Speech Impairment (Speech Disorder)

What is a speech impairment?

A speech impairment (sometimes called 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 impairment 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 impairments may have difficulty learning to read and write. Research suggests children with speech impairments 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 impairments

There are different classifications for speech impairments:

• 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 sound, 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 affects 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 impairments common?

Experts estimate that 5% of children in the U.S. ages 3-17 have a speech impairment 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 impairments. In adults, speech impairments are often 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 a speech impairment?

Speech impairment 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 impairments?

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

• 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 impairments 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 impairments?

Treatment varies depending on your situation. For example, speech therapy is a common treatment for many speech impairments (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 impairment?

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

Can speech impairments be prevented?

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

What can I expect if I have a speech impairment?

There are many types of speech impairments, which makes it hard to say exactly what you can expect. For example, some speech impairments 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 impairment, your healthcare provider is your best resource for information.

How do I take care of myself?

A speech impairment can affect your quality of life. Some suggestions for living with a speech impairment 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 impairments 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 impairment and a language disorder?

A speech impairment 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.

Why do we call it a speech impairment instead of a speech impediment?

Language changes. Over the years, people have called speech conditions by many names, including speech disorders, speech impediment and speech impairment. But these terms all have slightly different meanings.

The word “impediment” is obsolete in medicine. It’s from the 1600s and comes from the verb “to impede.” It refers to an illness or defect that hinders or gets in the way of (obstructs) functioning. Essentially, a speech impediment is something that blocks or hinders. Like a loose tooth or a new tongue piercing, it feels like something temporary or external that physically affects your ability to speak.

Now, people use terms like “speech disorder” and “speech impairment” instead. They both mean that something is going on that changes (disorder) or weakens (impairs) your ability to function or perform a task on a physical, psychological or structural (anatomical) level.

A note from Cleveland Clinic

Speech is one way that we connect with the world around us. Having a speech impairment 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 impairment may have difficulty learning. Adults with speech impairments 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 impairment, talk to a healthcare provider. They’ll be glad to help.