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Targeted Word Lists for Speech Therapy Practice

The speech therapy word lists are perfect for anyone who needs practice with speech and language concepts . For any type of practice...

...you need words to get started .

Now I don't know about you, but when I need to think of targeted words to use...

...I suffer from spontaneous memory loss , or SML.

It's more common than you might think ;)

This page has words for anyone to practice articulation, apraxia, language, phonology, or stuttering principles . They will help children and adults be successful meeting their goals.

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Each list of articulation sounds contains words with the target sound in the beginning, middle, and end position, including blends when applicable, as well as words that...

are common and functional (words we use all day...everyday)
are mostly 1 syllable (multi-syllabic words are more difficult)
have a phonemic context that don't interfere with production of the target sound (most words)

If "R" is the problem sound using the word "Rope" makes saying the "R" sound harder because the "O" sound is considered a round vowel.

A round vowel is one where you round your lips to say it. Go ahead...try it by saying "O" as in "boat". You rounded your lips didn't you? I thought you might.

Children who have difficulty with the "R" sound tend to say the "W" sound...they say "Wabbit" instead of "Rabbit".

The "W" sound is considered a rounded sound too. Try saying the "W" sound without rounding your lips...you can't because that is how the sound is made.

So by pairing the "R" sound with the "O" sound like in the word "Rope", this makes the word extra difficult for a child who has a problem saying the "R" sound because the "O" that follows the "R" will naturally make them want to round there lips.

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Types of Speech Impediments

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Phynart Studio / Getty Images

Articulation Errors

Ankyloglossia, treating speech disorders.

A speech impediment, also known as a speech disorder , is a condition that can affect a person’s ability to form sounds and words, making their speech difficult to understand.

Speech disorders generally become evident in early childhood, as children start speaking and learning language. While many children initially have trouble with certain sounds and words, most are able to speak easily by the time they are five years old. However, some speech disorders persist. Approximately 5% of children aged three to 17 in the United States experience speech disorders.

There are many different types of speech impediments, including:

Articulation errors

This article explores the causes, symptoms, and treatment of the different types of speech disorders.

Speech impediments that break the flow of speech are known as disfluencies. Stuttering is the most common form of disfluency, however there are other types as well.

Symptoms and Characteristics of Disfluencies

These are some of the characteristics of disfluencies:

Repeating certain phrases, words, or sounds after the age of 4 (For example: “O…orange,” “I like…like orange juice,” “I want…I want orange juice”)
Adding in extra sounds or words into sentences (For example: “We…uh…went to buy…um…orange juice”)
Elongating words (For example: Saying “orange joooose” instead of "orange juice")
Replacing words (For example: “What…Where is the orange juice?”)
Hesitating while speaking (For example: A long pause while thinking)
Pausing mid-speech (For example: Stopping abruptly mid-speech, due to lack of airflow, causing no sounds to come out, leading to a tense pause)

In addition, someone with disfluencies may also experience the following symptoms while speaking:

Vocal tension and strain
Head jerking
Eye blinking
Lip trembling

Causes of Disfluencies

People with disfluencies tend to have neurological differences in areas of the brain that control language processing and coordinate speech, which may be caused by:

Genetic factors
Trauma or infection to the brain
Environmental stressors that cause anxiety or emotional distress
Neurodevelopmental conditions like attention-deficit hyperactivity disorder (ADHD)

Articulation disorders occur when a person has trouble placing their tongue in the correct position to form certain speech sounds. Lisping is the most common type of articulation disorder.

Symptoms and Characteristics of Articulation Errors

These are some of the characteristics of articulation disorders:

Substituting one sound for another . People typically have trouble with ‘r’ and ‘l’ sounds. (For example: Being unable to say “rabbit” and saying “wabbit” instead)
Lisping , which refers specifically to difficulty with ‘s’ and ‘z’ sounds. (For example: Saying “thugar” instead of “sugar” or producing a whistling sound while trying to pronounce these letters)
Omitting sounds (For example: Saying “coo” instead of “school”)
Adding sounds (For example: Saying “pinanio” instead of “piano”)
Making other speech errors that can make it difficult to decipher what the person is saying. For instance, only family members may be able to understand what they’re trying to say.

Causes of Articulation Errors

Articulation errors may be caused by:

Genetic factors, as it can run in families
Hearing loss , as mishearing sounds can affect the person’s ability to reproduce the sound
Changes in the bones or muscles that are needed for speech, including a cleft palate (a hole in the roof of the mouth) and tooth problems
Damage to the nerves or parts of the brain that coordinate speech, caused by conditions such as cerebral palsy , for instance

Ankyloglossia, also known as tongue-tie, is a condition where the person’s tongue is attached to the bottom of their mouth. This can restrict the tongue’s movement and make it hard for the person to move their tongue.

Symptoms and Characteristics of Ankyloglossia

Ankyloglossia is characterized by difficulty pronouncing ‘d,’ ‘n,’ ‘s,’ ‘t,’ ‘th,’ and ‘z’ sounds that require the person’s tongue to touch the roof of their mouth or their upper teeth, as their tongue may not be able to reach there.

Apart from speech impediments, people with ankyloglossia may also experience other symptoms as a result of their tongue-tie. These symptoms include:

Difficulty breastfeeding in newborns
Trouble swallowing
Limited ability to move the tongue from side to side or stick it out
Difficulty with activities like playing wind instruments, licking ice cream, or kissing
Mouth breathing

Causes of Ankyloglossia

Ankyloglossia is a congenital condition, which means it is present from birth. A tissue known as the lingual frenulum attaches the tongue to the base of the mouth. People with ankyloglossia have a shorter lingual frenulum, or it is attached further along their tongue than most people’s.

Dysarthria is a condition where people slur their words because they cannot control the muscles that are required for speech, due to brain, nerve, or organ damage.

Symptoms and Characteristics of Dysarthria

Dysarthria is characterized by:

Slurred, choppy, or robotic speech
Rapid, slow, or soft speech
Breathy, hoarse, or nasal voice

Additionally, someone with dysarthria may also have other symptoms such as difficulty swallowing and inability to move their tongue, lips, or jaw easily.

Causes of Dysarthria

Dysarthria is caused by paralysis or weakness of the speech muscles. The causes of the weakness can vary depending on the type of dysarthria the person has:

Central dysarthria is caused by brain damage. It may be the result of neuromuscular diseases, such as cerebral palsy, Huntington’s disease, multiple sclerosis, muscular dystrophy, Huntington’s disease, Parkinson’s disease, or Lou Gehrig’s disease. Central dysarthria may also be caused by injuries or illnesses that damage the brain, such as dementia, stroke, brain tumor, or traumatic brain injury .
Peripheral dysarthria is caused by damage to the organs involved in speech. It may be caused by congenital structural problems, trauma to the mouth or face, or surgery to the tongue, mouth, head, neck, or voice box.

Apraxia, also known as dyspraxia, verbal apraxia, or apraxia of speech, is a neurological condition that can cause a person to have trouble moving the muscles they need to create sounds or words. The person’s brain knows what they want to say, but is unable to plan and sequence the words accordingly.

Symptoms and Characteristics of Apraxia

These are some of the characteristics of apraxia:

Distorting sounds: The person may have trouble pronouncing certain sounds, particularly vowels, because they may be unable to move their tongue or jaw in the manner required to produce the right sound. Longer or more complex words may be especially harder to manage.
Being inconsistent in their speech: For instance, the person may be able to pronounce a word correctly once, but may not be able to repeat it. Or, they may pronounce it correctly today and differently on another day.
Grasping for words: The person may appear to be searching for the right word or sound, or attempt the pronunciation several times before getting it right.
Making errors with the rhythm or tone of speech: The person may struggle with using tone and inflection to communicate meaning. For instance, they may not stress any of the words in a sentence, have trouble going from one syllable in a word to another, or pause at an inappropriate part of a sentence.

Causes of Apraxia

Apraxia occurs when nerve pathways in the brain are interrupted, which can make it difficult for the brain to send messages to the organs involved in speaking. The causes of these neurological disturbances can vary depending on the type of apraxia the person has:

Childhood apraxia of speech (CAS): This condition is present from birth and is often hereditary. A person may be more likely to have it if a biological relative has a learning disability or communication disorder.
Acquired apraxia of speech (AOS): This condition can occur in adults, due to brain damage as a result of a tumor, head injury , stroke, or other illness that affects the parts of the brain involved in speech.

If you have a speech impediment, or suspect your child might have one, it can be helpful to visit your healthcare provider. Your primary care physician can refer you to a speech-language pathologist, who can evaluate speech, diagnose speech disorders, and recommend treatment options.

The diagnostic process may involve a physical examination as well as psychological, neurological, or hearing tests, in order to confirm the diagnosis and rule out other causes.

Treatment for speech disorders often involves speech therapy, which can help you learn how to move your muscles and position your tongue correctly in order to create specific sounds. It can be quite effective in improving your speech.

Children often grow out of milder speech disorders; however, special education and speech therapy can help with more serious ones.

For ankyloglossia, or tongue-tie, a minor surgery known as a frenectomy can help detach the tongue from the bottom of the mouth.

A Word From Verywell

A speech impediment can make it difficult to pronounce certain sounds, speak clearly, or communicate fluently.

Living with a speech disorder can be frustrating because people may cut you off while you’re speaking, try to finish your sentences, or treat you differently. It can be helpful to talk to your healthcare providers about how to cope with these situations.

You may also benefit from joining a support group, where you can connect with others living with speech disorders.

National Library of Medicine. Speech disorders . Medline Plus.

Centers for Disease Control and Prevention. Language and speech disorders .

Cincinnati Children's Hospital. Stuttering .

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, and language .

Cleveland Clinic. Speech impediment .

Lee H, Sim H, Lee E, Choi D. Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms . J Commun Disord . 2017;65:54-64. doi:10.1016/j.jcomdis.2016.12.001

Nemours Foundation. Speech problems .

Penn Medicine. Speech and language disorders .

Cleveland Clinic. Tongue-tie .

University of Rochester Medical Center. Ankyloglossia .

Cleveland Clinic. Dysarthria .

National Institute on Deafness and Other Communication Disorders. Apraxia of speech .

Cleveland Clinic. Childhood apraxia of speech .

Stanford Children’s Hospital. Speech sound disorders in children .

Abbastabar H, Alizadeh A, Darparesh M, Mohseni S, Roozbeh N. Spatial distribution and the prevalence of speech disorders in the provinces of Iran . J Med Life . 2015;8(Spec Iss 2):99-104.

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Five Common Speech Disorders in Children

You have determined that your child has more than just a speech delay, now what? How do you determine what kind of speech disorder your child has and more importantly, what do you do about it? We have listed below five common speech disorders in children. Of course, we always recommend a visit to your pediatrician if you feel your child has any of these symptoms, and an appointment with an SLP may be necessary to begin an effective speech therapy treatment plan.

5 Common Speech Disorders in Children:

Articulation Disorder: An articulation disorder is a speech sound disorder in which a child has difficulty making certain sounds correctly. Sounds may be omitted or improperly altered during the course of speech. A child may substitute sounds (“wabbit” instead of “rabbit”) or add sounds improperly to words. Young children will typically display articulation issues as they learn to speak, but they are expected to “grow out of it” by a certain age. If the errors persist past a standard developmental age, which varies based on the sound, then that child has an articulation disorder.

The most common articulation disorders are in the form of a “lisp” – when a child does not pronounce the S sound correctly – or when a child cannot pronounce the R sound correctly. He may say “wabbit” instead of “rabbit” or “buhd” or instead of “bird.”

Apraxia of Speech is a communication disorder affecting the motor programming system for speech production. Speech production is difficult – specifically with sequencing and forming sounds. The person may know what he wants to say, but there is a disruption in the part of the brain that sends the signal to the muscle for the movement necessary to produce the sound. That leads to problems with articulation as well as intonation and speaking stress and rhythm errors. Apraxia of Speech can be discovered in childhood (CAS), or might be acquired (AOS) resulting from a brain injury or illness in both children and adults.

Fragile X Syndrome (FXS) is an inherited genetic disorder that is the most common cause of inherited intellectual disabilities in boys as well as autism (about 30% of children with FXS will have autism). It also affects girls, though their symptoms tend to be milder. It is greatly under-recognized and second only to Down syndrome in causing intellectual impairment.

FXS occurs when there is a mutation of FMRI gene and is an inherited disorder. If a child received a pre-mutated X chromosome from one of his parents (as a carrier), then he is at greater risk of developing FXS. Diagnosing Fragile X Syndrome is not easy for parents and doctors at the beginning of a child’s life. Few outward signs are noticeable within the first 9 months. These signs may include an elongated face and protruding eyes.

Intellectual disabilities, speech and language problems, and social anxiety occur most frequently in children with Fragile X. Speech symptoms include repetition of words and phrases, cluttered speech and difficulties with the pragmatics of speech. All of FXS’s symptoms can range from mild to very severe.

Stuttering occurs when speech is disrupted by involuntary repetitions, prolonging of sounds and hesitation or pausing before speech. Stuttering can be developmental, meaning it begins during early speech acquisition, or acquired due to brain trauma. No one knows the exact causes of stuttering in a child. It is considered to have a genetic basis, but the direct link has not yet been found. Children with relatives who stutter are 3 times as likely to develop stuttering. Stuttering is also more typical in children who have congenital disorders like cerebral palsy .

A child who stutters is typically not struggling with the actual production of the sounds—stress and a nervousness trigger many cases of stuttering. Stuttering is variable, meaning if the speaker does not feel anxious when speaking, the stuttering may not affect their speech.

Language disorders can be classified in three different ways: Expressive Language Disorder (ELD), Receptive Language Disorder (RLD) or Expressive-Receptive Language Disorder (ERLD). Children with Expressive Language Disorder do not have problems producing sounds or words, but have an inability to retrieve the right words and formulate proper sentences. Children with Receptive Language Disorder have difficulties comprehending spoken and written language. Finally, children with Expressive-Receptive Language Disorder will exhibit both kinds of symptoms. Grammar is a hard concept for them to understand and they may not use of articles (a, the), prepositions (of, with) and plurals. An early symptom is delay in the early stages of language, so if your child takes longer to formulate words or starting to babble, it can be a sign of ELD.

Children with Receptive Language Disorder may act like they are ignoring you or just repeat words that you say; this is known as “echolalia.” Even when repeating the words you say, they may not understand. An example of this is if you say, “Do you want to go to the park?” and they respond with the exact phrase and do not answer the question. They may not understand you or the fact that you asked them to do something.

Children with Expressive-Receptive Language Disorder can have a mix of these symptoms

These are some of the most common speech disorders in children. No child is the same and you know your child best. If you feel that your child has a speech disorder, contact your pediatrician to discuss treatment options.

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Overcoming Speech Impediment: Symptoms to Treatment

There are many causes and solutions for impaired speech

Types and Symptoms
Speech Therapy
Building Confidence

Speech impediments are conditions that can cause a variety of symptoms, such as an inability to understand language or speak with a stable sense of tone, speed, or fluidity. There are many different types of speech impediments, and they can begin during childhood or develop during adulthood.

Common causes include physical trauma, neurological disorders, or anxiety. If you or your child is experiencing signs of a speech impediment, you need to know that these conditions can be diagnosed and treated with professional speech therapy.

This article will discuss what you can do if you are concerned about a speech impediment and what you can expect during your diagnostic process and therapy.

FG Trade / Getty Images

Types and Symptoms of Speech Impediment

People can have speech problems due to developmental conditions that begin to show symptoms during early childhood or as a result of conditions that may occur during adulthood.

The main classifications of speech impairment are aphasia (difficulty understanding or producing the correct words or phrases) or dysarthria (difficulty enunciating words).

Often, speech problems can be part of neurological or neurodevelopmental disorders that also cause other symptoms, such as multiple sclerosis (MS) or autism spectrum disorder .

There are several different symptoms of speech impediments, and you may experience one or more.

Can Symptoms Worsen?

Most speech disorders cause persistent symptoms and can temporarily get worse when you are tired, anxious, or sick.

Symptoms of dysarthria can include:

Slurred speech
Slow speech
Choppy speech
Hesitant speech
Inability to control the volume of your speech
Shaking or tremulous speech pattern
Inability to pronounce certain sounds

Symptoms of aphasia may involve:

Speech apraxia (difficulty coordinating speech)
Difficulty understanding the meaning of what other people are saying
Inability to use the correct words
Inability to repeat words or phases
Speech that has an irregular rhythm

You can have one or more of these speech patterns as part of your speech impediment, and their combination and frequency will help determine the type and cause of your speech problem.

Causes of Speech Impediment

The conditions that cause speech impediments can include developmental problems that are present from birth, neurological diseases such as Parkinson’s disease , or sudden neurological events, such as a stroke .

Some people can also experience temporary speech impairment due to anxiety, intoxication, medication side effects, postictal state (the time immediately after a seizure), or a change of consciousness.

Speech Impairment in Children

Children can have speech disorders associated with neurodevelopmental problems, which can interfere with speech development. Some childhood neurological or neurodevelopmental disorders may cause a regression (backsliding) of speech skills.

Common causes of childhood speech impediments include:

Autism spectrum disorder : A neurodevelopmental disorder that affects social and interactive development
Cerebral palsy : A congenital (from birth) disorder that affects learning and control of physical movement
Hearing loss : Can affect the way children hear and imitate speech
Rett syndrome : A genetic neurodevelopmental condition that causes regression of physical and social skills beginning during the early school-age years.
Adrenoleukodystrophy : A genetic disorder that causes a decline in motor and cognitive skills beginning during early childhood
Childhood metabolic disorders : A group of conditions that affects the way children break down nutrients, often resulting in toxic damage to organs
Brain tumor : A growth that may damage areas of the brain, including those that control speech or language
Encephalitis : Brain inflammation or infection that may affect the way regions in the brain function
Hydrocephalus : Excess fluid within the skull, which may develop after brain surgery and can cause brain damage

Do Childhood Speech Disorders Persist?

Speech disorders during childhood can have persistent effects throughout life. Therapy can often help improve speech skills.

Speech Impairment in Adulthood

Adult speech disorders develop due to conditions that damage the speech areas of the brain.

Common causes of adult speech impairment include:

Head trauma
Nerve injury
Throat tumor
Stroke
Parkinson’s disease
Essential tremor
Brain tumor
Brain infection

Additionally, people may develop changes in speech with advancing age, even without a specific neurological cause. This can happen due to presbyphonia , which is a change in the volume and control of speech due to declining hormone levels and reduced elasticity and movement of the vocal cords.

Do Speech Disorders Resolve on Their Own?

Children and adults who have persistent speech disorders are unlikely to experience spontaneous improvement without therapy and should seek professional attention.

Steps to Treating Speech Impediment

If you or your child has a speech impediment, your healthcare providers will work to diagnose the type of speech impediment as well as the underlying condition that caused it. Defining the cause and type of speech impediment will help determine your prognosis and treatment plan.

Sometimes the cause is known before symptoms begin, as is the case with trauma or MS. Impaired speech may first be a symptom of a condition, such as a stroke that causes aphasia as the primary symptom.

The diagnosis will include a comprehensive medical history, physical examination, and a thorough evaluation of speech and language. Diagnostic testing is directed by the medical history and clinical evaluation.

Diagnostic testing may include:

Brain imaging , such as brain computerized tomography (CT) or magnetic residence imaging (MRI), if there’s concern about a disease process in the brain
Swallowing evaluation if there’s concern about dysfunction of the muscles in the throat
Electromyography (EMG) and nerve conduction studies (aka nerve conduction velocity, or NCV) if there’s concern about nerve and muscle damage
Blood tests, which can help in diagnosing inflammatory disorders or infections

Your diagnostic tests will help pinpoint the cause of your speech problem. Your treatment will include specific therapy to help improve your speech, as well as medication or other interventions to treat the underlying disorder.

For example, if you are diagnosed with MS, you would likely receive disease-modifying therapy to help prevent MS progression. And if you are diagnosed with a brain tumor, you may need surgery, chemotherapy, or radiation to treat the tumor.

Therapy to Address Speech Impediment

Therapy for speech impairment is interactive and directed by a specialist who is experienced in treating speech problems . Sometimes, children receive speech therapy as part of a specialized learning program at school.

The duration and frequency of your speech therapy program depend on the underlying cause of your impediment, your improvement, and approval from your health insurance.

If you or your child has a serious speech problem, you may qualify for speech therapy. Working with your therapist can help you build confidence, particularly as you begin to see improvement.

Exercises during speech therapy may include:

Pronouncing individual sounds, such as la la la or da da da
Practicing pronunciation of words that you have trouble pronouncing
Adjusting the rate or volume of your speech
Mouth exercises
Practicing language skills by naming objects or repeating what the therapist is saying

These therapies are meant to help achieve more fluent and understandable speech as well as an increased comfort level with speech and language.

Building Confidence With Speech Problems

Some types of speech impairment might not qualify for therapy. If you have speech difficulties due to anxiety or a social phobia or if you don’t have access to therapy, you might benefit from activities that can help you practice your speech.

You might consider one or more of the following for you or your child:

Joining a local theater group
Volunteering in a school or community activity that involves interaction with the public
Signing up for a class that requires a significant amount of class participation
Joining a support group for people who have problems with speech

Activities that you do on your own to improve your confidence with speaking can be most beneficial when you are in a non-judgmental and safe space.

Many different types of speech problems can affect children and adults. Some of these are congenital (present from birth), while others are acquired due to health conditions, medication side effects, substances, or mood and anxiety disorders. Because there are so many different types of speech problems, seeking a medical diagnosis so you can get the right therapy for your specific disorder is crucial.

Centers for Disease Control and Prevention. Language and speech disorders in children .

Han C, Tang J, Tang B, et al. The effectiveness and safety of noninvasive brain stimulation technology combined with speech training on aphasia after stroke: a systematic review and meta-analysis . Medicine (Baltimore). 2024;103(2):e36880. doi:10.1097/MD.0000000000036880

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, language .

Mackey J, McCulloch H, Scheiner G, et al. Speech pathologists' perspectives on the use of augmentative and alternative communication devices with people with acquired brain injury and reflections from lived experience . Brain Impair. 2023;24(2):168-184. doi:10.1017/BrImp.2023.9

Allison KM, Doherty KM. Relation of speech-language profile and communication modality to participation of children with cerebral palsy . Am J Speech Lang Pathol . 2024:1-11. doi:10.1044/2023_AJSLP-23-00267

Saccente-Kennedy B, Gillies F, Desjardins M, et al. A systematic review of speech-language pathology interventions for presbyphonia using the rehabilitation treatment specification system . J Voice. 2024:S0892-1997(23)00396-X. doi:10.1016/j.jvoice.2023.12.010

By Heidi Moawad, MD Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.

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R Word List Speech Therapy Materials

If your child is having trouble saying the sound R, my R Word List page can help you!

If you are a speech therapist and you need some R speech therapy materials, you have come to the right place!

Below you will find lots of free materials!

First, there is a FREE worksheet (for non-members) and link (for members) to access new articulation materials.
Second, there is a word list for quick viewing .
Next, you can sign up for a FREE newsletter and receive A LL THE WORD LISTS in one Folder in your Google Drive.
After that, check out a brief explanation on how to say the target sound.
Last, there are ideas for articulation practice that do not require flashcards or word lists. This is the most functional option and appropriate for children working on generalization.

If you need a more in-depth explanation of R and how to say:

prevocalic R

R Worksheets and More!

We have BRAND-NEW articulation worksheets for teaching, drill practice, generalization, and language based articulation games!

If you are a member, log in, download, and you are ready to roll here.
If you want to join, sign up here.

Just fill out the form below to grab your free worksheet!

21 free smashmats.

R Word List

Google Drive Word List

I LOVE, LOVE, LOVE Google Drive. I can access my word lists from any device; laptop, desktop, or phone.

If you want a copy, fill out the form above. I put all the word lists in one folder. Once you receive your email with the materials, make a copy of the files and they are yours to use and tweak as needed.

If you need help saving the word lists to your Google Drive, click here: Save Google Document
If you LOVE Google Drive as much as I do, check out our Speech Therapy Documentation Page.

R Packet Using High-Frequency Words

This is MY FAVORITE NEW RESOURCE! I HONESTLY use it all the time for each articulation session and handouts for home practice.

The words chosen for speech therapy can make all the difference between a good therapy program and a great one! For the generalization phase, it is crucial to use high-frequency words!! It only makes sense to use words that the client will actually say outside of the therapy room. Right?!

For only $5, you will receive 35 pages of materials including:

Flashcards that can be used as Cariboo Cards too, yeah!
Flashcard free games that can be used as home practice
Dot sheets, smash-mats, and/or coloring pages
Articulation warm-up sheets which can be used as a goal review sheet
Flashcards which contain word, phrase, and sentence level practice
Cut/paste sentence level worksheets
Self-assessment sheets
Parent handouts

Articulation Games for R

The R sound is a later developing sound, usually mastered by age 5. R is also one of the hardest sounds to master in ANY language!

Take turns with your child saying the desired words. It is important to practice hearing and saying the words.

Write - Say “write” as you take turns drawing on a piece of paper
Race - Say “race” as you and your child run across the yard
Ready - Say “ready” before you start your race
Read - Say “read” as your child reads a sentence in a book
Fork - Say “fork” during meals
Shirt - Say “shirt” as your child helps you with the laundry
Sorry - Say “sorry” while playing the board game, Sorry
Car - While talking about your favorite car, say “car”
Hair - Say “hair” while your child combs her hair
Wear - Say “I’m wearing” while describing what clothes you are wearing

Membership Site

If you are a parent and your child

has trouble saying multiple sounds
needs to work on vocabulary development
is working on improving grammar
is working on narrative structure
needs to work on social skills

AND you want

a step-by-step guide to help your child
ideas on how to improve all language skills at home
functional games

Then, our members site might be just what you need.

If you are a professional and you want:

Articulation Screening Tools
Data tracking sheets
Templates in Google Drive for easy data tracking and graphing
Homework sheets/parent handouts on articulation therapy
General flashcard games
36 flashcards for each sound: B, D, F, G, J, K, L, M, N, P, R, S, T, V, Z, SH, TH, CH
8-10 functional games for each sound
Language based worksheets to spice things up!
Picture description tasks
Short story stimuli

Our membership might be just what you need.

Example of Vocalic R Materials

When teaching prevocalic and vocalic R, we need the right cues and teaching materials. I added the new materials to the membership site.

Animated Cue Cards

animated cue cards for OR, AR, IRE, EAR, EAR, ER, AND RL
Great for teaching and providing the specific feedback each child needs (not too much or too little)

Printable Cue Cards

Printable cue cards for OR, AR, IRE, EAR, EAR, ER, AND RL
These are great handouts and help to keep all caregivers on the same page!

Teaching Material

visual cues for how to combine the vowel to R
use for teaching phase and review as needed

Specific Vocalic R Warm Up

Warm-Up for: OR, AR, IRE, EAR, EAR, ER, AND RL
Use for goal review, anatomy review, and to "warm up" muscles
plus get quick drill practice

Prevocalic & Vocalic R Practice

If a child can either say the prevocalic R but not the vocalic R (and vice versa), you can use that!
Use phonetic placement to facilitate the needed R.
I LOVE THESE!

New Print and No-Print Materials

web memory game
no-print flashcards
print flashcards
leveled flashcards
Word Lists For Speech Therapy
R Word List For Articulation Practice

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Speech Sound Disorders

On this page:

About Speech Sound Disorders

Signs and symptoms of speech sound disorders, causes of speech sound disorders, seeing a professional, other resources.

Children may say some sounds the wrong way as they learn to talk. They learn some sounds earlier, like p, m, or w. Other sounds take longer to learn, like z, v, or th. Most children can say almost all speech sounds correctly by 4 years old. A child who does not say sounds by the expected ages may have a speech sound disorder. You may hear the terms "articulation disorder" and "phonological disorder" to describe speech sound disorders like this.

To learn more about what you should expect your child to be able to say, see these two resources:

ASHA's Communication and Feeding Milestones: Birth to 5 Years
Your Child's Communication Development: Kindergarten Through Fifth Grade

Adults can also have speech sound disorders. Some adults have problems that started when they were children. Others may have speech problems after a stroke or traumatic brain injury . To learn more about adult speech disorders after a stroke or traumatic brain injury, see apraxia of speech in adults and dysarthria .

Your child may substitute one sound for another, leave sounds out, add sounds, or change a sound. It can be hard for others to understand them.

It is normal for young children to say the wrong sounds sometimes. For example, your child may make a "w" sound for an "r" and say "wabbit" for "rabbit." They may leave sounds out of words, such as "nana" for "banana." This is okay when they are young. It may be a problem if they keep making these mistakes as they get older.

You and your child may also sound different because you have an accent or dialect. This is not a speech sound disorder.

The chart below shows the ages when most English-speaking children develop sounds. Children learning more than one language may develop some sounds earlier or later.

	Makes cooing sounds
	Laughs and makes playful sounds
	Makes speech-like babbling sounds like
	Babbles longer strings of sounds like
	Says and in words Familiar people understand the child's speech
	Says and in words May still make mistakes on the and sounds Most people understand the child’s speech

Many children learn to say speech sounds over time, but some do not. You may not know why your child has problems speaking.

Some children have speech problems because the brain has trouble sending messages to the speech muscles telling them how and when to move. This is called apraxia. Childhood apraxia of speech is not common but will cause speech problems.

Some children have speech problems because the muscles needed to make speech sounds are weak. This is called dysarthria .

Your child may have speech problems if he has

a developmental disorder, like autism;
a genetic syndrome, like Down syndrome;
hearing loss, from ear infections or other causes; or
brain damage, like cerebral palsy or a head injury.

Adults can also have speech sound disorders. Some adults have problems that started when they were children. Others may develop speech problems after a stroke or traumatic brain injury , or other trauma. To learn more about adult speech disorders, see apraxia of speech in adults , dysarthria , laryngeal cancer , and oral cancer .

Testing for Speech Sound Disorders

A speech-language pathologist, or SLP, can test your child's speech. The SLP will listen to your child to hear how they say sounds. The SLP also will look at how your child moves their lips, jaw, and tongue. The SLP may also test your child’s language skills. Many children with speech sound disorders also have language disorders. For example, your child may have trouble following directions or telling stories.

It is important to have your child’s hearing checked to make sure they do not have a hearing loss. A child with a hearing loss may have more trouble learning to talk.

The SLP can also help decide if you have a speech problem or speak with an accent. An accent is the unique way that groups of people sound. Accents are NOT a speech or language disorder.

Treatment for Speech Sound Disorders

SLPs can help you or your child say sounds correctly and clearly. Treatment may include the following:

Learning the correct way to make sounds
Learning to tell when sounds are right or wrong
Practicing sounds in different words
Practicing sounds in longer sentences

See ASHA information for professionals on the Practice Portal’s Speech Sound Disorders page.

Identify the Signs
Typical Speech and Language Development

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10 Most Common Speech-Language Disorders & Impediments

As you get to know more about the field of speech-language pathology you’ll increasingly realize why SLPs are required to earn at least a master’s degree . This stuff is serious – and there’s nothing easy about it.

In 2016 the National Institute on Deafness and Other Communication Disorders reported that 7.7% of American children have been diagnosed with a speech or swallowing disorder. That comes out to nearly one in 12 children, and gets even bigger if you factor in adults.

Whether rooted in psycho-speech behavioral issues, muscular disorders, or brain damage, nearly all the diagnoses SLPs make fall within just 10 common categories…

Types of Speech Disorders & Impediments

Apraxia of speech (aos).

Apraxia of Speech (AOS) happens when the neural pathway between the brain and a person’s speech function (speech muscles) is lost or obscured. The person knows what they want to say – they can even write what they want to say on paper – however the brain is unable to send the correct messages so that speech muscles can articulate what they want to say, even though the speech muscles themselves work just fine. Many SLPs specialize in the treatment of Apraxia .

There are different levels of severity of AOS, ranging from mostly functional, to speech that is incoherent. And right now we know for certain it can be caused by brain damage, such as in an adult who has a stroke. This is called Acquired AOS.

However the scientific and medical community has been unable to detect brain damage – or even differences – in children who are born with this disorder, making the causes of Childhood AOS somewhat of a mystery. There is often a correlation present, with close family members suffering from learning or communication disorders, suggesting there may be a genetic link.

Mild cases might be harder to diagnose, especially in children where multiple unknown speech disorders may be present. Symptoms of mild forms of AOS are shared by a range of different speech disorders, and include mispronunciation of words and irregularities in tone, rhythm, or emphasis (prosody).

Stuttering – Stammering

Stuttering, also referred to as stammering, is so common that everyone knows what it sounds like and can easily recognize it. Everyone has probably had moments of stuttering at least once in their life. The National Institute on Deafness and Other Communication Disorders estimates that three million Americans stutter, and reports that of the up-to-10-percent of children who do stutter, three-quarters of them will outgrow it. It should not be confused with cluttering.

Most people don’t know that stuttering can also include non-verbal involuntary or semi-voluntary actions like blinking or abdominal tensing (tics). Speech language pathologists are trained to look for all the symptoms of stuttering , especially the non-verbal ones, and that is why an SLP is qualified to make a stuttering diagnosis.

The earliest this fluency disorder can become apparent is when a child is learning to talk. It may also surface later during childhood. Rarely if ever has it developed in adults, although many adults have kept a stutter from childhood.

Stuttering only becomes a problem when it has an impact on daily activities, or when it causes concern to parents or the child suffering from it. In some people, a stutter is triggered by certain events like talking on the phone. When people start to avoid specific activities so as not to trigger their stutter, this is a sure sign that the stutter has reached the level of a speech disorder.

The causes of stuttering are mostly a mystery. There is a correlation with family history indicating a genetic link. Another theory is that a stutter is a form of involuntary or semi-voluntary tic. Most studies of stuttering agree there are many factors involved.

Dysarthria is a symptom of nerve or muscle damage. It manifests itself as slurred speech, slowed speech, limited tongue, jaw, or lip movement, abnormal rhythm and pitch when speaking, changes in voice quality, difficulty articulating, labored speech, and other related symptoms.

It is caused by muscle damage, or nerve damage to the muscles involved in the process of speaking such as the diaphragm, lips, tongue, and vocal chords.

Because it is a symptom of nerve and/or muscle damage it can be caused by a wide range of phenomena that affect people of all ages. This can start during development in the womb or shortly after birth as a result of conditions like muscular dystrophy and cerebral palsy. In adults some of the most common causes of dysarthria are stroke, tumors, and MS.

A lay term, lisping can be recognized by anyone and is very common.

Speech language pathologists provide an extra level of expertise when treating patients with lisping disorders . They can make sure that a lisp is not being confused with another type of disorder such as apraxia, aphasia, impaired development of expressive language, or a speech impediment caused by hearing loss.

SLPs are also important in distinguishing between the five different types of lisps. Most laypersons can usually pick out the most common type, the interdental/dentalised lisp. This is when a speaker makes a “th” sound when trying to make the “s” sound. It is caused by the tongue reaching past or touching the front teeth.

Because lisps are functional speech disorders, SLPs can play a huge role in correcting these with results often being a complete elimination of the lisp. Treatment is particularly effective when implemented early, although adults can also benefit.

Experts recommend professional SLP intervention if a child has reached the age of four and still has an interdental/dentalised lisp. SLP intervention is recommended as soon as possible for all other types of lisps. Treatment includes pronunciation and annunciation coaching, re-teaching how a sound or word is supposed to be pronounced, practice in front of a mirror, and speech-muscle strengthening that can be as simple as drinking out of a straw.

Spasmodic Dysphonia

Spasmodic Dysphonia (SD) is a chronic long-term disorder that affects the voice. It is characterized by a spasming of the vocal chords when a person attempts to speak and results in a voice that can be described as shaky, hoarse, groaning, tight, or jittery. It can cause the emphasis of speech to vary considerably. Many SLPs specialize in the treatment of Spasmodic Dysphonia .

SLPs will most often encounter this disorder in adults, with the first symptoms usually occurring between the ages of 30 and 50. It can be caused by a range of things mostly related to aging, such as nervous system changes and muscle tone disorders.

It’s difficult to isolate vocal chord spasms as being responsible for a shaky or trembly voice, so diagnosing SD is a team effort for SLPs that also involves an ear, nose, and throat doctor (otolaryngologist) and a neurologist.

Have you ever heard people talking about how they are smart but also nervous in large groups of people, and then self-diagnose themselves as having Asperger’s? You might have heard a similar lay diagnosis for cluttering. This is an indication of how common this disorder is as well as how crucial SLPs are in making a proper cluttering diagnosis .

A fluency disorder, cluttering is characterized by a person’s speech being too rapid, too jerky, or both. To qualify as cluttering, the person’s speech must also have excessive amounts of “well,” “um,” “like,” “hmm,” or “so,” (speech disfluencies), an excessive exclusion or collapsing of syllables, or abnormal syllable stresses or rhythms.

The first symptoms of this disorder appear in childhood. Like other fluency disorders, SLPs can have a huge impact on improving or eliminating cluttering. Intervention is most effective early on in life, however adults can also benefit from working with an SLP.

Muteness – Selective Mutism

There are different kinds of mutism, and here we are talking about selective mutism. This used to be called elective mutism to emphasize its difference from disorders that caused mutism through damage to, or irregularities in, the speech process.

Selective mutism is when a person does not speak in some or most situations, however that person is physically capable of speaking. It most often occurs in children, and is commonly exemplified by a child speaking at home but not at school.

Selective mutism is related to psychology. It appears in children who are very shy, who have an anxiety disorder, or who are going through a period of social withdrawal or isolation. These psychological factors have their own origins and should be dealt with through counseling or another type of psychological intervention.

Diagnosing selective mutism involves a team of professionals including SLPs, pediatricians, psychologists, and psychiatrists. SLPs play an important role in this process because there are speech language disorders that can have the same effect as selective muteness – stuttering, aphasia, apraxia of speech, or dysarthria – and it’s important to eliminate these as possibilities.

And just because selective mutism is primarily a psychological phenomenon, that doesn’t mean SLPs can’t do anything. Quite the contrary.

The National Institute on Neurological Disorders and Stroke estimates that one million Americans have some form of aphasia.

Aphasia is a communication disorder caused by damage to the brain’s language capabilities. Aphasia differs from apraxia of speech and dysarthria in that it solely pertains to the brain’s speech and language center.

As such anyone can suffer from aphasia because brain damage can be caused by a number of factors. However SLPs are most likely to encounter aphasia in adults, especially those who have had a stroke. Other common causes of aphasia are brain tumors, traumatic brain injuries, and degenerative brain diseases.

In addition to neurologists, speech language pathologists have an important role in diagnosing aphasia. As an SLP you’ll assess factors such as a person’s reading and writing, functional communication, auditory comprehension, and verbal expression.

Speech Delay – Alalia

A speech delay, known to professionals as alalia, refers to the phenomenon when a child is not making normal attempts to verbally communicate. There can be a number of factors causing this to happen, and that’s why it’s critical for a speech language pathologist to be involved.

The are many potential reasons why a child would not be using age-appropriate communication. These can range anywhere from the child being a “late bloomer” – the child just takes a bit longer than average to speak – to the child having brain damage. It is the role of an SLP to go through a process of elimination, evaluating each possibility that could cause a speech delay, until an explanation is found.

Approaching a child with a speech delay starts by distinguishing among the two main categories an SLP will evaluate: speech and language.

Speech has a lot to do with the organs of speech – the tongue, mouth, and vocal chords – as well as the muscles and nerves that connect them with the brain. Disorders like apraxia of speech and dysarthria are two examples that affect the nerve connections and organs of speech. Other examples in this category could include a cleft palette or even hearing loss.

The other major category SLPs will evaluate is language. This relates more to the brain and can be affected by brain damage or developmental disorders like autism. There are many different types of brain damage that each manifest themselves differently, as well as developmental disorders, and the SLP will make evaluations for everything.

Issues Related to Autism

While the autism spectrum itself isn’t a speech disorder, it makes this list because the two go hand-in-hand more often than not.

The Centers for Disease Control and Prevention (CDC) reports that one out of every 68 children in our country have an autism spectrum disorder. And by definition, all children who have autism also have social communication problems.

Speech-language pathologists are often a critical voice on a team of professionals – also including pediatricians, occupational therapists, neurologists, developmental specialists, and physical therapists – who make an autism spectrum diagnosis .

In fact, the American Speech-Language Hearing Association reports that problems with communication are the first detectable signs of autism. That is why language disorders – specifically disordered verbal and nonverbal communication – are one of the primary diagnostic criteria for autism.

So what kinds of SLP disorders are you likely to encounter with someone on the autism spectrum?

A big one is apraxia of speech. A study that came out of Penn State in 2015 found that 64 percent of children who were diagnosed with autism also had childhood apraxia of speech.

This basic primer on the most common speech disorders offers little more than an interesting glimpse into the kind of issues that SLPs work with patients to resolve. But even knowing everything there is to know about communication science and speech disorders doesn’t tell the whole story of what this profession is all about. With every client in every therapy session, the goal is always to have the folks that come to you for help leave with a little more confidence than when they walked in the door that day. As a trusted SLP, you will build on those gains with every session, helping clients experience the joy and freedom that comes with the ability to express themselves freely. At the end of the day, this is what being an SLP is all about.

Ready to make a difference in speech pathology? Learn how to become a Speech-Language Pathologist today

Emerson College - Master's in Speech-Language Pathology online - Prepare to become an SLP in as few as 20 months. No GRE required. Scholarships available.
NYU Steinhardt - NYU Steinhardt's Master of Science in Communicative Sciences and Disorders online - ASHA-accredited. Bachelor's degree required. Graduate prepared to pursue licensure.
Arizona State University - Online - Online Bachelor of Science in Speech and Hearing Science - Designed to prepare graduates to work in behavioral health settings or transition to graduate programs in speech-language pathology and audiology.

Second Opinion

Speech Sound Disorders in Children

What are speech sound disorders in children?

It’s normal for young children learning language skills to have some trouble saying words the right way. That’s part of the learning process. Their speech skills develop over time. They master certain sounds and words at each age. By age 8, most children have learned how to master all word sounds.

But some children have speech sound disorders. This means they have trouble saying certain sounds and words past the expected age. This can make it hard to understand what a child is trying to say.

Speech sound problems include articulation disorder and phonological process disorder.

Articulation disorder is a problem with making certain sounds, such as “sh.”

Phonological process disorder is a pattern of sound mistakes. This includes not pronouncing certain letters.

What causes speech sound disorders in a child?

Often, a speech sound disorder has no known cause. But some speech sound errors may be caused by:

Injury to the brain

Thinking or development disability

Problems with hearing or hearing loss, such as past ear infections

Physical problems that affect speech, such cleft palate or cleft lip

Disorders affecting the nerves involved in speech

Which children are at risk for speech sound disorders?

The cause often is not known, but children at risk for a speech sound disorder include those with:

Developmental disorders such as autism

Genetic disorders such as Down syndrome

Hearing loss

Nervous system disorders such as cerebral palsy

Illnesses such as frequent ear infections

Physical problems such as a cleft lip or palate

Too much thumb-sucking or pacifier use

Low education level of the parent

Lack of support for learning in the home

What are the symptoms of speech sound disorders in a child?

Your child’s symptoms depend on what type of speech sound disorder your child has. He or she may have trouble forming some word sounds correctly past a certain age. This is called articulation disorder. Your child may drop, add, distort, or swap word sounds. Keep in mind that some sound changes may be part of an accent. They are not speech errors. Signs of this problem can include:

Leaving off sounds from words (example: saying “coo” instead of “school”)

Adding sounds to words (example: saying “puhlay” instead of “play”)

Distorting sounds in words (example: saying “thith” instead of “this”)

Swapping sounds in words (example: saying “wadio” instead of “radio”)

If your child often makes certain word speech mistakes, he or she may have phonological process disorder. The mistakes may be common in young children learning speech skills. But when they last past a certain age, it may be a disorder. Signs of this problem are:

Saying only 1 syllable in a word (example: “bay” instead of “baby”)

Simplifying a word by repeating 2 syllables (example: “baba” instead of “bottle”)

Leaving out a consonant sound (example: “at” or “ba” instead of “bat”)

Changing certain consonant sounds (example: “tat” instead of “cat”)

How are speech sound disorders diagnosed in a child?

First, your child’s healthcare provider will check his or her hearing. This is to make sure that your child isn’t simply hearing words and sounds incorrectly.

If your child’s healthcare provider rules out hearing loss, you may want to talk with a speech-language pathologist. This is a speech expert who evaluates and treats children who are having problems with speech-language and communication.

By watching and listening to your child speak, a speech-language pathologist can determine whether your child has a speech sound disorder. The pathologist will evaluate your child’s speech and language skills. He or she will keep in mind accents and dialect. He or she can also find out if a physical problem in the mouth is affecting your child’s ability to speak. Finding the problem and getting help early are important to treat speech sound disorders.

How are speech sound disorders treated in a child?

The speech-language pathologist can put together a therapy plan to help your child with his or her disorder. These healthcare providers work with children to help them:

Notice and fix sounds that they are making wrong

Learn how to correctly form their problem sound

Practice saying certain words and making certain sounds

The pathologist can also give you activities and strategies to help your child practice at home. If your child has a physical problem in the mouth, the pathologist can refer your child to an ear, nose, throat healthcare provider or orthodontist if needed.

Spotting a speech sound disorder early can help your child overcome any speech problems. He or she can learn how to speak well and comfortably.

How can I help my child live with a speech sound disorder?

You can do things to take care of your child with a speech sound disorder:

Keep all appointments with your child’s healthcare provider.

Talk with your healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include experts such as speech-language pathologists and counselors. Your child’s care team will depend on your child’s needs and the severity of the speech sound disorder.

Tell others of your child’s disorder. Work with your child’s healthcare provider and schools to develop a treatment plan.

Reach out for support from local community services. Being in touch with other parents who have a child with a speech sound disorder may be helpful.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child has:

Symptoms that don’t get better, or get worse

New symptoms

Key points about speech sound disorders in children

A speech sound disorder means a child has trouble saying certain sounds and words past the expected age.

A child with an articulation disorder has problems making certain sounds the right way.

A child with phonological process disorder regularly makes certain word speech mistakes.

The cause of this problem is often unknown.

A speech-language pathologist can help diagnose and treat a speech sound disorder.

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child’s condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Fluency Disorder

Age-Appropriate Speech and Language Milestones
Communication Disorders in Children

Rhotacism: A complete guide to this speech impediment

Remember when you were a child and spoke by making your “R’s” sound like “W’s” and everything thought it was cute? That’s known as rhotacism and some people live with it even as adults. What is rhotacism, what is it like in other languages, and what are its symptoms? What does it look like as a speech impediment and what are some examples? What are its causes? How does it affect the brain ? Is it curable and how can it be fixed? This article will answer all your doubts about rhotacism.

What is rhotacism?

Rhotacism is a speech impediment that is defined by the lack of ability, or difficulty in, pronouncing the sound R . Some speech pathologists, those who work with speech impediments may call this impediment de-rhotacization because the sounds don’t become rhotic, rather they lose their rhotic quality. It could also be called a residual R error.

It’s not such an uncommon phenomenon and actually also happens with the letter L , a phenomenon known as lambdacism . Sometimes people mistake these speech impediments for a lisp, of which they are not. Within the 2000-2001 school year, more than 700,000 students within the American public school system were categorized as having either a language impediment or a speech impediment. Ironically, all three speech impediments contain the troubled letter within them.

The word rhotacism comes from the New Latin rhotacism meaning peculiar or excessive use of [r]. The Latin word came from Ancient Greek word rhōtakismós which means to incorrectly use “rho” which is the equivalent of the Greek R. For language nerds, here’s a really great explanation of how the word came into being.

How does rhotacism work in different languages?

Rhotacism is, in theory , more common among people whose native language has a trilled R. For example, in Spanish the “rr” is a trilled R. Other languages with a trilled R include Bulgarian, Hungarian, Arabic, Finnish, Romanian, Indonesian, Russian , Italian, and most Swedish speakers. Some people might mock Asians, specifically Chinese, for not being able to pronounce the English word “broccoli” correctly- rather pronouncing it “browccoli”. This isn’t due to a rhotacism, however. It’s actually due to the fact that Mandarin (Chinese) words can have an “r” sound in the beginning of a word, but not in the middle or end of a word. This leads them to have issues in their phonotactics and creates an inability to pronounce the English “R” in the middle of words.

The leader of Hezbollah, Hasan Nasrallah, is a Lebanese leader and is mocked for his rhotacism when he says, “ Amwīka ” and “ Iswā’īl ” for the Arabic Amrīka (America), and Isrā’īl (Israel). He is a native Arabic speaker- a language which has the trilled R. Notice how he puts a W sound in those two words where the R sound usually is.

Symptoms of rhotacism

Some people try to hide their impediment by avoiding words with R ’s in them.
An overall inability to say R sounds
Using trilled R’s or guttural R’s (such as the French R) when trying to pronounce the regular English R.

Rhotacism as a speech impediment

Using a strict classification, only about 5%-10% of the human population speaks in a completely normal way. Everyone else suffers from some type of speech disorder or another. For children of any language, the R sounds are usually the hardest to master and often end up being the last ones a child learns. That’s why baby talk if you think about it, doesn’t really use explicit or strong R sounds. In English, rhotacism often comes off as a W sound which is why “Roger Rabbit” sounds like “Woger Wabbit”. R is often more difficult because a child has to learn the different combination of the /r/ sounds, not just the letter itself, unlike other letters. For example, when it comes before and after vowel sounds. The combination of a vowel with the /r/ sound is called a phenome and in English, there are eight combinations of these:

– The prevocalic R , such as “rain”

– The RL , such as “girl”

– The IRE, such as “tire”

– The AR, such as “car”

– The EAR , “such as “beer”

– The OR , such as “seashore”

– The ER , such as “butter”

– The AIR , such as “software”

A speech impediment is a speech disorder , not a language disorder . Speech disorders are problems in being able to produce the sounds of speech whereas language disorders are problems with understanding and/or being able to use words. Language disorders, unlike speech disorders, have nothing to do with speech production.

Often what happens is that the person speaking isn’t tensing their tongue enough, or not moving their tongue correctly (up and backward depending on the dialect) which makes the W or “uh” sound come out. It may also be that the person is moving their lips instead of their tongue.

Examples of rhotacism

Barry Kripke from the TV show The Big Bang Theory has both rhotacism and lambdacism- meaning he has issues pronouncing both his R ’s and his L ’s.
The most famous of rhotacism would be Elmer Fudd from Looney Tunes . He pronounces the word “rabbit” [ˈɹ̠ʷæbɪ̈t] as “wabbit” [ˈwæbɪ̈t]
In Monty Python’s Life of Brian , the 1979 film’s character Pilate suffers from rhotacism. In the film, people mock him for his inability to be understood easily.

Here’s a video with a woman who suffers from rhotacism. She explains how difficult it can be to have the speech impediment.

Causes of rhotacism

For many people, the causes of rhotacism are relatively unknown-, especially in adults. However, scientists theorize that the biggest cause is that the person grew up in an environment where they heard R ’s in a weird way, the shape of their mouths are different than normal, or their tongues and lips never learned how to produce the letter. In children, this could happen because the parents or adults around think the way the child talks (using baby talk) is cute and the child never actually learns how to produce it.

For one internet forum user, it has to do with how they learned the language , “I speak various languages, I pronounce the “R” normal in Dutch, French, and Spanish, but I have a rhotacism when speaking English. It’s the way I learnt it.”

For other people, speech issues are a secondary condition to an already existing, serious condition. Physically, it would be a cleft lip or a cleft palate. Neurologically, it could be a condition such as cerebral palsy. It may also be a tongue tie . Almost everyone has a stretch of skin that runs along the bottom of their tongue. If that skin is too tight and reaches the tip of the tongue, it can make pronouncing (and learning how to pronounce) R ’s and L ’s difficult. If the tongue tie isn’t fixed early on, it can be incredibly difficult to fix and learn how to pronounce later.

How the brain affects rhotacism

The brain affects rhotacism only for those who suffer from it not due to a physical impediment (such as a cleft palate). For some, this could happen because the brain doesn’t have the phonemic awareness and never actually learned what the letter R is supposed to sound like. This is common with kids whose parents spoke to them in “baby talk” and encouraged the child’s baby talk, too. This kind of behavior only strengthens a child’s inner concept that / R / is pronounced like “w” or “uh”.

Another reason could be that the brain connections simply don’t allow the lips or mouth to move in the way they need to in order to pronounce the R . This inability has little to do with physical incapabilities and more to do with mental ones. Some people with rhotacism have an issue with their oral-motor skills which means that there isn’t sufficient communication in the parts of the brain responsible for speech production.

Treatment for rhotacism

Is rhotacism curable.

It can have negative social effects- especially among younger children, such as bullying, which lowers self-esteem and can have a lasting effect. However, if the impediment is caught early enough on and is treated rather quickly, there is a good overall prognosis meaning it’s curable.

However, some people never end up being able to properly pronounce that R and they end up substituting other sounds, such as the velar approximant (like w sounds) , the uvular approximant (also known as the “French R ”), and the uvular trill ( like the trilled R in Spanish).

How to fix rhotacism

Rhotacism is fixed by speech therapy . Before anything else, there needs to be an assessment from a Speech Language Pathologist (SLP) who will help decide if the problem can be fixed. If a child is involved, the SLP would predict if the child can outgrow the problem or not. After the diagnosis, a speech therapist will work with the person who suffers from the speech impediment by possibly having weekly visits with some homework and practice instructions. Therapy happens in spouts- a period of a few weeks and a break. There is a follow-up to see if there has been an improvement in pronunciation. In the U.S., children who are in school and have a speech disorder are placed in a special education program. Most school districts provide these children with speech therapy during school hours.

Another option, often used alongside speech therapy, is using a speech therapy hand-held tool that helps isolate the sound being pronounced badly and gives an image of the proper tongue placement to enable better pronunciation.

One study tested a handheld tactical tool (known as Speech Buddies) and the traditional speech therapy methods. The study found that students who used the hand-held tool (alongside speech therapy) improved 33% faster than those who used only the traditional speech therapy methods.

Have you or someone you know ever struggled with rhotacism? Let us know what you think in the comments below!

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Speech Impediment Guide: Definition, Causes, and Resources

December 8, 2020

Tables of Contents

What Is a Speech Impediment?

Types of speech disorders, speech impediment causes, how to fix a speech impediment, making a difference in speech disorders.

Communication is a cornerstone of human relationships. When an individual struggles to verbalize information, thoughts, and feelings, it can cause major barriers in personal, learning, and business interactions.

Speech impediments, or speech disorders, can lead to feelings of insecurity and frustration. They can also cause worry for family members and friends who don’t know how to help their loved ones express themselves.

Fortunately, there are a number of ways that speech disorders can be treated, and in many cases, cured. Health professionals in fields including speech-language pathology and audiology can work with patients to overcome communication disorders, and individuals and families can learn techniques to help.

A woman struggles to communicate due to a speech disorder.

Commonly referred to as a speech disorder, a speech impediment is a condition that impacts an individual’s ability to speak fluently, correctly, or with clear resonance or tone. Individuals with speech disorders have problems creating understandable sounds or forming words, leading to communication difficulties.

Some 7.7% of U.S. children — or 1 in 12 youths between the ages of 3 and 17 — have speech, voice, language, or swallowing disorders, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). About 70 million people worldwide, including some 3 million Americans, experience stuttering difficulties, according to the Stuttering Foundation.

Common signs of a speech disorder

There are several symptoms and indicators that can point to a speech disorder.

Unintelligible speech — A speech disorder may be present when others have difficulty understanding a person’s verbalizations.
Omitted sounds — This symptom can include the omission of part of a word, such as saying “bo” instead of “boat,” and may include omission of consonants or syllables.
Added sounds — This can involve adding extra sounds in a word, such as “buhlack” instead of “black,” or repeating sounds like “b-b-b-ball.”
Substituted sounds — When sounds are substituted or distorted, such as saying “wabbit” instead of “rabbit,” it may indicate a speech disorder.
Use of gestures — When individuals use gestures to communicate instead of words, a speech impediment may be the cause.
Inappropriate pitch — This symptom is characterized by speaking with a strange pitch or volume.

In children, signs might also include a lack of babbling or making limited sounds. Symptoms may also include the incorrect use of specific sounds in words, according to the American Speech-Language-Hearing Association (ASHA). This may include the sounds p, m, b, w, and h among children aged 1-2, and k, f, g, d, n, and t for children aged 2-3.

Signs of speech disorders include unintelligible speech and sound omissions, substitutions, and additions.

Categories of Speech Impediments

Speech impediments can range from speech sound disorders (articulation and phonological disorders) to voice disorders. Speech sound disorders may be organic — resulting from a motor or sensory cause — or may be functional with no known cause. Voice disorders deal with physical problems that limit speech. The main categories of speech impediments include the following:

Fluency disorders occur when a patient has trouble with speech timing or rhythms. This can lead to hesitations, repetitions, or prolonged sounds. Fluency disorders include stuttering (repetition of sounds) or (rapid or irregular rate of speech).

Resonance disorders are related to voice quality that is impacted by the shape of the nose, throat, and/or mouth. Examples of resonance disorders include hyponasality and cul-de-sac resonance.

Articulation disorders occur when a patient has difficulty producing speech sounds. These disorders may stem from physical or anatomical limitations such as muscular, neuromuscular, or skeletal support. Examples of articulation speech impairments include sound omissions, substitutions, and distortions.

Phonological disorders result in the misuse of certain speech sounds to form words. Conditions include fronting, stopping, and the omission of final consonants.

Voice disorders are the result of problems in the larynx that harm the quality or use of an individual’s voice. This can impact pitch, resonance, and loudness.

Impact of Speech Disorders

Some speech disorders have little impact on socialization and daily activities, but other conditions can make some tasks difficult for individuals. Following are a few of the impacts of speech impediments.

Poor communication — Children may be unable to participate in certain learning activities, such as answering questions or reading out loud, due to communication difficulties. Adults may avoid work or social activities such as giving speeches or attending parties.
Mental health and confidence — Speech disorders may cause children or adults to feel different from peers, leading to a lack of self-confidence and, potentially, self-isolation.

Resources on Speech Disorders

The following resources may help those who are seeking more information about speech impediments.

Health Information : Information and statistics on common voice and speech disorders from the NIDCD

Speech Disorders : Information on childhood speech disorders from Cincinnati Children’s Hospital Medical Center

Speech, Language, and Swallowing : Resources about speech and language development from the ASHA

Children and adults can suffer from a variety of speech impairments that may have mild to severe impacts on their ability to communicate. The following 10 conditions are examples of specific types of speech disorders and voice disorders.

1. Stuttering

This condition is one of the most common speech disorders. Stuttering is the repetition of syllables or words, interruptions in speech, or prolonged use of a sound.

This organic speech disorder is a result of damage to the neural pathways that connect the brain to speech-producing muscles. This results in a person knowing what they want to say, but being unable to speak the words.

This consists of the lost ability to speak, understand, or write languages. It is common in stroke, brain tumor, or traumatic brain injury patients.

4. Dysarthria

This condition is an organic speech sound disorder that involves difficulty expressing certain noises. This may involve slurring, or poor pronunciation, and rhythm differences related to nerve or brain disorders.

The condition of lisping is the replacing of sounds in words, including “th” for “s.” Lisping is a functional speech impediment.

6. Hyponasality

This condition is a resonance disorder related to limited sound coming through the nose, causing a “stopped up” quality to speech.

7. Cul-de-sac resonance

This speech disorder is the result of blockage in the mouth, throat, or nose that results in quiet or muffled speech.

8. Orofacial myofunctional disorders

These conditions involve abnormal patterns of mouth and face movement. Conditions include tongue thrusting (fronting), where individuals push out their tongue while eating or talking.

9. Spasmodic Dysphonia

This condition is a voice disorder in which spasms in the vocal cords produce speech that is hoarse, strained, or jittery.

10. Other voice disorders

These conditions can include having a voice that sounds breathy, hoarse, or scratchy. Some disorders deal with vocal folds closing when they should open (paradoxical vocal fold movement) or the presence of polyps or nodules in the vocal folds.

Speech Disorders vs. Language Disorders

Speech disorders deal with difficulty in creating sounds due to articulation, fluency, phonology, and voice problems. These problems are typically related to physical, motor, sensory, neurological, or mental health issues.

Language disorders, on the other hand, occur when individuals have difficulty communicating the meaning of what they want to express. Common in children, these disorders may result in low vocabulary and difficulty saying complex sentences. Such a disorder may reflect difficulty in comprehending school lessons or adopting new words, or it may be related to a learning disability such as dyslexia. Language disorders can also involve receptive language difficulties, where individuals have trouble understanding the messages that others are trying to convey.

About 5% of children in the U.S. have a speech disorder such as stuttering, apraxia, dysarthria, and lisping.

Resources on Types of Speech Disorders

The following resources may provide additional information on the types of speech impediments.

Common Speech Disorders: A guide to the most common speech impediments from GreatSpeech

Speech impairment in adults: Descriptions of common adult speech issues from MedlinePlus

Stuttering Facts: Information on stuttering indications and causes from the Stuttering Foundation

Speech disorders may be caused by a variety of factors related to physical features, neurological ailments, or mental health conditions. In children, they may be related to developmental issues or unknown causes and may go away naturally over time.

Physical and neurological issues. Speech impediment causes related to physical characteristics may include:

Brain damage
Nervous system damage
Respiratory system damage
Hearing difficulties
Cancerous or noncancerous growths
Muscle and bone problems such as dental issues or cleft palate

Mental health issues. Some speech disorders are related to clinical conditions such as:

Autism spectrum disorder
Down syndrome or other genetic syndromes
Cerebral palsy or other neurological disorders
Multiple sclerosis

Some speech impairments may also have to do with family history, such as when parents or siblings have experienced language or speech difficulties. Other causes may include premature birth, pregnancy complications, or delivery difficulties. Voice overuse and chronic coughs can also cause speech issues.

The most common way that speech disorders are treated involves seeking professional help. If patients and families feel that symptoms warrant therapy, health professionals can help determine how to fix a speech impediment. Early treatment is best to curb speech disorders, but impairments can also be treated later in life.

Professionals in the speech therapy field include speech-language pathologists (SLPs) . These practitioners assess, diagnose, and treat communication disorders including speech, language, social, cognitive, and swallowing disorders in both adults and children. They may have an SLP assistant to help with diagnostic and therapy activities.

Speech-language pathologists may also share a practice with audiologists and audiology assistants. Audiologists help identify and treat hearing, balance, and other auditory disorders.

How Are Speech Disorders Diagnosed?

Typically, a pediatrician, social worker, teacher, or other concerned party will recognize the symptoms of a speech disorder in children. These individuals, who frequently deal with speech and language conditions and are more familiar with symptoms, will recommend that parents have their child evaluated. Adults who struggle with speech problems may seek direct guidance from a physician or speech evaluation specialist.

When evaluating a patient for a potential speech impediment, a physician will:

Conduct hearing and vision tests
Evaluate patient records
Observe patient symptoms

A speech-language pathologist will conduct an initial screening that might include:

An evaluation of speech sounds in words and sentences
An evaluation of oral motor function
An orofacial examination
An assessment of language comprehension

The initial screening might result in no action if speech symptoms are determined to be developmentally appropriate. If a disorder is suspected, the initial screening might result in a referral for a comprehensive speech sound assessment, comprehensive language assessment, audiology evaluation, or other medical services.

Initial assessments and more in-depth screenings might occur in a private speech therapy practice, rehabilitation center, school, childcare program, or early intervention center. For older adults, skilled nursing centers and nursing homes may assess patients for speech, hearing, and language disorders.

How Are Speech Impediments Treated?

Once an evaluation determines precisely what type of speech sound disorder is present, patients can begin treatment. Speech-language pathologists use a combination of therapy, exercise, and assistive devices to treat speech disorders.

Speech therapy might focus on motor production (articulation) or linguistic (phonological or language-based) elements of speech, according to ASHA. There are various types of speech therapy available to patients.

Contextual Utilization — This therapeutic approach teaches methods for producing sounds consistently in different syllable-based contexts, such as phonemic or phonetic contexts. These methods are helpful for patients who produce sounds inconsistently.

Phonological Contrast — This approach focuses on improving speech through emphasis of phonemic contrasts that serve to differentiate words. Examples might include minimal opposition words (pot vs. spot) or maximal oppositions (mall vs. call). These therapy methods can help patients who use phonological error patterns.

Distinctive Feature — In this category of therapy, SLPs focus on elements that are missing in speech, such as articulation or nasality. This helps patients who substitute sounds by teaching them to distinguish target sounds from substituted sounds.

Core Vocabulary — This therapeutic approach involves practicing whole words that are commonly used in a specific patient’s communications. It is effective for patients with inconsistent sound production.

Metaphon — In this type of therapy, patients are taught to identify phonological language structures. The technique focuses on contrasting sound elements, such as loud vs. quiet, and helps patients with unintelligible speech issues.

Oral-Motor — This approach uses non-speech exercises to supplement sound therapies. This helps patients gain oral-motor strength and control to improve articulation.

Other methods professionals may use to help fix speech impediments include relaxation, breathing, muscle strengthening, and voice exercises. They may also recommend assistive devices, which may include:

Radio transmission systems
Personal amplifiers
Picture boards
Touch screens
Text displays
Speech-generating devices
Hearing aids
Cochlear implants

Resources for Professionals on How to Fix a Speech Impediment

The following resources provide information for speech therapists and other health professionals.

Assistive Devices: Information on hearing and speech aids from the NIDCD

Information for Audiologists: Publications, news, and practice aids for audiologists from ASHA

Information for Speech-Language Pathologists: Publications, news, and practice aids for SLPs from ASHA

Speech Disorder Tips for Families

For parents who are concerned that their child might have a speech disorder — or who want to prevent the development of a disorder — there are a number of activities that can help. The following are tasks that parents can engage in on a regular basis to develop literacy and speech skills.

Introducing new vocabulary words
Reading picture and story books with various sounds and patterns
Talking to children about objects and events
Answering children’s questions during routine activities
Encouraging drawing and scribbling
Pointing to words while reading books
Pointing out words and sentences in objects and signs

Parents can take the following steps to make sure that potential speech impediments are identified early on.

Discussing concerns with physicians
Asking for hearing, vision, and speech screenings from doctors
Requesting special education assessments from school officials
Requesting a referral to a speech-language pathologist, audiologist, or other specialist

When a child is engaged in speech therapy, speech-language pathologists will typically establish collaborative relationships with families, sharing information and encouraging parents to participate in therapy decisions and practices.

SLPs will work with patients and their families to set goals for therapy outcomes. In addition to therapy sessions, they may develop activities and exercises for families to work on at home. It is important that caregivers are encouraging and patient with children during therapy.

Resources for Parents on How to Fix a Speech Impediment

The following resources provide additional information on treatment options for speech disorders.

Speech, Language, and Swallowing Disorders Groups: Listing of self-help groups from ASHA

ProFind: Search tool for finding certified SLPs and audiologists from ASHA

Baby’s Hearing and Communication Development Checklist: Listing of milestones that children should meet by certain ages from the NIDCD

If identified during childhood, speech disorders can be corrected efficiently, giving children greater communication opportunities. If left untreated, speech impediments can cause a variety of problems in adulthood, and may be more difficult to diagnose and treat.

Parents, teachers, doctors, speech and language professionals, and other concerned parties all have unique responsibilities in recognizing and treating speech disorders. Through professional therapy, family engagement, positive encouragement and a strong support network, individuals with speech impediments can overcome their challenges and develop essential communication skills.

Additional Sources

American Speech-Language-Hearing Association, Speech Sound Disorders

Identify the Signs, Signs of Speech and Language Disorders

Intermountain Healthcare, Phonological Disorders

MedlinePlus, Speech disorders – children

National Institutes of Health, National Institutes on Deafness and Other Communication Disorders, “Quick Statistics About Voice, Speech, Language”

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Hard Words to Say with a Lisp: How to Work Around Your Speech Disability

Saying hard words is never easy, but it can be especially difficult when you have a speech disability. A lisp is a common speech disability that can make it difficult to pronounce certain sounds. If you have a lisp, don’t worry! There are plenty of ways to work around your speech disability and still communicate effectively with others. In this blog post, we will discuss some strategies that you can use to overcome your lisp and say hard words with ease!

What is a lisp, and how do you know if you have one?

Common causes of lisps, hard words to say with a lisp, how to correct a lisp, when is the best time to seek help for a lisp, how speech therapy can help correct a lisp.

What is a lisp? A l isp is a speech disorder that can make it difficult to say certain words. This disorder can make it difficult to produce the /s/ and /z/ sounds. A lisp is a very common sort of speech impediment.

It does not matter if you find the English language difficult or the Spanish language is harder. But the way you pronounce a difficult word, whether it’s from a native or foreign language, is what involves a lisp. If you are not sure if you have a lisp, there are a few ways that you can check. One way is to say the word “seesaw”. You will most likely say “seesaw” as “seesaow” if you have a lisp. Another way to check is to say the word “lizard”. If you have a lisp, you will most likely say “lizard” as “lidger”. If you think you may have a lisp, it is important to speak with your doctor.

Common causes of this functional speech disorder can include:

Neurological problems: Some people may develop a lisp due to a neurological problem, such as a stroke.
Mouth and teeth problems: Some people may develop a lisp if they have problems with their mouth or teeth, such as a misaligned jaw. Or they may either have a tongue tie or tongue thrust. Tongue-tie is a condition where the tongue is firmly connected to the floor of the mouth and movement is restricted. Tongue thrust is when the tongue protrudes between the front teeth.
Speech disorders: Some people may develop a lisp if they have another speech disorder or learn to pronounce sounds incorrectly.

What Are the Types of Lisps?

There are four professional categories of lisps , as the Speech-Language Pathology Graduate Programs outlines.

A frontal lisp is the most common and occurs when individuals push their tongues too far forward.

A lateral lisp happens if air moves over the sides of the tongue when speaking, resulting in a slurred sound.

People with palatal lisps touch their tongue to the roof of their mouth while saying certain sounds.

Dental lisps are easily confused with frontal lisps, but these occur with the wrong mouth position; the individual pushes their tongue against the teeth — not through them.

If you have a lisp, it can be difficult to say certain words. Some of the hardest words to say with a lisp include “th” sounds (as in “think”), “s” sounds (as in “see”), and “z” sounds (as in “zoo”). Many people think that a lisp is usually only found in kids before the age of five. By the time they attend school, many would think they wouldn’t have lisp anymore and go on with their everyday lives. But honestly, it can still be present in adults who did not take this speech impediment seriously and did not seek help. If you have difficulty in pronouncing the word with s, z, and th, please consider that you have a lisp.

Here are some hard words to say with a lisp:

narcissistic
sixth sense
statistician
specificities
Mississippi

This is just a shortlist of problematic word lisp, and there sure are plenty more speech sound errors that you may find as you continue reading words.

If you have a lisp , there are a few things that you can do to help correct it.

Practice on your own.

One thing is to practice saying the words that are difficult for you. Another thing is to make sure that you are using the right muscles when you speak. You can do this by practicing your speech in front of a mirror.

Seek out a Speech pathologist

They are specialists who can help children with lisps. They will evaluate what type of lisp your child has and then help them with it over a period of time. It can take a few months to a few years to get rid of a lisp. If a child is older when working with a speech-language pathologist, it may take longer.

Frenotomy or frenulopasty

If your child’s lisp is from a tongue-tie, a doctor may recommend a simple in-office procedure called a frenotomy to reduce the tethering. They take a pair of scissors and snip the excess tissue holding the tongue down. If the tongue-tie is more severe, they might require a surgery called frenuloplasty.

Other strategies

Another strategy is to mime the words that you are trying to say. This can help you get the pronunciation correct. You can also try speaking more slowly and enunciating each word clearly.

If you are having difficulty pronouncing certain words, it is best to seek help as soon as possible. The earlier you seek help, the easier it will be to correct the lisp. If you wait too long, the speech muscles may become harder to retrain.

If you have a lisp, speech therapy can help correct it. Speech therapists will evaluate your lisp and give you exercises to help improve your pronunciation. It may take time and effort, but you can overcome your lisp with patience and practice.

Speech pathologists work with people who have lisps to help them recognize what their lisp sounds like and how to position their tongue in the correct place to make the sound. They do this by giving them exercises, like saying specific words or phrases with the sounds in them. Once your child has been working on their lisp for a while, your speech pathologist will engage them in conversation to challenge them to remember proper tongue placement.

Lisps are just one type of speech impediment. There are still others who have difficulty saying short or long words with R, L, D, K, and many more. Now that you know some of the mispronounced words that you need to work on, you can either practice on your own or find professional help to help you pronounce words correctly.

References:

https://www.colgate.com/en-us/oral-health/developmental-disabilities/what-is-a-lisp-and-what-causes-it

https://www.wordnik.com/lists/lispers-nemeses

https://www.webmd.com/children/what-is-a-lisp#091e9c5e8217eb1b-1-4

https://www.wikihow.com/Talk-with-a-Lisp

What to Know About Speech Impairment

A speech impairment affects people who have problems speaking in a regular tone of voice or tempo. Speech impairments make it hard for people to communicate properly, and they can happen in both children and adults. ‌

These disorders can cause frustration and embarrassment to the person suffering from them.

What is Speech Impairment?

People who have speech impairments have a hard time pronouncing different speech sounds. They might distort the sounds of some words and leave other sounds out completely.

There are three general categories of speech impairment:

Fluency disorder. This type can be described as continuity, smoothness, rate, and effort in speech production.
Voice disorder. A voice disorder means you have an atypical tone of voice. It could be an unusual pitch, quality, resonance, or volume.
Articulation disorder. If you have an articulation disorder, you might distort certain sounds. You could also fully omit sounds.

Stuttering , or stammering, is a common fluency disorder that affects about 3 million Americans. It usually affects young children who are just learning to speak, but it can continue on into adulthood.

Speech and language impairments are two words that are often used interchangeably, but they are two very different types of problems.

Speech means talking. It uses the jaw muscles, tongue, lips, and vocal chords. Language is a set of words and symbols made to communicate a message. Language and speech disorders can affect you separately, or both can happen at the same time.

Types of Speech Impairments

Speech impairments can begin in childhood and carry on through your adult years. Others can happen due to trauma, or after a medical event like a stroke.

The types of speech impairments are:

Childhood apraxia of speech. This can happen to children when it’s time for them to start talking. The brain’s signals don’t communicate with the mouth, so the child can’t move their lips and tongue in the way they’re mean to.
Dysarthria. This type of speech impairment happens when the muscles you use to talk are too weak, and can’t form words properly.
Orofacial myofunctional disorders (OMD). OMDs are characterized by an abnormal pattern of facial muscle use. OMD interferes with how the facial muscles, including the tongue, are used. People who suffer from OMD might also struggle to breathe through their nose.
Speech sound disorders. It’s normal for children to struggle to pronounce certain sounds as they learn to talk. But after ages four or five, constant mispronunciation might signal a problem. It can continue into adulthood, or some people get it after a stroke.
Stuttering. Stuttering can mean repeating words or sounds like “uh” and “um” (disfluencies) involuntarily. Stuttering can be intensified by strong emotions or stress.
Voice. A voice disorder can mean you “lost” your voice because you stressed it too much. It can also mean a chronic cough or paralysis of the vocal cords, among others.

Health Issues That Affect Speech Impairment

Other than childhood speech impairments, there are a range of reasons you could get one in your adult years. They can happen due to a traumatic event, illness, or surgery.

Dysarthria , aphasia, and voice disturbances can happen in adulthood, and are usually due to these medical events.

Aphasia. Aphasia is the loss of ability to understand words, spoken or written. There are many types of aphasia . It can happen after a stroke or if a tumor reaches the part of the brain where language is processed.

Medical issues that can cause aphasia:

Head trauma
Transient ischemic attack (TIA)
Brain tumor
Alzheimer’s disease

Dysarthria. Dysarthria is usually caused by a nerve problem. The person suffering from it loses the ability to make certain sounds or might have poor pronunciation. It can also affect your ability to control the tongue, larynx, lips, and vocal chords.

Medical issues that can cause dysarthria:

Facial trauma
Diseases that affect your nervous system
Side effects of certain medication
Alcoholic intoxication
Dentures that don’t fit properly
Transient ischemic attack (TIA) ‌

Voice disturbances. Traumatic events or extreme stress placed on the vocal cords can cause you to “lose” your voice or have a vocal disturbance. Disease can also affect the way your voice sounds.

Cancerous or noncancerous growths or nodules on the vocal cords can make your voice sound different.

Understanding Speech Impairments

Having a speech impairment can be a very frustrating and embarrassing experience for the person experiencing it. It’s important to be patient and understanding when communicating.

Try the following tips to improve communication and foster an accepting environment with someone who has a speech impairment:

Speak slowly and use hand gestures
Keep a pen and paper handy in case it’s needed to communicate
Maintain a calm environment free of stimulating sounds
Use simple phrases when you speak
Use your normal tone of voice

Consulting with a mental health care provider can help with feelings of anger and depression that can accompany speech impairments.

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Common Speech Impediments: Causes, Symptoms, Treatment, And Support

Speech impediments include a variety of both language and speech disorders, some of which can be addressed through online speech therapy with speech-language pathologists. They can arise because of heredity and genetics, developmental delays, or even damage to Broca’s area—the part of the brain that’s involved in language skills and speech skills. They may also be linked to other conditions like autism spectrum disorder, cerebral palsy, dyslexia, or even hearing loss. It depends on the type and the cause, but most speech impediments and speech impairments can be treated through speech therapy.

That said, recognizing when a speech impediment may be present can help you get yourself or your child the treatment and support they may need for improved academic and/or social functioning and self-confidence.

A girl in a white blouse sits at her desk at school and smiles softly while looking at the camera.

Common symptoms of a speech impediment

There are many different types of speech impediments a person can have, so the symptoms can vary. That said, those listed below are common symptoms that could be initial indicators that you or your child may be experiencing speech problems or challenges:

Elongating words
Quiet or muffled speech
Blinking frequently
Distorted sounds while talking
Frequent changes in pitch
Poor voice quality
Visible frustration when trying to communicate
Overall difficulty communicating and expressing thoughts and ideas
Inability to repeat words
Inability to pronounce words the same way twice
A phobia of speaking in public
Speaking slowly and carefully
Speech delay
Frequent pauses when talking
Limited vocabulary over several years, delayed language development

Some speech and language disorders are consistent with underlying mental health conditions such as autism. You can visit licensed health professionals or speech therapists to receive an accurate diagnosis and find out how to treat a speech impediment or language disorder, and its underlying cause, if applicable.

Key categories of speech impediments

Speech impediments or communication disorders can take many forms, from speech sound disorders to voice-related disorders. While speech sound disorders mostly result from sensory or motor causes, voice-related disorders deal with physical problems regarding speech. Read on for a list of some of the most common categories of speech impediments.

Voice disorders

Voice disorders primarily arise due to issues regarding the health and structure of the larynx or the voice box. They can impact pitch, resonance, volume, and voice quality. Symptoms of a voice disorder may include having a hoarse, quivering, strained, choppy, or weak and whispery voice, which can make it difficult to produce speech sounds.

The root cause of these disorders can be either organic, like alterations to respiratory, laryngeal, or vocal tract mechanisms, or functional, like improper use of the voice. Some risk factors that may contribute to vocal health challenges include allergies, psychological stress, age, excessive alcohol or drug use, screaming, scarring from neck surgery, or even gastroesophageal reflux disease (GERD). Examples of voice disorders include laryngitis, vocal cord paralysis/weakness, polyps or nodes present on the vocal cords, leukoplakia, or muscle tension dysphonia.

Fluency disorders

A person may be diagnosed with a fluency disorder if they have trouble with speech timing and rhythm which makes it difficult to create a normal speech pattern. These disorders are characterized by interruptions in the typical flow of speaking, including abnormal repetitions, hesitation, and prolongations. Their cause is unknown, but it may be genetic. Symptoms can also be exacerbated by stress and anxiety. Stuttering is the most common example of fluency disorders.

Symptoms of a fluency disorder may include dragging out syllables, speaking breathlessly, repetition of words, speaking slowly, and being tense while speaking. Secondary symptoms may include fidgeting, mumbling, saying “um” or “uh” often, not using certain problematic words, rearranging words in sentences, and anxiety around speaking. Treatment options vary depending on the specific disorder. With stuttering, for example, slowing down, practicing, using speech monitors, attending speech therapy, and receiving cognitive behavioral therapy (CBT) are all potential treatment options.

Articulation disorders and phonological disorders

Articulation and phonological disorders are two types of speech disorders classified as speech sound disorders that may impact communication. An articulation disorder includes speech that commonly exhibits errors such as substitution, omission, distortion, and/or addition (SODA). Although the actual causes of articulation disorders aren’t well understood, contributing factors may include brain injuries, a cleft palate/cleft lip, or nerve damage. Phonological disorders typically involve producing sounds correctly but using them in the wrong place and are more predictable than articulation errors. There may also be a genetic factor that contributes to both disorders and other families may be impacted as well. A licensed speech-language pathologist (SLP) can determine if an individual may have an articulation disorder or a phonological disorder. Ongoing speech therapy is typically the recommended treatment method.

Speech impediments versus language impairments

A speech impediment is typically characterized by difficulty creating sound due to factors like fluency disorders or other voice problems. These disorders may arise from underlying mental health issues, neurological problems, or physical factors or conditions impacting speech muscles.

Language impairments, on the other hand, are more about difficulty processing, reading, and writing and can be connected to an issue processing receptive language. They’re common in children, especially when they first start school. Language impairments relate to meaning, whereas speech impediments relate to sound. It’s also very common for a language impairment disorder to present alongside a learning disability like dyslexia.

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Examples of speech impediments

Below is a brief overview of a few of the most common speech disorders and speech impediments, along with symptoms and potential treatment options.

Apraxia of speech is a speech sound disorder that affects the pathways of the brain. It’s characterized by a person having difficulty expressing their thoughts accurately and consistently. It involves the brain being able to form the words and knowing exactly what to say, but the person then being unable to properly execute the required speech movements to deliver accurate sounds. In mild cases, a person will only have small limitations in their ability to form speech sounds. In severe cases, alternate communication methods may need to be used.

An SLP is the type of provider who can diagnose apraxia. To diagnose speech disorders, including both childhood apraxia (sometimes called verbal apraxia) and acquired apraxia, they may ask the individual to perform simple speech tasks like repeating a particular word several times or repeating a list of words that increase in length. Apraxia generally needs to be monitored by both parents and an SLP over time for an accurate diagnosis to be possible.

There are various treatment options for apraxia, the most common being one-on-one meetings with a speech pathologist. They’ll likely help you or your child build helpful strategies and skills to help strengthen problem areas and communicate more clearly. Some other treatment methods include improving speech intelligibility or using alternate forms of communication, like electronic speech or manual signs and gestures.

The National Institute on Deafness and Other Communication Disorders describes aphasia as a communication disorder that results in a person’s inability to speak, write, and/or understand language. Like other communication disorders, it may occur because of damage to the portions of the brain that are involved in language, which is common in those who have experienced a stroke. It may also come on gradually in those who have a tumor or a progressive neurological disease like Alzheimer’s. Symptoms may include saying or writing sentences that don’t make sense, a reduction in a person’s ability to understand a conversation, and substituting certain sounds and words for others.

Since this disorder is usually caused by damage to parts of the brain, it will typically first be recognized in an MRI or CT scan that can confirm the presence of a brain injury. The extent and type of aphasia can generally only be determined by observing the affected part of the brain and determining how extensively it has been damaged, which is often done with the help of an SLP.

Treatment options for aphasia can be restorative (aimed at restoring impaired function) or compensatory (aimed at compensating for deficits).

Dysarthria

Dysarthria is usually caused by brain damage or facial paralysis that affects the muscles of the jaw, tongue, or throat, which may result in deficits in a person’s speech. It may also be caused by other conditions like Lou Gehrig’s disease, Parkinson’s, or a stroke. It’s considered a nervous system disorder, subclassified as a motor speech disorder. It’s commonly seen in those who already have other speech disorders, such as aphasia or apraxia. Symptoms of dysarthria include slurred speech, speaking too slowly, speaking too quickly, speaking very softly, being unable to move one’s lips or jaw, and having monotonous speech.

Dysarthria can be diagnosed by an expert in speech-language pathology through an exam and tests like MRI, CT, electromyography, or the Denver articulation screening examination. Treatment depends upon the severity and rate of progression of the disorder. Some potential examples include tactics like slowing down while talking, doing exercises to help strengthen jaw muscles, moving the lips and tongue more, and learning strategies for speaking more loudly. Hand gestures and speech machines may also help.

The importance of treatment

It is important to treat speech disorders; the consequences of an untreated speech or language impediment can vary widely depending on the type, symptoms, and severity, as well as the age and life situation of the individual. In general, it’s usually helpful to seek professional advice on treating speech disorders as soon as you notice or suspect an impediment present in yours or your child’s speech. Especially for moderate to severe cases, some potential effects of leaving these common speech disorders untreated can include:

Poor academic performance/dropping out of school
Decrease in quality of life
Social anxiety and an inability to connect with people
Damaged relationships
Social isolation
Hospitalization

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Seeking professional support

Meeting with an SLP is usually the recommended first step for someone who believes they or their child may have a speech impediment. If you have a teenager with dyslexia, there are resources for dyslexic teens that can give supportive information about the condition. Healthcare providers may also provide helpful insights and ask about your family members’ history when it comes to speech and language-related issues as they can be hereditary. While these professionals can help with the physical aspects of a variety of speech and language impediments, you or your child may also benefit from emotional support in relation to the mental health effects of having an impediment. A therapist may be able to provide this type of guidance. If your child is experiencing a speech impediment, a counselor may be able to work with them to process their feelings of frustration and learn healthy coping mechanisms for stress. They can help you manage the same feelings if you receive a speech or language impediment diagnosis, or may be able to support you in your journey of parenting a child with a speech or language impediment diagnosis.

In addition to support at home, teenagers with a diagnosed speech impairment or impediment can receive special education services at school. The Centers for Disease Control notes that under the Individuals with Disabilities Act (IDEA) and Section 504, schools must provide support and accommodations for students with speech disorders. For some children, support groups can provide outlets for social connections and advice for coping.

Meeting with a therapist in person is an option if there are providers in your area. That said, many people find it less intimidating or more comfortable to meet with a therapist virtually. For example, a teen who is experiencing a speech or language impediment may feel better interacting with a counselor through the online chat feature that virtual therapy platforms like TeenCounseling provide. It may allow them to express themselves more clearly than they could face-to-face or over the phone. Parents who need support in caring for a child with a speech or language impediment may find the availability and convenience of meeting with a therapist through an online therapy service like BetterHelp to be most beneficial. Research suggests that online and in-person therapy offer similar benefits for a variety of conditions, so you can choose the format that’s best for you.

Counselor reviews

See below for reviews of TeenCounseling therapists written by parents who sought help for their children through this service.

“Kathleen has been good for my daughter to talk to. I am thankful for her to give my daughter someone else's perspective other than her parents. Thank you.”

“I love Ms. Jones. She doesn’t over-talk or judge you. She gives really good advice and if you're confused she knows how to break it down or explain whatever it is so you can understand. If you need to talk about anything, she’s always an open ear and responds quickly. Not only does she give you points from others' perspectives but she steps into yours so she can understand why certain things are the way they are. In my first session, I was nervous and I think she could tell. She’ll crack a joke every now and then to make me feel more comfortable. She’s just such a bundle of joy and a good counselor to have.”

Speech and language impediments can vary widely in terms of types, causes, symptoms, and severity. These are diagnosed by professionals in the field of speech and language pathology or by a medical doctor. A therapist can provide emotional support for those who are having difficulty coping with their own or their child’s diagnosis or other related challenges.

What are the 3 speech impediments?

Speech impediments can manifest in a variety of ways. Three of the most common are listed below:

Voice disorders affect the tone, pitch, quality, and volume of a person’s voice. A person with a voice disorder may have difficulty speaking or being heard clearly by others. Voice disorders can be either functional or organic. Functional disorders occur due to improper use of the parts of the throat that produce speech, such as overuse of the voice leading to vocal fatigue. Organic voice disorders result from physical anatomical changes, such as nodules on the vocal cords.
Fluency disorders affect the rate, rhythm, and cadence of speech. Those with fluency disorders may speak in a disjointed, choppy, or prolonged fashion, making them difficult for others to understand clearly. While many types of fluency disorders exist, stuttering is likely the best-known. Speech often requires precise timing to convey a message accurately, which fluency disorders can disrupt.
Speech sound disorders are a broad category of disorders that interferes with a person’s ability to produce sounds and words correctly. Speech sound disorders can present very differently from person to person. Sometimes word sounds are omitted or added where not appropriate, and sometimes word sounds are distorted or substituted completely. A typical example of a speech sound disorder is the substitution of “r” for “w” in words like “rabbit” (becoming “wabbit”). Many children experience that substitution, but it does not become a disorder until the child does not outgrow it.

Other types of disorders can cause problems with expressive communication or tongue-tie those experiencing them, such as developmental language disorder. Language disorders also cause concerns related to expressive communication, but the concerns are due to a lack of understanding of one or more components of language, not an inability to produce or use word sounds.

What do you call a speech impediment?

Speech impediments are typically referred to as speech disorders . Speech refers to the ability to form speech sounds using the vocal cords, mouth, lips, and tongue. Speech also requires that a rhythm and cadence be maintained. Speech disorders indicate a problem producing intelligible speech; word sounds may be omitted or misplaced, the rhythm of the speech may be difficult to follow, or a person’s voice might be strangely pitched or too soft to hear clearly.

It is important not to confuse speech disorders with language disorders . Language disorders arise due to difficulty understanding what words mean, how word sounds fit together, or how to use spoken language to communicate. Language problems may affect how a person speaks, but the root cause of the concern is linked to their understanding of language, not their ability to produce intelligible speech.

How do I know if I have a speech impediment?

If you’re experiencing a sudden onset of impaired speech with no apparent cause, seek medical attention immediately. Strokes, traumatic brain injuries, and other serious medical conditions can cause sudden changes in speaking ability. Gradual changes in speaking ability may also indicate an underlying medical problem. If you’re concerned that your speaking ability has been gradually deteriorating, consider making an appointment with a healthcare provider in the near future.

Most people with a speech disorder are diagnosed in childhood. Parents often identify speech-related concerns in early childhood based on their child’s speech patterns. The child’s pediatrician may also refer the child to a speech-language pathologist, a professional specializing in evaluating and treating speech disorders. If problems persist until the child is in school, teachers and other school officials might initiate a referral for an evaluation if they believe speech concerns are present. Children often receive speech and language therapy that resolves or improves their speech problems.

Speech disorders also appear in adulthood, often due to injury or illness. It is also possible, although rare, for speech problems to be misdiagnosed or missed outright during a person’s childhood. In that case, the speech disorder may have been present since childhood and symptoms persisted into adulthood.

If you’re finding it difficult to communicate verbally with others, have an easily identifiable speech problem (like stuttering), or receive feedback that others have trouble understanding you, consider making an appointment with your doctor for an evaluation and referral to the appropriate healthcare providers.

What are 5 causes of speech impairment?

Speech and language disorders can result from conditions that interfere with the development of perceptual, structural, motor, cognitive, or socioemotional functions. The cause of many speech disorders is unknown, but research has indicated several underlying factors that may be responsible:

Pre-existing genetic conditions, like Down’s syndrome or Fragile X syndrome. Evidence suggests that genes may play a role even if genetic abnormalities do not result in a diagnosable genetic condition.
Physical abnormalities, such as damage or improper development of the respiratory system, facial muscles, or cranial nerves.
Hearing problems, which can delay a child’s acquisition of speech.
Neurodevelopmental disorders, such as autism spectrum disorder, may interfere with speech development. There is also evidence to suggest that those with attention-deficit hyperactivity disorder may have a more challenging time acquiring speech skills.
Neurological conditions such as cerebral palsy.

Mental health concerns can also cause problems communicating with others. For example, an underlying anxiety disorder may lead to selective mutism , wherein a child speaks only under certain circumstances.

Is speech impediment a disability?

A speech-language disorder is considered a “ communication disability ” under the Americans with Disabilities Act (ADA). The ADA requires government and businesses to establish “effective communication” with people who have communication disabilities. Effective communication can be established in several ways. For those with a speech disorder, accommodation may be as simple as ensuring the person can get hold of writing materials if they need to express themselves quickly. In some cases, organizations may use a transliterator, or person trained to recognize unclear speech and repeat it clearly.

Because speech disorders are known to lead to academic struggles in K-12 and higher education settings, they are categorized as a disability under the Individuals with Disabilities Education Improvement Act (IDEIA) . The IDEIA sets guidelines for all schools in the United States, public or not public, guaranteeing each child a right to accommodations and interventions for their speech disorder.

Can I fix my speech impediment?

Whether or not a speech disorder can be completely eliminated depends heavily on individual factors. The cause of the disorder, its severity, and the type of speech dysfunction all play a role in determining whether a particular disorder can be completely resolved. While it is not possible to guarantee that a speech disorder can be “cured,” nearly all disorders are treatable, and improvement is likely possible.

Can you treat a speech impediment?

Yes, many speech disorders are highly treatable. Most people receive treatment as children when most speech disorders become apparent. For children, speech-language pathologists will identify the specific speech disorder, search for an underlying cause, and design an intervention that targets that child’s speech problem. For example, a child who struggles with articulation errors and producing word sounds consistently may benefit from a contextual utilization approach . Contextual utilization leverages the fact that one sound is easier or more difficult to pronounce depending on which other sounds surround it.

Speech disorders that emerge in adulthood may be more challenging to treat due to underlying factors, such as brain injury. Suppose an adult experiences a traumatic brain injury that affects their speaking ability. In that case, a speech-language pathologist may help them find alternative communication methods, such as using a computer. They may also help them directly restore some of their speaking ability by leading them through exercises that improve nerve function and muscle control.

Is a speech impediment mental?

Speech disorders can be caused by various factors, many of which have nothing to do with the brain. However, there is a relationship between psychiatric mental health concerns and difficulty with spoken communication . Although researchers are still unsure of the exact cause, studies have identified a significant link between speech disorders and mental health disorders like schizophrenia, bipolar disorder, and major depression.

Neurodevelopmental disorders, such as autism spectrum disorder and attention-deficit hyperactivity disorder, are also associated with an increased risk of developing a speech disorder. Although the link between neurodevelopmental disorders and speech disorders is not fully understood, evidence suggests that treating the speech disorder is still possible.

Finally, speech disorders can also be caused by illness or injury in the brain, such as cancer, an infection, or traumatic brain injury. Although these are not considered mental or developmental disorders, they may affect brain function and mental acuity. Speaking is a complex process, and there are many ways it can be affected.

Is autism a speech impediment?

Autism spectrum disorder is not a speech disorder, but it is heavily associated with communication problems. Those on the autism spectrum often use repetitive or rigid language and may not follow communication norms. They may repeat phrases continuously, use a modified tone of voice, or introduce information that has little to do with the conversation at hand.

Those on the autism spectrum are often able to form word sounds properly. The communication deficits of autism spectrum disorder are more closely related to language disorders than speech disorders. Speech disorders are associated with difficulty producing or using word sounds correctly, whereas language disorders are associated with a lack of understanding of one or more language components.

Autism spectrum disorder is also characterized by difficulties using pragmatic communication, or communication that is appropriate to a specific social situation. Although not a disorder of speech, a limited ability to recognize the socioemotional content of speech can significantly impact interpersonal communication and social interactions.

Recognizing And Navigating Teen Depression Medically reviewed by Elizabeth Erban , LMFT, IMH-E
ADHD Signs In Women, Men, And Children Medically reviewed by Julie Dodson , MA
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6 Types of Speech Impediments

Stacie bennett.

Speech-Language Pathologist , Trenton , New Jersey

Jan 28, 2022 ‘Speech and language impediment’ is a very broad term that refers to a communication disorder in an individual that has depressed social, language, communication, hearing, or fluency skills.

A language impairment involves understanding and sharing thoughts and ideas. For example, this person may not have adequate or “age-appropriate” vocabulary and grammar skills. Again, there are several different language disorders that fall under this category that will be addressed in this blog.

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3 Types of Speech Disorders

Apraxia of speech is a neurogenic (starts in the nervous system) communication disorder that involves the planning system for speech.

Individuals with Apraxia know what they want to say, but there is a disconnect in the part of the brain that tells a specific muscle to move. When someone is diagnosed with apraxia of speech , they may have signs of groping, which is where the mouth searches for the position to create the sound.

When this occurs, it affects how long or short the sounds are, and could lead to odd pitch or volume issues and to sounds being distorted or substituted. A tell-tale sign of someone who has apraxia is that they lose the ability to produce sounds that they previously could say.

For instance, if you ask a child to say the word “dog,” which they do successfully and then ask them to say the same word again 10 minutes later, they will not be able to do it.

Speech sound disorders may be of two varieties: articulation (the production of sounds) or phonological processes (sound patterns).

An articulation disorder may take the form of substitution, omission, addition, or distortion of normal speech sounds.

Phonological process disorders may involve more systematic difficulties with the production of particular types of sounds, such as those made in the back of the mouth, like “k” and “g” (ASHA 2018).

Educating a child on the appropriate ways to produce a speech sound and encouraging the child to practice this articulation over time may produce natural speech.

For additional reading on articulation and phonological disorders, check these blogs:

What Are Phonological Processes
Process of Articulation Therapy

Stuttering is a disruption in the fluency of an individual’s speech, which begins in childhood and may persist over a lifetime.

Stuttering is a form of disfluency (an inability to produce fluent speech). Disfluency becomes a problem because it impedes successful communication between two parties. Disfluencies may be due to unwanted repetitions of sounds (e.g., “I-I-I want ice cream”), or the extension of speech sounds (e.g., “S——tart the wash”), syllables (e.g., “Na-na-na nasty”), or words (e.g., “go-go-go to the store”). Disfluencies also incorporate unintentional pauses in speech, in which the individual is unable to produce speech sounds (ASHA 2016).

Unfortunately, the cause of stuttering is unknown, which makes it more difficult to treat. Treatment can vary from person to person depending on the severity and type of stuttering that is occurring.

Stutter or stammer can be normal for kids who learn language.

Read more on how to distinguish stuttering as a part of typical speech development from stuttering as a speech disorder!

3 Types of Language Disorders

Specific Learning Impairment (SLI) is diagnosed when a child’s language is not developing as rapidly or as typically as other children. In order for a child to be diagnosed with SLI, they cannot have Autism Spectrum Disorder, Apraxia, hearing loss, or an abnormality of the speech mechanisms. If those disorders are present, they do not have SLI and are exhibiting speech patterns typical of those diagnoses. Usually, the first indication of SLI is that the child is later than usual in starting to speak and subsequently is delayed in putting words together to form sentences. Spoken language may be immature. In many children with SLI, understanding of language , or receptive language, is also impaired, though this may not be obvious unless the child is given a formal assessment. This diagnosis is reserved for children whose language difficulties persist into school age, not for children who are speech delayed and eventually catch up to their peers.

Aphasia is an inability to comprehend or formulate language because of damage to specific brain regions.

The major causes are a cerebral vascular accident (stroke), or head trauma, but aphasia can also be the result of brain tumors, brain infections, or neurodegenerative diseases such as dementia (ASHA 2017).

The difficulties of people with aphasia can range from occasional trouble finding words, to losing the ability to speak, read, or write; intelligence, however, is unaffected. Any person of any age can develop aphasia, given that it is often caused by a traumatic injury. However, people who are middle-aged and older are the most likely to experience the problem.

Language-based learning disabilities occur in children who are falling behind their same-aged peers. These children will have difficulties with spelling, reading, and/or writing, but have normal intelligence levels. This is a common source of academic struggles in young children and can often be misdiagnosed or missed in typical assessments.

The key to supporting students with LBLD is knowing how to adjust curriculum and instruction to ensure they develop proficient language and literacy skills . Most individuals with LBLD need instruction that is specialized, explicit, structured, and multisensory, as well as ongoing, guided practice aimed at remediating their specific areas of weakness.

There are a lot of speech and language impediments that can occur in children and adults. This blog only scratches the surface of these disorders, so please stay tuned and check out Speech Blubs regularly for more in-depth blogs regarding these subjects.

If there’s a topic you’d like to know more about, please reach out to us and we will get working on it! As always, if you feel like your child is exhibiting any signs or symptoms of these disorders, it’s important that you make an appointment with a speech-language pathologist as soon as possible to get a full evaluation.

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Speech impairment in adults

Speech and language impairment may be any of several problems that make it difficult to communicate.

Considerations

The following are common speech and language disorders.

Aphasia is loss of the ability to understand or express spoken or written language. It commonly occurs after strokes or traumatic brain injuries. It can also occur in people with brain tumors or degenerative diseases that affect the language areas of the brain. This term does not apply to children who have never developed communication skills. There are many different types of aphasia.

In some cases of aphasia, the problem eventually corrects itself, but in others, it doesn't get better.

With dysarthria , the person has problems expressing certain sounds or words. They have poorly pronounced speech (such as slurring) and the rhythm or speed of speech is changed. Usually, a nerve or brain disorder has made it difficult to control the tongue, lips, larynx, or vocal cords, which make speech.

Dysarthria, which is difficulty pronouncing words, is sometimes confused with aphasia, which is difficulty producing language. They have different causes.

People with dysarthria may also have problems swallowing.

VOICE DISTURBANCES

Anything that changes the shape of the vocal cords or the way they work will cause a voice disturbance. Lump-like growths such as nodules, polyps, cysts, papillomas, granulomas, and cancers can be to blame. These changes cause the voice to sound different from the way it normally sounds.

Some of these disorders develop gradually, but anyone can develop a speech and language impairment suddenly, usually due to a stroke or trauma.

Alzheimer disease
Brain tumor (more common in aphasia than dysarthria)
Head trauma
Transient ischemic attack (TIA)
Alcohol intoxication
Diseases that affect nerves and muscles (neuromuscular diseases), such as amyotrophic lateral sclerosis (ALS or Lou Gehrig disease), cerebral palsy, myasthenia gravis, or multiple sclerosis (MS)
Facial trauma
Facial weakness, such as Bell's palsy or tongue weakness
Head and neck cancer surgery
Nervous system (neurological) disorders that affect the brain, such as Parkinson disease or Huntington disease (more common in dysarthria than aphasia)
Poorly fitting dentures
Side effects of medicines that act on the central nervous system, such as narcotics, phenytoin, or carbamazepine
Growths or nodules on the vocal cords
People who use their voice heavily (teachers, coaches, vocal performers) are more likely to develop voice disorders.

For dysarthria, ways to help improve communication include speaking slowly and using hand gestures. Family and friends need to provide plenty of time for those with the disorder to express themselves. Typing on an electronic device or using pen and paper can also help with communication.

For aphasia, family members may need to provide frequent orientation reminders, such as the day of the week. Disorientation and confusion often occur with aphasia.Using nonverbal ways of communicating may also help.

It's important to maintain a relaxed, calm environment and keep external stimuli to a minimum.

Speak in a normal tone of voice (this condition is not a hearing or emotional problem).
Use simple phrases to avoid misunderstandings.
Don't assume that the person understands.
Provide communication aids, if possible, depending on the person and condition.

Mental health counseling may help with depression or frustration that many people with speech impairment have.

When to Contact a Medical Professional

Contact the provider if:

Impairment or loss of communication comes on suddenly
There is any unexplained impairment of speech or written language

What to Expect at Your Office Visit

Unless the problems have developed after an emergency event, the provider will take a medical history and perform a physical exam. The medical history may require the assistance of family or friends.

The provider will likely ask about the speech impairment. Questions may include when the problem developed, whether there was an injury, and what medicines the person takes.

Diagnostic tests that may be performed include the following:

Blood tests
Cerebral angiography to check blood flow in the brain
CT or MRI scan of the head to check for problems such as tumor
Electroencephalogram (EEG) to measure electrical activity of the brain
Electromyography ( EMG ) to check the health of the muscles and the nerves that control the muscles
Lumbar puncture to check the cerebrospinal fluid that surrounds the brain and spinal cord
Urine tests
X-rays of the skull

If the tests find other medical problems, other specialist doctors will need to be consulted.

For help with the speech problem, a speech and language therapist or social worker will likely need to be consulted.

Alternative Names

Language impairment; Impairment of speech; Inability to speak; Aphasia; Dysarthria; Slurred speech; Dysphonia voice disorders

Kirshner HS. Dysarthria and apraxia of speech. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 14.

Kirshner HS, Wilson SM. Aphasia and aphasic syndromes. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 13.

Rossi RP, Kortte JH, Palmer JB. Speech and language disorders. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation . 4th ed. Philadelphia, PA: Elsevier; 2019:chap 155.

Review Date 5/2/2022

Updated by: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Meaning of speech impediment in English

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stammeringly
stutteringly

Examples of speech impediment

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Voice, Speech, and Language

Developmental Language Disorder

Diseases and Conditions

Apraxia of Speech
Auditory Processing Disorder
Autism Spectrum Disorder: Communication Problems in Children
Recurrent Respiratory Papillomatosis or Laryngeal Papillomatosis
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Voice, Speech, and Language in the News: NIDCD-Supported Research

May 29, 2024 Babies babble squeals and growls in clustering patterns observable from birth through the first year, suggesting this active vocal exploration is important to speech development
May 28, 2024 Is It a Sound of Music…or of Speech? Scientists Uncover How Our Brains Try to Tell the Difference
May 8, 2024 Take care of your voice - NIH News in Health

You asked, we answered: Can aphasia ever get better?

Confused man sitting on the couch with a concerned woman

I have aphasia. Sometimes it's better than at other times. I have always succeeded in remembering and saying the correct word, even if it is three hours later. Also, occasionally I get the sentence wrong and sometimes, embarrassingly. Will I ever improve?

Answered by Speech-Language Pathologist Carol Gaebler, MS, CCC-SLP

Aphasia is a neurogenic disorder caused by injury to the brain, usually from a stroke or trauma to the speech and language centers. In the U.S., it is estimated that more than 2 million people, both children and adults, are affected by aphasia. The disorder impacts the use of language and can cause challenges in how a person understands what they hear and read and how they select and use words.

When we are trying to say a word, we think about the features of that word and instantaneously search our lexicon, or word bank, for that word. After a stroke or brain injury, delays in word finding are common and can be frustrating. Sometimes, we select a word from that bank that is not our intended target (e.g., calling for one of our children but saying another child’s name).

Word retrieval errors, referred to as paraphasias , can occur, often in the form of a word that sounds like the intended target (e.g. “bran” for brain or “carpet” for carpal). These are called phonemic paraphasias , as the sounds, or phonemes, in the words are similar. Another type of paraphasia can occur when words with similar meanings are accidentally used. For example, referring to your wife as your sister. Wife and sister are words associated with female relatives.

These substitutions by the brain reflect a verbal output error that occurred when searching for the target word. Most of the time, we monitor these errors as they are produced and try to correct them. For some people with aphasia, the ability to recognize and correct these errors as they occur is lost or significantly delayed.

A speech-language pathologist is trained to evaluate and treat aphasia and other speech and language difficulties. Once they have identified the type, severity and characteristics of the aphasia, they can provide strategies to lessen the impact of word substitutions. These strategies, which may help increase the likelihood of selecting the correct lexicon from the word bank, include:

Using gestures
Verbally describing word targets

The most dramatic improvements in aphasia usually occur within the first year after onset of the disorder, however, subtle improvements can be achieved in those with chronic or longstanding deficits with the assistance of speech therapy and the practice of compensatory strategies.

The Munroe-Meyer Institute, or MMI, houses the UNMC Speech-Language Pathology Department. The speech-language pathologists from MMI serve inpatients and outpatients within the Nebraska Medicine enterprise. A referral can be obtained from a physician for a speech-language evaluation and treatment.

If you are interested in learning more, the following websites contain information about aphasia and speech-language pathology:

www.unmc.edu/mmi

www.asha.org

www.aphasia.org

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How to improve your communication with someone with a speech impairment

by Claire Davies, The Conversation

October marked alternative and augmentative communication (AAC) awareness month. AAC includes all means of communication that a person may use besides talking . Low-tech methods include means of interaction like hand gestures, facial movements, or pointing, while more high-tech tools might include a speech generating device accessed through pointing or a joystick, eye-tracking, or even a brain-computer interface.

British physicist Stephen Hawking was long the most famous person associated with AAC, using an advanced computer system to generate sentences and speech. American actor Val Kilmer is another well-known person who has used AAC. Kilmer suffered irreparable damage to his voice due to throat cancer. However, in the latest installment of the Top Gun film franchise, artificial intelligence was used to "clone" the actor's voice.

In 2006, 1.9% of the Canadian population self-identified as having a speech disability . Unfortunately, this was the last time Statistics Canada identified speech disability within the Canadian census. That makes it difficult to gather more recent data of the number of people in Canada with impaired speech.

Need for more acceptance

Speech impairments can occur at a young age with disabilities such as cerebral palsy or autism spectrum disorder , but can also manifest later in life as a result of progressive disorders such as motor neuron disease, throat cancer, muscular dystrophy or strokes.

Increased acceptance of the use of AAC technologies in general society can enhance the quality of life for people with speech impairment by increasing autonomy, leading to more positive social interactions, better engagement in education and confidence in employment.

The Accessible Canada Act recognizes communication as a priority area, while the United Nations Convention on the Rights of Persons with Disabilities promotes the rights of autonomy, safety and social participation, and recognizes communication as a human right.

Tackling stigma

However, even if people have access to AAC technology, they can still face stigma and exclusion. Here are some things we can all do to be more inclusive of people with impaired speech:

Start with basic respect. Understand that cognition and lack of verbal speech are not correlated. Many people with speech impairments have no cognitive deficits at all and are just as intelligent as anyone else. They want others to be more patient and understanding of speech disabilities. In social situations , they might often be underestimated and treated as children even though they are capable and competent. Show them respect, even though they may sound different when they talk.

Pre-programmed sentences on a tablet or speech generating device do not suggest that the person is incapable of developing those ideas. They may have spent 20 minutes typing out those messages in an attempt to meet the fast-paced environment in which we all live.

Take time to listen. Individuals with speech impairment may need to type out phrases one letter at a time. Some may use a smartphone or iPad with a texting app, while others use an eye-tracking device or brain-computer interface to select letters using an on-screen keyboard. Be patient and wait for the person to speak.

As one occupational therapist noted , "[A problem] I often find some of my clients run into is not being given enough time to get their message written down. They're composing it and the communication partner might not realize they need to give them a little extra time." A conversation may require you to pause, ask a question and wait for an answer. Stop, think, be patient and understanding.

In addition, it's important to realize that the use of some AAC technologies can be tiring. To use systems that rely on eye movements, for example, an individual must focus and is unable to use other means of communication such as emotional expression at the same time. Recognize that shorter conversations may be better. Perhaps try communicating by email or text. Let the person respond in their own time.

Be an advocate. People with speech impairments must always advocate for themselves. If you are planning a conference or hiring for a position, ask what accommodations might be beneficial rather than relying on the individual to request them. Provide advance notice of conversation topics or questions. Engage people with speech impairments in social events. If you see someone passing judgment, speak up.

Technology is improving, and maybe one day people with impaired speech will be able to communicate with the same ease as those without. But until then, being a friend to people with speech impairments means being patient and listening.

Provided by The Conversation

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Patient Care & Health Information
Diseases & Conditions
Parkinson's disease

Parkinson's disease is a progressive disorder that affects the nervous system and the parts of the body controlled by the nerves. Symptoms start slowly. The first symptom may be a barely noticeable tremor in just one hand. Tremors are common, but the disorder also may cause stiffness or slowing of movement.

In the early stages of Parkinson's disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time.

Although Parkinson's disease can't be cured, medicines might significantly improve your symptoms. Occasionally, a health care professional may suggest surgery to regulate certain regions of your brain and improve your symptoms.

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Parkinson's disease symptoms can be different for everyone. Early symptoms may be mild and go unnoticed. Symptoms often begin on one side of the body and usually remain worse on that side, even after symptoms begin to affect the limbs on both sides.

Parkinson's symptoms may include:

Tremor. Rhythmic shaking, called tremor, usually begins in a limb, often your hand or fingers. You may rub your thumb and forefinger back and forth. This is known as a pill-rolling tremor. Your hand may tremble when it's at rest. The shaking may decrease when you are performing tasks.
Slowed movement, known as bradykinesia. Over time, Parkinson's disease may slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk. It may be difficult to get out of a chair. You may drag or shuffle your feet as you try to walk.
Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can be painful and limit your range of motion.
Impaired posture and balance. Your posture may become stooped. Or you may fall or have balance problems as a result of Parkinson's disease.
Loss of automatic movements. You may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.
Speech changes. You may speak softly or quickly, slur, or hesitate before talking. Your speech may be more of a monotone rather than have the usual speech patterns.
Writing changes. It may become hard to write, and your writing may appear small.

When to see a doctor

See a health care professional if you have any of the symptoms associated with Parkinson's disease — not only to diagnose your condition but also to rule out other causes for your symptoms.

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In Parkinson's disease, certain nerve cells called neurons in the brain gradually break down or die. Many of the symptoms of Parkinson's are due to a loss of neurons that produce a chemical messenger in your brain called dopamine. When dopamine levels decrease, it causes irregular brain activity, leading to problems with movement and other symptoms of Parkinson's disease.

The cause of Parkinson's disease is unknown, but several factors appear to play a role, including:

Genes. Researchers have identified specific genetic changes that can cause Parkinson's disease. But these are uncommon except in rare cases with many family members affected by Parkinson's disease.

However, certain gene variations appear to increase the risk of Parkinson's disease but with a relatively small risk of Parkinson's disease for each of these genetic markers.

Environmental triggers. Exposure to certain toxins or environmental factors may increase the risk of later Parkinson's disease, but the risk is small.

Researchers also have noted that many changes occur in the brains of people with Parkinson's disease, although it's not clear why these changes occur. These changes include:

The presence of Lewy bodies. Clumps of specific substances within brain cells are microscopic markers of Parkinson's disease. These are called Lewy bodies, and researchers believe these Lewy bodies hold an important clue to the cause of Parkinson's disease.
Alpha-synuclein found within Lewy bodies. Although many substances are found within Lewy bodies, scientists believe that an important one is the natural and widespread protein called alpha-synuclein, also called a-synuclein. It's found in all Lewy bodies in a clumped form that cells can't break down. This is currently an important focus among Parkinson's disease researchers. Researchers have found the clumped alpha-synuclein protein in the spinal fluid of people who later develop Parkinson's disease.

Risk factors

Risk factors for Parkinson's disease include:

Age. Young adults rarely experience Parkinson's disease. It ordinarily begins in middle or late life, and the risk increases with age. People usually develop the disease around age 60 or older. If a young person does have Parkinson's disease, genetic counseling might be helpful in making family planning decisions. Work, social situations and medicine side effects are also different from those of an older person with Parkinson's disease and require special considerations.
Heredity. Having a close relative with Parkinson's disease increases the chances that you'll develop the disease. However, your risks are still small unless you have many relatives in your family with Parkinson's disease.
Sex. Men are more likely to develop Parkinson's disease than are women.
Exposure to toxins. Ongoing exposure to herbicides and pesticides may slightly increase your risk of Parkinson's disease.

Complications

Parkinson's disease is often accompanied by these additional problems, which may be treatable:

Thinking difficulties. You may experience cognitive problems, such as dementia, and thinking difficulties. These usually occur in the later stages of Parkinson's disease. Such cognitive problems aren't usually helped by medicines.

Depression and emotional changes. You may experience depression, sometimes in the very early stages. Receiving treatment for depression can make it easier to handle the other challenges of Parkinson's disease.

You also may experience other emotional changes, such as fear, anxiety or loss of motivation. Your health care team may give you medicine to treat these symptoms.

Swallowing problems. You may develop difficulties with swallowing as your condition progresses. Saliva may accumulate in your mouth due to slowed swallowing, leading to drooling.
Chewing and eating problems. Late-stage Parkinson's disease affects the muscles in the mouth, making chewing difficult. This can lead to choking and poor nutrition.

Sleep problems and sleep disorders. People with Parkinson's disease often have sleep problems, including waking up frequently throughout the night, waking up early or falling asleep during the day.

People also may experience rapid eye movement sleep behavior disorder, which involves acting out dreams. Medicines may improve your sleep.

Bladder problems. Parkinson's disease may cause bladder problems, including being unable to control urine or having difficulty in urinating.
Constipation. Many people with Parkinson's disease develop constipation, mainly due to a slower digestive tract.

You may also experience:

Blood pressure changes. You may feel dizzy or lightheaded when you stand due to a sudden drop in blood pressure (orthostatic hypotension).
Smell dysfunction. You may experience problems with your sense of smell. You may have trouble identifying certain odors or the difference between odors.
Fatigue. Many people with Parkinson's disease lose energy and experience fatigue, especially later in the day. The cause isn't always known.
Pain. Some people with Parkinson's disease experience pain, either in specific areas of their bodies or throughout their bodies.
Sexual dysfunction. Some people with Parkinson's disease notice a decrease in sexual desire or performance.

Because the cause of Parkinson's is unknown, there are no proven ways to prevent the disease.

Some research has shown that regular aerobic exercise might reduce the risk of Parkinson's disease.

Some other research has shown that people who consume caffeine — which is found in coffee, tea and cola — get Parkinson's disease less often than those who don't drink it. Green tea also is related to a reduced risk of developing Parkinson's disease. However, it is still not known whether caffeine protects against getting Parkinson's or is related in some other way. Currently there is not enough evidence to suggest that drinking caffeinated beverages protects against Parkinson's.

Parkinson's disease care at Mayo Clinic

Loscalzo J, et al., eds. Parkinson's disease. In: Harrison's Principles of Internal Medicine. 21st ed. McGraw Hill; 2022. https://accessmedicine.mhmedical.com. Accessed April 4, 2022.
Parkinson's disease: Hope through research. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Parkinsons-Disease-Hope-Through-Research. Accessed April 4, 2022.
Ferri FF. Parkinson disease. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. https://www.clinicalkey.com. Accessed April 4, 2022.
Chou KL. Diagnosis and differential diagnosis of Parkinson disease. https://www.uptodate.com/contents/search. Accessed April 4, 2022.
Hornykiewicz O. The discovery of dopamine deficiency in the parkinsonian brain. Journal of Neural Transmission Supplementum. 2006; doi:10.1007/978-3-211-45295-0_3.
Spindler MA, et al. Initial pharmacologic treatment of Parkinson disease. https://www.uptodate.com/contents/search. Accessed April 4, 2022.
Relaxation techniques for health. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/stress/relaxation.htm. Accessed April 4, 2022.
Taghizadeh M, et al. The effects of omega-3 fatty acids and vitamin E co-supplementation on clinical and metabolic status in patients with Parkinson's disease: A randomized, double-blind, placebo-controlled trial. Neurochemistry International. 2017; doi:10.1016/j.neuint.2017.03.014.
Parkinson's disease: Fitness counts. Parkinson's Foundation. http://www.parkinson.org/pd-library/books/fitness-counts. Accessed April 4, 2022.Green tea. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed April 4, 2022.
Green tea. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed April 4, 2022.
Tarsy D. Nonpharmacologic management of Parkinson disease. https://www.uptodate.com/contents/search. Accessed April 4, 2022.
Caffeine. Natural medicines. https://naturalmedicines.therapeuticresearch.com. Accessed April 4, 2022.
Jankovic J. Etiology and pathogenesis of Parkinson disease.
Thomas A. Allscripts EPSi. Mayo Clinic. April 22, 2022.
Post B, et al. Young onset Parkinson's disease: A modern and tailored approach. Journal of Parkinson's Disease. 2020; doi:10.3233/JPD-202135.
Bower JH (expert opinion). Mayo Clinic. May 16, 2023.
Robbins JA, et al. Swallowing and speech production in Parkinson's disease. Annals of Neurology.1986; doi:10.1002/ana.410190310.
Hauser RA, et al. Orally inhaled levodopa (CVT-301) for early morning OFF periods in Parkinson's disease. Parkinsonism and Related Disorders. 2019; doi:10.1016/j.parkreldis.2019.03.026.
Dashtipour K, et al. Speech disorders in Parkinson's disease: Pathophysiology, medical management and surgical approaches. Neurodegenerative Disease Management. 2018; doi:10.2217/nmt-2018-0021.
Mishima T, et al. Personalized medicine in Parkinson's disease: New options for advanced treatments. Journal of Personalized Medicine. 2021; doi:10.3390/jpm11070650.
Jenner P, et al. Istradefylline — A first generation adenosine A2A antagonist for the treatment of Parkinson's disease. Expert Review of Neurotherapeutics. 2021; doi:10.1080/14737175.2021.1880896.
Isaacson SH, et al. Blinded SAPS-PD assessment after 10 weeks of pimavanserin treatment for Parkinson's disease psychosis. Journal of Parkinson's Disease. 2020; doi:10.3233/JPD-202047.
Al-Shorafat DM, et al. B-blocker-induced tremor. Movement Disorders Clinical Practice. 2021; doi:10.1002/mdc3.13176.
Haahr A, et al. 'Striving for normality' when coping with Parkinson's disease in everyday life. A metasynthesis. International Journal of Nursing Studies. 2021; doi:10.1016/j.ijnurstu.2021.103923.
Mehanna R, et al. Age cutoff for early-onset Parkinson's disease: Recommendations from the International Parkinson and Movement Disorder Society task force on early-onset Parkinson's disease. Movement Disorders Clinical Practice. 2022; doi:10.1002/mdc3.13523.
Siderowf A, et al. Assessment of heterogeneity among participants in the Parkinson's Progression Markers Initiative cohort using alpha-synuclein seed amplification: A cross-sectional study. The Lancet Neurology. 2023; doi:10.1016/S1474-4422(23)00109-6.
Berg D, et al. Alpha-synuclein seed amplification and its uses in Parkinson's disease. The Lancet Neurology. 2023; doi:10.1016/S1474-4422(23)00124-2.

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IMAGES

6 Types of Speech Impediments
Speech Impediment Guide: Definition, Causes & Resources
19+ Charming Speech Impediment Quotes That Will Unlock Your True Potential
Speech Impediment Awareness Card
6 Types of Speech Impediments
Speech Impediment synonyms

VIDEO

AAC, literacy and fun: What's in the witch's kitchen?
My journey with stammering
Cemeteries, Weddings, Dead Bodies...Oh, my!
Difficult Connected Speech in the English Language

COMMENTS

65 Speech Therapy Word Lists for Speech Therapy Practice
Targeted Word Lists for Speech Therapy Practice. The speech therapy word lists are perfect for anyone who needs practice with speech and language concepts.For any type of practice.....you need words to get started.. Now I don't know about you, but when I need to think of targeted words to use.....I suffer from spontaneous memory loss, or SML.. It's more common than you might think ;)
Speech Impediments (Speech Disorders)
A speech impediment, or speech disorder, is a condition that makes it hard for you to communicate. There are many types of speech impediments, and anyone can develop one. In some cases, children are born with conditions that affect speech. Other times, people have conditions or injuries that affect speech. Speech therapy can help.
Types of Speech Impediments
A speech impediment, also known as a speech disorder, is a condition that can affect a person's ability to form sounds and words, making their speech difficult to understand. Speech disorders generally become evident in early childhood, as children start speaking and learning language. While many children initially have trouble with certain ...
Word Lists For Speech Therapy
Activities By Disorder. General Speech-Language; Articulation; WH Questions; Late Talker; Vocabulary; Social Language; Receptive Language; Grammar Games; Story Grammar; ... Word Lists For Speech Therapy. Affordable Membership Program. Instant access to 3,500+ research based materials and documents! Join Today. What's New!
Five Common Speech Disorders in Children
5 Common Speech Disorders in Children: Articulation Disorder: An articulation disorder is a speech sound disorder in which a child has difficulty making certain sounds correctly. Sounds may be omitted or improperly altered during the course of speech. A child may substitute sounds ("wabbit" instead of "rabbit") or add sounds improperly ...
Speech Impediment: Types in Children and Adults
Common causes of childhood speech impediments include: Autism spectrum disorder: A neurodevelopmental disorder that affects social and interactive development. Cerebral palsy: A congenital (from birth) disorder that affects learning and control of physical movement. Hearing loss: Can affect the way children hear and imitate speech.
R Word List For Articulation Practice
It is important to practice hearing and saying the words. Write - Say "write" as you take turns drawing on a piece of paper. Race - Say "race" as you and your child run across the yard. Ready - Say "ready" before you start your race. Read - Say "read" as your child reads a sentence in a book.
Stuttering
When children are learning a lot of words or new speech sounds, you may notice some of these typical disfluencies. This is normal. The following types of disfluencies happen when someone stutters: Part-word repetitions - "I w-w-w-want a drink." One-syllable word repetitions - "Go-go-go away." Prolonged sounds - "Ssssssssam is nice."
Speech Sound Disorders
Other sounds take longer to learn, like z, v, or th. Most children can say almost all speech sounds correctly by 4 years old. A child who does not say sounds by the expected ages may have a speech sound disorder. You may hear the terms "articulation disorder" and "phonological disorder" to describe speech sound disorders like this.
Speech disorders: Types, symptoms, causes, and treatment
Learn about the different types of speech disorders, such as stuttering, apraxia, and dysarthria, and how they affect a person's ability to produce sounds that create words. Find out the symptoms, causes, diagnosis, and treatment options for speech disorders.
10 Most Common Speech-Language Disorders & Impediments
Spasmodic Dysphonia (SD) is a chronic long-term disorder that affects the voice. It is characterized by a spasming of the vocal chords when a person attempts to speak and results in a voice that can be described as shaky, hoarse, groaning, tight, or jittery. It can cause the emphasis of speech to vary considerably.
Speech Sound Disorders in Children
Key points about speech sound disorders in children. A speech sound disorder means a child has trouble saying certain sounds and words past the expected age. A child with an articulation disorder has problems making certain sounds the right way. A child with phonological process disorder regularly makes certain word speech mistakes.
Rhotacism: A complete guide to this speech impediment
A speech impediment is a speech disorder, not a language disorder. Speech disorders are problems in being able to produce the sounds of speech whereas language disorders are problems with understanding and/or being able to use words. Language disorders, unlike speech disorders, have nothing to do with speech production.
Speech Impediment Guide: Definition, Causes, and Resources
Commonly referred to as a speech disorder, a speech impediment is a condition that impacts an individual's ability to speak fluently, correctly, or with clear resonance or tone. Individuals with speech disorders have problems creating understandable sounds or forming words, leading to communication difficulties.
Hard Words to Say with a Lisp: Working Around Your Speech Disability
Hard words to say with a lisp. If you have a lisp, it can be difficult to say certain words. Some of the hardest words to say with a lisp include "th" sounds (as in "think"), "s" sounds (as in "see"), and "z" sounds (as in "zoo"). Many people think that a lisp is usually only found in kids before the age of five.
Speech Impairment: Types and Health Effects
There are three general categories of speech impairment: Fluency disorder. This type can be described as continuity, smoothness, rate, and effort in speech production. Voice disorder. A voice ...
Dysarthria (Slurred Speech): Symptoms, Causes & Treatment
Dysarthria (pronounced "dis-AR-three-uh") is a motor speech disorder that makes it difficult to form and pronounce words. Motor speech disorders occur when damage to your nervous system prevents you from fully controlling parts of your body that control speech, like your tongue, voice box (larynx) and jaw. Dysarthria makes it challenging to ...
Speech disorder
Speech disorders, impairments, or impediments, are a type of communication disorder in which normal speech is disrupted. [1] This can mean fluency disorders like stuttering, cluttering or lisps. Someone who is unable to speak due to a speech disorder is considered mute. [2] Speech skills are vital to social relationships and learning, and ...
Common Speech Impediments: Causes, Symptoms, Treatment, And Support
Overall difficulty communicating and expressing thoughts and ideas. Inability to repeat words. Inability to pronounce words the same way twice. A phobia of speaking in public. Speaking slowly and carefully. Speech delay. Frequent pauses when talking. Limited vocabulary over several years, delayed language development.
6 Types of Speech Impediments
3 Types Language Disorders. Specific Language Impairment. Aphasia. Language-Based Learning Disabilities. Key Takeaways about Speech Impediments. A speech impediment relates to the way an individual produces or articulates specific sounds. One example of this is stuttering. Under the umbrella of a speech impairment lies several different types ...
Speech impairment in adults: MedlinePlus Medical Encyclopedia
DYSARTHRIA. With dysarthria, the person has problems expressing certain sounds or words. They have poorly pronounced speech (such as slurring) and the rhythm or speed of speech is changed. Usually, a nerve or brain disorder has made it difficult to control the tongue, lips, larynx, or vocal cords, which make speech.
SPEECH IMPEDIMENT definition
SPEECH IMPEDIMENT meaning: 1. a difficulty in speaking clearly, such as a lisp or stammer 2. a difficulty in speaking clearly…. Learn more.
Voice, Speech, and Language
Nearly 1 in 12 Children Ages 3-17 Has a Disorder Related to Voice, Speech, Lang… Prevent Voice Problems: Stay Hydrated (Multimedia content) Statistics and Epidemiology
You asked, we answered: Can aphasia ever get better?
Answered by Speech-Language Pathologist Carol Gaebler, MS, CCC-SLP. Aphasia is a neurogenic disorder caused by injury to the brain, usually from a stroke or trauma to the speech and language centers. In the U.S., it is estimated that more than 2 million people, both children and adults, are affected by aphasia.
How to improve your communication with someone with a speech impairment
Speech impairments can occur at a young age with disabilities such as cerebral palsy or autism spectrum disorder, ... Others' words, not firsthand experience, shape scientific and religious belief ...
Parkinson's disease
Parkinson's disease is a progressive disorder that affects the nervous system and the parts of the body controlled by the nerves. Symptoms start slowly. The first symptom may be a barely noticeable tremor in just one hand. Tremors are common, but the disorder also may cause stiffness or slowing of movement.