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However, fluent speech on a topic may be an indication of a high degree of knowledge. It is estimated that 17% of the United States population has a disorder of communication, with or without a concomitant swallowing disorder. Therefore, such problems as hearing loss and communicative disorders due to strokes and degenerative diseases of the brain will increase significantly in the coming decades. Consistent with increases in the number of older Americans, the prevalence of communicative disorders associated with aging is expected to increase in the future. Other disabilities associated with communication disorders include autism, cerebral palsy, and various genetic syndromes. A majority of the estimated 6 million individuals with intellectual disabilities in the United States have speech and language problems. Communicative disorders are prevalent to a much higher degree in children who have other kinds of disabilities. Generally, a greater proportion of younger children tend to have a communication or a swallowing disorder. Communicative disorders are the second highest of the handicapping conditions of school-age children. It is estimated that at least 17% of the United States population has a disorder of communication, with or without a concomitant swallowing disorder. However, for several reasons, adults may experience language disorders for the first time. Limited communicative behaviors may lead to social isolation. Van Riper's definition emphasizes deviancy from the normal and the problem it creates for effective communication. It is hard to specify how often and to what extent speech should call attention to itself before it is diagnosed as defective. Normal hearing also is essential for monitoring one's own speech production. If speech is not perceived, communication is impaired at all age levels. The limited language may not be produced at all or only inappropriately. Fluent speech flows, because speech also can stimulate more speech as suggested in the behavioral analysis of language. The question of syntax emerges only when the child has acquired certain words to be put in order. Children do not learn grammatical morphemes before they learn other forms of verbal behavior. It has been suggested that speakers somehow follow the rules of taking turns and not interrupting the speaker, maintaining eye contact, and maintaining topics of conversation. This approach has been criticized by those who think of language as a tool that people use in social interactions. Anything may be meaningful, but if listeners do not find that meaning, the communication is likely to stop abruptly. Words, phrases, or sentences are linguistic structures containing meaning within them. Anything said may be meaningful. Anything said may be meaningful, but if listeners do not find that meaning, the communication is likely to stop abruptly. One can articulate speech sounds without producing oral language, but one cannot produce oral language without articulating speech sounds. The child with language disorders has difficulty narrating a story. The child did not maintain the topic of conversation, and he introduced a new topic in the middle of another by interrupting the clinician. The child may not maintain a topic of discussion, may interrupt a speaker with irrelevant utterances, and may not take turns in conversation. Complex or unusual forms of sentences may be acquired not at all or very late.
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