From the Guidelines
Conversation disorder, also known as functional communication disorder, is characterized by symptoms such as abnormal articulation, prosody, and accent, which cannot be explained by medical conditions, and diagnostic criteria require significant internal inconsistency in performance compared to well-described lesion-based patterns of aphasia, dysgraphia, and alexia. The symptoms of conversation disorder may include language impairments impacting understanding, word finding, syntax, reading, and writing, often along with other functional cognitive symptoms 1. Diagnostic criteria for conversation disorder involve identifying internally inconsistent changes in articulation and prosody, alterations to vowel and consonant production, stress, rhythm, and intonation, which are not compatible with recognized neurological conditions 1.
Key Symptoms
- Abnormal articulation and prosody
- Language impairments impacting understanding, word finding, syntax, reading, and writing
- Internally inconsistent changes in articulation and prosody
- Alterations to vowel and consonant production, stress, rhythm, and intonation
Diagnostic Criteria
- Significant internal inconsistency in performance compared to well-described lesion-based patterns of aphasia, dysgraphia, and alexia
- Internally inconsistent changes in articulation and prosody
- Alterations to vowel and consonant production, stress, rhythm, and intonation
- Symptoms cannot be better explained by another medical or mental disorder
The treatment of conversation disorder involves a multidisciplinary approach, including speech and language therapy, which addresses illness beliefs, self-directed attention, and abnormal movement patterns through education, symptomatic treatment, and cognitive behavioral therapy within a supportive therapeutic environment 1. Speech and language professionals have a key role in the management of people with communication and related symptoms of functional neurological disorder, and these consensus recommendations serve as both a practical toolkit and a starting point for further research into evidence-based treatments.
From the Research
Symptoms of Conversation Disorder
- Difficulty initiating or maintaining conversations
- Struggling to understand social cues, such as tone of voice or body language
- Trouble with verbal or nonverbal communication, including speaking, listening, or interpreting gestures
- Feeling anxious or avoiding social interactions due to communication difficulties
Diagnostic Criteria
- The provided studies do not directly address the diagnostic criteria for conversation disorder 2, 3, 4, 5.
- However, study 4 discusses communication difficulties in adults with intellectual disability, which may be related to conversation disorder.
- According to 4, communication difficulties are prevalent in adults with intellectual disability, with 57.9% of participants experiencing communication difficulties, and 23.5% reporting severe difficulties.
Related Communication Difficulties
- Study 4 found that level of intellectual disability, low social participation, challenging behaviors, and diagnosis of Down syndrome were significantly associated with communication difficulties.
- Study 5 investigated the changes in depression, anxiety, and obsessive-compulsive symptoms during methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD), but did not directly address conversation disorder.
- There is limited research available on conversation disorder, and more studies are needed to establish clear diagnostic criteria and treatment options 2, 3, 4, 5.