil-
dren with speech production difficulties may experience difficulty with phonological knowl-
edge of speech sounds or the ability to coordi nate movements for speech in varying degrees.
Speech sound disorder is thus heterogeneous in its underlying mechanisms and includes pho-
nological disorder and articulation disorder . A speech sound disorder is diagnosed when