definition of speech disturbance

• Brain & Nervous System

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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• Introduction

Prevalence of speech disorders

Classification of speech disorders, treatment and rehabilitation, development of speech correction.

• Voice disorders
• Disorders of language development
• Stuttering, or stammering
• Dysphasia and aphasia
• Shaking palsy
• Intellectual disability
• Language and mental disorder
• Speech of the hard of hearing
• Loss of tongue
• Nasal speech
• Cleft palate speech

speech disorder

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• Table Of Contents

speech disorder , any of the disorders that impair human speech .

Human communication relies largely on the faculty of speech, supplemented by the production of certain sounds, each of which is unique in meaning. Human speech is extraordinarily complex, consisting of sound waves of a diverse range of frequencies, intensities, and amplitudes that convey specific information. The production and reception of these sounds require a properly functioning ear and auditory system, as well as intact and healthy vocal and sound-generating structures, including the larynx , the tongue, and the lips.

Vocal communication can be rendered difficult or impossible by deformities in the physical structures used in speech and sound production or by disorders affecting areas of the brain that process speech and sound.

The study of speech disorders

In the United States , statistics from the early 21st century compiled by the National Institute on Deafness and Other Communication Disorders revealed that approximately 5 percent of American children had detectable speech disorders by age six or seven. About 7.5 million Americans were found to be unable to use their voice normally. Disorders of articulation among young children were frequent.

Studies in Germany, Austria, and other central European countries suggest that the incidence and prevalence of speech disorders in these countries follow patterns similar to those observed among other Western countries. There are, however, deviations from these trends. For example, the incidence of cleft palate is very high among Native Americans, while it is much lower among blacks than in whites. Studies of stuttering that have focused on specific populations, including Americans, Europeans, and Africans, have indicated that the prevalence of the disorder among these populations is highly variable. However, generalization of the data suggests that roughly 2.5 percent of children under age five are affected by stuttering . For some speech disorders, reliable data on global prevalence and distribution are lacking.

In accordance with physiological considerations, disorders of communication are first classified into disorders of voice and phonic respiration, disorders of articulated speech, and disorders of language . It has been known for a long time that the majority of communication disorders are not caused by local lesions of the teeth, tongue, vocal cords, or regulating brain centres. Since these predominant disorders of voice and speech develop from derangements of the underlying physiological functions of breathing, use of the voice, speaking habits, or emotional disorders, this group has been labeled as functional. The remainder of the communication disorders with clearly recognizable structural abnormalities in the total speech mechanism has been labeled organic.

While this empirical grouping has certain implications for the selection of the appropriate treatment, it is not satisfactory because organic structure and living function can never be separated. Certain functional disorders of the voice caused by its habitual abuse may very well lead to secondary structural changes, such as the growths (polyps and nodules) of the vocal cords, which develop as a result of vocal abuse. On the other hand, all the obviously organic and structural lesions, such as loss of the tongue from accident or surgery, will almost inevitably be followed by emotional and other psychological reactions. In this case, the functional components are of a secondary nature but to a great extent will influence the total picture of disturbance, including the patient’s ability to adjust to the limitation , to relearn a new mode of appropriate function, and to make the best of his or her condition.

Within these major groups, the various types of communication disorders have for a long time, and in most parts of the world, been described by the listener’s perceptual impression. Most languages employ specific words for the various types of abnormal speech, such as stuttering, stammering, cluttering, mumbling, lisping, whispering, and many others. The problem with such subjective and symptomatic labels is the fact that they try to define the final, audible result, the recognizable phenomenon, and not by any means the underlying basis. This general human tendency to describe disorders of communication by what the listener hears is analogous to the attempts of early medicine to classify diseases by the patient’s symptoms that the diagnosing physician could see or hear or feel or perhaps smell. Before the great discoveries of the 19th century had erected a logical basis for medical pathology , the various diseases were classified as numerous types of fevers, congestions, and dyscrasias. Thus, malaria was originally thought to be caused by the evil emanations (miasma) of the bad air ( mal aria ) near swamps until it was recognized to be caused by a blood parasite transmitted by the mosquito.

The various approaches of medical, psychiatric, psychological, educational, behavioral, and other schools of speech pathology have made great advances in the recent past and better systems of classification continue to be proposed. They aim at grouping the observable symptoms of speech disorders according to the underlying origins instead of the listener’s subjective impressions. While this is relatively easy in the case of language loss from, for example, a brain stroke because the destroyed brain areas can be identified at autopsy, it is more difficult in the case of the large group of so-called functional speech disorders for two reasons: first, they are definitely not caused by gross, easily visible organic lesions, and, second, many functional disorders are outgrown through maturation or appropriate learning (laboratory study of the involved tissues in such cases would reveal no detectable lesions). It is hoped that refined methods of study in the areas of both “functional” psychology and “organic” neurophysiology will eventually reveal the structural bases for the prevalent disorders of voice and speech.

The selection of methods in the medical treatment or educational rehabilitation of communication disorders depends primarily on the underlying basis for the disturbance. Any case of chronic hoarseness should be evaluated first by a laryngologist to establish a precise diagnosis . This is particularly important in the older age groups in which an incipient laryngeal cancer is often overlooked because the patient does not pay attention to his or her deteriorating voice. The prognosis of all cancers becomes rapidly poorer the longer the disease remains unrecognized. As soon as disease of the larynx is excluded as a cause of the vocal complaint, vocal rehabilitation by a competent speech pathologist should be considered.

Malformations, diseases, or injuries of the peripheral speech mechanism are treated by appropriate specialists. The plastic surgeon repairs a cleft of the palate. The neurologist and internist treat the stroke patient until he or she has recovered sufficiently to be referred for reeducation of language abilities. The pediatrician treats the child with intellectual disability , while the geneticist counsels the family regarding the possible inheritance of the disorder and its future avoidance. Deafness or severe hearing loss in early childhood is a typical cause for severe delay of language development and should be promptly recognized through appropriate examination by the ear surgeon (otologist) and hearing specialist (audiologist). Cases of childhood autism (withdrawal, severe eccentricities) or early schizophrenia are recognized with increasing frequency by speech pathologists, child psychiatrists, pediatricians, and clinical psychologists. This multitude of various professional interests in the recognition and rehabilitation of such exceptional children is well served by the coordination of these efforts in the modern team approach. But again, the largest group of disorders of voice and speech has causes other than these grossly organic lesions. They belong within the province of speech rehabilitation by experts in speech pathology and other functional practitioners.

In the 21st century, researchers from diverse fields, including neuroscience, bioengineering, and linguistics, worked to develop state-of-the-art devices capable of generating a synthetic voice controlled by activity in the speech centres of a person’s brain. Part of this research entailed mapping sound produced by the voice of healthy individuals to movements of the vocal tract, which allowed for the subsequent development of algorithms that associate brain activity generated during speech with specific vocal tract movements. Those movements could then be used to produce a synthetic version of an individual’s voice. In an early trial, one such neural decoder successfully generated understandable sentences that had been silently mimed by a person with intact speech.

That humankind has been troubled by speech afflictions since the beginning of recorded history can be gleaned from numerous remarks in the books of the Bible. Further, many scientific and medical writers from the time of antiquity to the Middle Ages reported observations of speech and voice disorders. The recommended remedies merely reflected the inadequacies of the philosophical or empirical notions of their times. Scientifically oriented speech pathology originated in Germany during the latter part of the 19th century, following closely the development of otolaryngology. Three names stand out in this respect: Carl Ludwig Merkel ( Anthropophonik ; 1857), Adolph Kussmaul ( The Disorders of Speech ; 1877), and Hermann Gutzmann, Sr., who became the first professor of speech pathology at the University of Berlin Medical School around 1900.

During the same time, the new science of experimental phonetics was developed by Jean-Pierre Rousselot in Paris, who promptly recognized the great contributions that experimental phonetics could make to the study of normal and disturbed speech. This close collaboration of medical speech pathology with experimental phonetics has remained typical for the European continent where speech correction is customarily carried out under the direction of physicians in the ear, nose, and throat departments of the university hospitals. The designation of speech and voice pathology as logopedics and phoniatrics with its medical orientation subsequently reached many other civilized nations, notably in Japan and on the South American continent. The national organizations in most of these areas are now represented in the International Association of Logopedics and Phoniatrics, which was founded in Vienna in 1924.

The evolution of speech correction in the Anglo-Saxon countries followed a different trend. Although the United Kingdom has had a long tradition in general and experimental phonetics, its College of Speech Therapists was organized as an examining and supervisory body in 1945. Similar organizations followed in other areas of the British Commonwealth.

American speech pathology elected a different way. The American Speech-Language-Hearing Association (ASHA), founded in 1925 in New York City as the American Academy of Speech Correction, became the organizing, examining, and supervisory body for a rapidly growing membership, which surpassed 130,000 by 2008. Many colleges and universities in the United States are accredited by ASHA and offer degrees in speech pathology and audiology , some including work at the doctoral level. The large majority of ASHA members work as speech clinicians. A smaller number with master’s degrees and a still smaller number with doctoral degrees staff clinics that deal with communication disorders and that are usually affiliated with hospitals, colleges, universities, and occasionally with civic organizations.

Russian speech correction originally followed the developments of European logopedics and phoniatrics. One facet of early speech pathology research in Russia was its emphasis on Pavlovian theory ( conditioning and retraining) and intensive use of neuropsychiatric methods, including pharmacology, sleep therapy, and other intensive treatment programs during hospitalization. Similar trends operate in the eastern European countries, such as in the Czech Republic , where the first independent medical department of logopedics and phoniatrics was organized at the Faculty of Medicine of Charles University in Prague.

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What Are Language Disorders?

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Children come to the world almost pre-programmed to learn the language of their environment. But while it appears automatic for a child to learn to read, speak, and understand communication around them—the pace at which these skills are learned vary among children. In some cases, children may not meet certain developmental milestones .

A language disorder occurs when a child is unable to compose their thoughts , ideas, and messages using language. This is known as an expressive language disorder. When a child faces difficulty in understanding what is communicated via language, this is called a receptive language disorder.

Sometimes, a child may live with a mix of expressive and receptive language disorders. A lack of understanding or poor expression of language does not always indicate a language disorder, however. This could simply be the result of a speech delay.

Read on to learn about the types, characteristics, causes, and trusted treatment methods to manage language disorders in children .

Types of Language Disorders in Children 

With language , there are specific achievements expected when children mark a certain age. At 15 months, it is likely that a child can recognize between five to ten people when they are named by parents or caregivers. At 18 months, it is expected that a child can respond to simple directives like ‘let’s go outside’ without challenges. This is an already receptive child.

If at 18 months, a child is unable to pronounce ‘mama’ and ‘dada’, or if at 24 months, this child does not have at least 25 words in their vocabulary—this could signal an expressive language disorder.

Receptive Language Disorder

When a child struggles to understand the messages communicated to, or around them, this can be explained as a receptive disorder. Children with receptive challenges will usually display these difficulties before the age of four.  

Receptive difficulties may be observed where a child does not properly understand oral communication directed at, or around them.

In such cases, the child struggles to understand the spoken conversations or instructions directed around them. Likewise, written words may be difficult to process. Simple gestures to come, go, or sit still may also prove challenging to comprehend.

Expressive Language Disorders

Expressive language disorders occur when a child is unable to use language to communicate their thoughts or feelings.

In this sense, oral communication is just one of the affected areas. A child may also consider written communications difficult to express.

Children with expressive disorders will find it difficult to name objects, tell stories, or make gestures to communicate a point. This disorder can cause challenges with asking or answering questions, and may lead to improper grammar usage when communicating.

Symptoms of Language Disorders

Language disorders are a common observation in children. Up to 1 out of 20 children exhibit at least one symptom of a language disorder as they grow. The symptoms of receptive disorders include:

• Difficulty understanding words that are spoken
• Challenges with following spoken directions
• Experiencing strain with organizing thoughts

Expressive language disorders are identified through the following traits in children:

• Struggling to piece words into a sentence
• Adopting simple and short words when speaking 
• Arranging spoken words in a skewed manner
• Difficulty finding correct words when speaking
• Resorting to placeholders like ‘er’ when speaking
• Skipping over important words when communicating
• Using tenses improperly 
• Repeating phrases or questions when answering

Causes of Language Disorders

With a language disorder, the child does not develop the normal skills necessary for speech and language. The factors responsible for language disorders are unknown, this explains why they are often termed developmental disorders .  

Disabilities or Brain Injury

Despite the uncertainty around the causes of these disorders, certain factors have strong links to these conditions. In particular, other developmental disorders like autism and hearing loss commonly co-occur with language disorders. Likewise, a child with learning disabilities may also live with language disorders.

Aphasia is another condition linked with language disorders. This condition develops from damage to the portion of the brain responsible for language. Aphasia may be caused by a stroke, blows to the head, and brain infections.  The injury may increase the chances of developing a language disorder.  

Diagnosis of Language Disorders

To determine if a child has a language disorder, the first step is to receive an expert’s assessment of their condition.

A speech-language pathologist or a neuropsychologist may administer standardized tests. These are to review the child’s levels of language reception and expression.

The Link Between Deafness and Language Problems

In making their assessment, the health expert will conduct a hearing test to discover if the child suffers from hearing loss. This is because deafness is one of the most common causes of language problems.  

Treatment of Language Disorders

Language disorders can have far-reaching effects on the life of a child. These disorders can lead to poor social interactions, or a dependence on others as an adult. Challenges with reception and expression can also lead to reading challenges, or problems with learning .

To manage this condition, parents/guardians should exercise patience and care when dealing with children managing language disorders. While it can be challenging, children already experience frustration when dealing with others and expressing themselves. Caregivers can provide a place of comfort for children who have learning challenges.

For expert guidance, a speech-language pathologist can work with children and their guardians to improve communication and expression.

Because language disorders can be emotionally taxing, parents and children with these disorders can try therapy . This will help in navigating the emotional and behavioral issues caused by language impairments.

NCBI. Speech and Language Disorders in Children: Implications for the Social Security Administration's Supplemental Security Income Program .

MedlinePlus. Language Disorders in Children .

Ritvo A, Volkmar F, Lionello-Denolf K et al. Receptive Language Disorders . Encyclopedia of Autism Spectrum Disorders . 2013:2521-2526. doi:10.1007/978-1-4419-1698-3_1695

Reindal L, Nærland T, Weidle B, Lydersen S, Andreassen O, Sund A. Structural and Pragmatic Language Impairments in Children Evaluated for Autism Spectrum Disorder (ASD) .  J Autism Dev Disord . 2021. doi:10.1007/s10803-020-04853-1

National Institute on Deafness and Other Communication Disorders. Aphasia .

Centers for Disease Control and Prevention. Language and Speech Disorders in Children .

By Elizabeth Plumptre Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.

What is a speech impairment?

A speech impairment refers to an impaired ability to produce speech sounds and may range from mild to severe. It may include an articulation disorder, characterized by omissions or distortions of speech sounds; a fluency disorder, characterized by atypical flow, rhythm, and/or repetitions of sounds; or a voice disorder, characterized by abnormal pitch, volume, resonance, vocal quality, or duration.

The American Speech-Language Hearing Association (ASHA) has published its official definitions in Definitions of Communication Disorders and Variations .

Additional information is available from Speech and Language Impairments  hosted by the Center for Parent Information and Resources.

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.
• 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.
• 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.
• Calvin University - Calvin University's Online Speech and Hearing Foundations Certificate - Helps You Gain a Strong Foundation for Your Speech-Language Pathology Career.

• Last edited on March 29, 2021

Speech Sound Disorder (Phonological Disorder)

Table of contents, dsm-5 diagnostic criteria, pathophysiology, differential diagnosis, for patients, for providers.

Speech Sound Disorder (also known as Phonological Disorder) is a disorder where speech sound production is not consistent with what is expected based on the child's developmental stage and age. Additionally, the speech production deficits must not be due to a physical, structural, neurological, or hearing impairment. Children with the disorder may not have knowledge of phonological speech sounds, or be unable to coordinate movements (i.e. - articulation) for speech.

Epidemiology

There is a prevalence of speech sound disorders in young children is 8 to 9 percent. [1]

Comorbidity

Language disorder (especially in those expressive deficits) may co-occur with speech sound disorder. Individuals may also have a history of delay or poor coordination involving facial musculature (e.g. - chewing, maintaining mouth closure, and nose blowing).

What is the Timeline of Development of Speech?

Criterion a.

Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.

Criterion B

The disturbance causes limitations in effective communication that interfere with social participation, academic achievement, or occupational performance, individually or in any combination.

Criterion C

Onset of symptoms is in the early developmental period.

Criterion D

The difficulties are not attributable to congenital (i.e. - during fetal development) or acquired conditions, such as cerebral palsy, cleft palate, deafness or hearing loss, traumatic brain injury , or other medical or neurological conditions. Hereditary and genetic disorders (e.g. - Down syndrome ) are excluded from this criterion.

Speech sound disorder can be due to various etiologies, and thus is a heterogeneous condition. For example, individuals with genetic disorders such as Down syndrome , DiGeorge (22q11.2 Deletion) syndrome , and the FoxP2 gene mutation may have speech sound disorder.

• Consider regional, social, or cultural/ethnic variations of speech before giving the diagnosis
• Hearing impairment or deafness may result in abnormalities of speech. Only when the language deficits are in excess of what is expected, should a diagnosis of speech sound disorder may be made.
• Speech impairment can be caused by structural deficits such as cleft palate.
• Speech impairment can be due to a motor disorder such as cerebral palsy. This is dysarthria and not speech sound disorder.
• Limited speech might be due to selective mutism. Selective mutism may develop concurrently in children with speech disorder due to embarrassment about their impairments. Most children with selective mutism have normal speech in comfortable environments, such as at home or with friends.

Most children with speech sound disorder respond well to speech therapy. Speech difficulties often improve over time, and the disorder may not be lifelong. For some, certain speech errors can persist into adulthood.