How Speech & Language Issues Can Be Misdiagnosed As Behavioral Problems: Are You Treating The Right Problem?

A toddler who melts down out of nowhere. 

A child who refuses to follow directions. 

A student who acts out during class. 

At first glance, these behaviors can look like defiance, attention-seeking, or even a sign of behavioral disorder, but what if the root cause is not behavioral at all? Instead, they may be struggling with their ability to communicate properly.

Speech and language struggles are often misunderstood in many children, and as a result, these kids are sometimes mislabeled as having behavioral problems. This misinterpretation often results in frustration for the child and their loved ones, as well as a delay in the child getting the right support. This is very unfortunate, as greater progress can be expected from children who have received early support with speech therapy. 

If your child is struggling to communicate, don’t use the wait-and-see approach. The best age to start speech therapy is when you first notice that there are issues. Book an Appointment with one of our highly skilled speech therapists. The first call is free, and after that, people with insurance only pay an average of $18 per session!  

The Overlap Between Communication and Behavior

Communication is at the heart of how children express their needs, regulate their emotions, and interact with others. When those skills are not as strong as they should be, children often act out. 

Communication challenges are common in children, with approximately 1 in 14 (7.2%) children ages 3-17 in the United States having had a disorder related to voice, speech, or language in the last 12 months. Unfortunately, there is also a lot of research that has shown a strong connection between communication skills and behavior. One study notes that language skills play a significant role in a child’s ability to regulate their attention and behavior. In simple terms, children who struggle to understand or use language are more likely to struggle with behavior than their peers who do not have these struggles.

When you break it down, it makes sense that children with these difficulties act out more than someone who does not.

A child who struggles to communicate may not be able to:

• Ask for help
• Explain what's wrong
• Understand instructions
• Express their frustration using words

This can quickly turn into:

• Tantrums
• Withdrawal
• Aggression
• Non-compliance

Despite what onlookers may believe, these behaviors are not intentionally “bad behavior”; they’re often a form of communication for a child who cannot otherwise find the words to express themselves. 

What happens when speech and language disorders go unnoticed?

One of the biggest challenges is that problems with speech and language are not always obvious. Some children may:

• Speak clearly (expressive language) but have trouble understanding language (receptive language)
• Speak in short or simple sentences that appear to be age-appropriate at a glance
• Mask their difficulties with avoidance or humor

Because of this, underlying communication issues can sometimes get overlooked, especially in a busy classroom or clinical setting. Furthermore, one study found that 71% of children who were referred for an underlying mental health disorder actually had an undetected speech or language impairment. 

Common Misdiagnoses for Speech, Language, and Communication Challenges

Speech and language disorders can be mistaken for a range of behavioral or developmental conditions. 

Let’s break down some of the most common misdiagnoses. 

Attention-Deficit/Hyperactivity Disorder (ADHD)

• Children with language difficulties can sometimes appear inattentive or impulsive as they may not understand what's being asked of them. This can be mistaken for ADHD. 

Oppositional Defiant Disorder (ODD)

• A child who doesn't understand what's being asked of them, feels overwhelmed by language demands, or avoids tasks that they struggle with can be labeled as defiant and uncooperative. 

Autism Spectrum Disorder (ASD)

• While communication challenges are common in ASD, not all language delays are ASD. 

Emotional or Behavioral Disorders

• Language delays are strongly linked to emotional and behavioral challenges. Studies have shown that toddlers with language delays often have more emotional and behavioral problems than their peers. This can lead to them being mislabeled as having anxiety or another mental health disorder. 

Why do some children get misdiagnosed, and how can it affect them? 

Misdiagnosing a child with something other than a speech, language, or communication disorder is not typically due to inattention. Instead, it's often the result of symptoms that overlap and systematic gaps. 

Behavior is usually more visible than communication. Behavior gets attention, disrupts the classroom, concerns caregivers, and demands immediate response. On the other hand, communication difficulties can be subtle and harder to detect for those who don't have specialized training. 

Children are not always assessed for their communication skills.  Parents and medical professionals may rely on observed behaviors rather than digging deep to find the underlying cause. 

There are many negative consequences when speech and language challenges are misdiagnosed as behavioral issues. 

• Delayed Intervention - Speech and language disorders are more effectively treated early. Delays can have a negative impact on academic performance, social skills, and long-term outcomes. 
• Increased Frustration - Children who are often misunderstood can become frustrated, which can intensify the behavioral issues. 
• Lower-Self-Esteem - Being repeatedly labeled as “difficult” or “defiant” can cause a child to feel negative about themselves and who they are.

Why Choose Great Speech? 

Finding the right support for your child should not feel overwhelming or out of reach. At Great Speech, we make high-quality virtual speech therapy accessible, personalized, and effective. 

No two children are the same, and their therapy shouldn't be either. We take the time to understand your child’s unique needs and goals. From there, a customized plan is created to target the root of the communication difficulties, not just the behaviors at the surface. 

Schedule a call to get started today!