Acquired neurologic deficits in young children: a diagnostic journey with Dora

Young children with limited communication abilities are often difficult to diagnose. When a neurologic insult occurs prior to language development, the communication effects tend to be less predictable than when the same event occurs in an older child or in an adult with a history of "normal" language use. Information in the medical chart regarding status during prelinguistic periods for cognition, motor, and verbal function should be helpful in predicting outcomes in some instances, but a series of decisions, over time, are likely to be necessary to reach a definitive communication diagnosis. As children become more verbal, the characteristics of the motor speech system can lead to new or changing diagnoses.