Speech Impediment

What is a speech impediment?

A speech impediment, or speech disorder, happens when you have trouble saying sounds so that people don’t understand what you’re saying. Some people are born with conditions that affect their speech. But you can develop a speech impediment at any time in your life if you’re injured or have a medical condition that affects your voice or your ability to speak.

Without treatment, children with speech impediments may have difficulty learning to read and write. Research suggests children with speech impediments may develop mental health issues like anxiety and depression. Adults may feel anxious about trying to communicate and develop social isolation that can lead to depression.

Types of speech impediments

There are different classifications for speech impediments:

• Fluency disorders.
• Orofacial myofunctional disorders (OMD).
• Speech sound disorders.
• Voice disorders.

Fluency disorders

Fluency is the flow of a person’s speech. A person is fluent when they speak continuously and smoothly. A fluency disorder involves chronic and repeated interruptions to speech flow. Examples of fluency disorders are:

• Stuttering: If you stutter, you may sound like you’re trying to say a word or a syllable, but it’s not coming out.
• Cluttering: If you clutter, you may speak quickly, merging words or cutting off parts of words.

Orofacial myofunctional disorders (OMD)

An orofacial myofunctional disorder is when something affects how you use or move your face, mouth and tongue muscles. OMDs may affect how you speak, making it hard for you to make sounds like “s” as in sun or “sh” as in ship.

Speech sound disorders

A speech sound disorder is a speech impediment that affects your child’s or your ability to say sounds clearly. Examples of speech sound disorders are:

• Apraxia in adults.
• Articulation disorders.
• Childhood apraxia of speech.
• Dysarthria.

Voice disorders

Some voice disorders may affect your ability to speak. Examples include:

• Hoarseness.
• Laryngitis.
• Spasmodic dysphonia.

Are speech impediments common?

Experts estimate that 5% of children in the U.S. ages 3-17 have a speech impediment that lasts for a week or longer. By the time children are in first grade, 5% have noticeable issues. About 2% of children in the U.S. have voice disorders that affect their ability to speak.

The overall picture is less clear when we’re talking about adults who have speech impediments. Often, speech disorders in adults are classified by the specific condition.

For example, more than 3 million people in the U.S. stutter, or about 10% of the total U.S. population. While most people outgrow stuttering during their childhood, 1 in 4 people experience stuttering as adults. Voice disorders affect 4% of adults in the U.S.

What are the symptoms of speech disorders?

Speech disorder symptoms vary depending on the cause. For example, if you have stuttering, you can’t control the muscles that you use to speak, so you repeat sounds or syllables or hold or draw out certain sounds or syllables. If you have a voice disorder, your voice may sound uneven or shaky, strangled or breathy.

What causes speech impediments?

Healthcare providers don’t know all the reasons why children and adults have speech impediments. In general, anything that may cause brain damage or nerve damage may affect your ability to speak:

• Neurodevelopmental conditions like autism spectrum disorder, attention-deficit/hyperactivity disorder (ADHD) or epilepsy.
• Traumatic brain injury (TBI).
• Medical conditions like stroke, brain tumor or dementia.

How are speech impediments diagnosed?

Healthcare providers usually begin diagnosis with a comprehensive physical examination. A pediatrician may do a developmental evaluation. A provider or pediatrician may refer you or your child to a speech-language pathologist (SLP), a specialist who diagnoses and treats conditions that affect your ability to communicate.

What are treatments for speech impediments?

Treatment varies depending on your situation. For example, speech therapy is a common treatment for many speech disorders. If you have a voice disorder that affects your speech, your provider may refer you to specialists for voice therapy.

Can you fix a speech impediment?

In some cases, yes, speech therapy can help people overcome speech impediments. But everyone is different. You can develop a speech impediment if you have an underlying condition that affects your ability to speak. In that case, speech therapy may help, but it may not fix your speech impediment.

Can speech disorders be prevented?

There’s no way to prevent most speech disorders. You may be able to prevent some voice disorders by protecting your voice from overuse.

What can I expect if I have a speech impediment?

There are many types of speech impediments, which makes it hard to say exactly what you can expect. For example, some speech impediments improve as children grow older. If a medical condition causes speech issues, your speech is likely to improve as you get better. But there are situations when people need long-term speech therapy so they can communicate. If you have a speech impediment, your healthcare provider is your best resource for information.

How do I take care of myself?

A speech impediment can affect your quality of life. Some suggestions for living with a speech impediment are:

• Consider support groups: Connecting with a national or local support group can help you find people who understand what it’s like to experience speech issues.
• Consider mental health support: People who have speech impediments may experience depression or anxiety. Working with a counselor or psychologist may help.

When should I see a healthcare provider?

Visit a healthcare provider as soon as you feel like something is affecting your ability to speak, hear or communicate with others. Visit a provider if you think your child might have difficulties with language or comprehension.

When should I go to the emergency room?

A sudden change in your ability to speak may be a symptom of a serious medical condition that needs immediate care. A stroke or head injury can affect speech. If you’re with someone who has the following symptoms, call 911 or your local emergency service number right away. To recognize the warning signs of a stroke, remember to think BE FAST:

• B. Be watchful for a sudden loss of balance.
• E. Look out for sudden loss of vision in one or both eyes. Are they experiencing double vision?
• F. Ask the person to smile. Look for a droop on one or both sides of their face, which is a sign of muscle weakness or paralysis.
• A. A person having a stroke often has muscle weakness on one side. Ask them to raise their arms. If they have one-sided weakness (and didn’t have it before), one arm will stay higher while the other will sag and drop downward.
• S. Strokes often cause a person to lose their ability to speak. They might slur their speech or have trouble choosing the right words.
• T. Time is critical, so don’t wait to get help! If possible, look at your watch or a clock and remember when symptoms start. Telling a healthcare provider when symptoms started can help the provider know what treatment options are best.

What’s the difference between a speech impediment and a language disorder?

A speech impediment happens when your mouth, jaw, tongue and vocal tract can’t work together to produce recognizable words. A language disorder happens when you have trouble understanding what others are saying. You may have trouble expressing your thoughts in ways that people understand.

A note from Cleveland Clinic

Speech is one way that we connect with the world around us. Having a speech impediment can make it hard to make that connection. It can be frustrating when you can’t communicate what you want people to know. Without treatment, a child with a speech impediment may have difficulty learning. Adults with speech impediments sometimes feel anxious and stressed about communicating using speech. Often, speech therapy can help. If you’re concerned about being able to communicate or think your child may have a speech impediment, talk to a healthcare provider. They’ll be glad to help.