CHARGE syndrome: communication

This page is about how CHARGE syndrome affects the development of children’s communication skills. 

It covers specific features of the condition and their effects, ways to create the right conditions for communication with your child, and a total communication approach. 

There are also links throughout to other pages on this site for more detailed information on many of the topics included here.

On this page:

• Why are communication skills affected in children with CHARGE syndrome? 
• Creating the right conditions for communication
• A total communication approach

Why are communication skills affected in children with CHARGE syndrome? 

CHARGE syndrome is a condition with many features, including:

• Hearing impairment.
• Vision impairment.
• Sensory integration problems – all of our senses working together so that we can function properly in everyday life.
• Executive function difficulties – the mental skills we use to organise and manage tasks in everyday life, and control behaviour. 

As a result, in many children with CHARGE syndrome, their communication skills are affected. This can affect their ability to express themselves and understand others. 

Specifically, communication skills in children with CHARGE can be affected by:

• Varying degrees of hearing loss, depending on their symptoms and whether they can be effectively treated with hearing aids or cochlear implants.
• Sight problems ranging from blurring of images to no perception of light or sight at all.
• Delayed visual maturation. This is seen in newborns who at first don’t seem able to see or follow objects with their eyes. It usually improves by about four to six months of age without treatment, but can sometimes take up to 12 months.
• Difficulty predicting the results of things they do or the effect on others (an executive function difficulty). This can lead to delayed reactions – which don’t always mean they don’t want to communicate. They just need more time.
• Difficulty understanding abstract symbols (symbols that don’t refer to a specific object), if both their sight and hearing are affected.
• Difficulty with intentional communication – for example, not understanding that pointing at a cup might encourage someone to get the cup or start talking about the cup.

Creating the right conditions for communication

Children with CHARGE syndrome need people to respond to them sensitively in a way that is meaningful to them. 

They often have their own way of processing information and how they feel, emotionally and physically, before they respond.

It’s important that they understand they can trust you and others to respond to them. This is essential to developing communication skills.

You can create the right conditions for trust and good communication with your child by:

• Establishing a good relationship with them so that you can learn to recognise their processes and adapt to them. 
• Organising their world by providing a safe physical and social environment.
• Establish routines and predictable ways of doing things so that they feel safe.
• Creating interesting situations that will stimulate them.
• Providing enough one-to-one time.
• Allowing them to take the initiative and bring their own to the conversation.

This content was last reviewed in July 2023. We’ll review it again in 2025.