Academic Comorbidity and Outcome
Not surprisingly, children with communication disorders, espe-cially language disorders, are academically vulnerable. Bashir and Scavuzzo (1992) suggest that this vulnerability arises fromthe persistence of these disorders in the face of the continuing need for language in school. Even if a language disorder has been remediated, children may have failed in the meantime; and it is immensely hard for many children in many schools to succeed again, once they have failed for any reason. A further complica-tion is the comorbidity of Learning Disorders in these children. Of children with language disorders 50% to 75% will have per-sistent academic problems. They tend to learn less at any given time and learn more slowly than their peers. These children need ongoing comprehensive special educational services and regular re-evaluation of their educational needs.
Children with Phonologic Disorder may also have persistent problems. These are generally less severe than those of language-disordered children, unless both types of disorders are present. Lewis and Fairbairn (1992) reported mild but persistent problems with reading and spelling in individuals with phonologic disorder, even into young adulthood. Subjects tended to improve steadily over time however. Although most of the subjects and all of the ad-olescents and adults were considered normal speakers, they tended to show subtle phonologic problems on specialized tests. Again, children with an associated language disorder fared less well.
The academic and social consequences of these conditions, as well as their psychiatric comorbidities, require the clinician to be sensitive to their presence and diligent in their remediation.