speech problem definition

• Health Conditions

What to Know About Speech Disorders

Speech disorders can affect the way a person creates sounds to form words. Certain voice disorders may also be considered speech disorders.

Some people with speech disorders are aware of what they would like to say but unable to articulate their thoughts. This may lead to self-esteem issues and the development of depression .

Speech disorders can affect adults and children. Early treatment can correct these conditions.

Types of speech disorders

One of the most commonly experienced speech disorders is stuttering. Other speech disorders include apraxia and dysarthria .

• Apraxia: a motor speech disorder caused by damage to the parts of the brain related to speaking.
• Dysarthria: a motor speech disorder in which the muscles of the mouth, face, or respiratory system may become weak or have difficulty moving.

People who stutter can experience the following types of disruption:

• Repetitions : involuntarily repeat sounds, vowels, or words.
• Blocks : difficulty making the necessary speech sounds despite knowing what you want to say
• Prolongations : stretching or drawing out of particular sounds or words

Apraxia may present itself in the following ways:

• long pauses between syllables
• having to move the lips, jaw, or tongue a few times before speaking
• slower rate of speech
• distorted sounds in speech, such as sound substitutions or difficulty saying long words

People who live with dysarthria may experience the following symptoms:

• slurred speech
• speaking too slowly or too quickly
• soft or quiet speech
• difficulty moving the mouth or tongue

What causes speech disorders?

Speech disorders affect the vocal cords, muscles, nerves, and other structures within the throat.

Causes may include:

• vocal cord damage
• brain damage
• muscle weakness
• respiratory weakness
• polyps or nodules on the vocal cords
• vocal cord paralysis

People who have certain medical or developmental conditions may also have speech disorders. Common conditions that can lead to speech disorders are:

• attention deficit hyperactivity disorder (ADHD)
• oral cancer
• laryngeal cancer
• Huntington’s disease
• amyotrophic lateral sclerosis (ALS) , also known as Lou Gehrig’s disease

Speech disorders may be hereditary, and they can develop over time.

What are the symptoms of a speech disorder?

Several symptoms may be present depending on the cause of the speech disorder. Common symptoms experienced by people with speech disorders are:

• repeating sounds , which is most often seen in people who stutter
• adding extra sounds and words
• elongating words
• making jerky movements while talking, usually involving the head
• blinking several times while talking
• visible frustration when trying to communicate
• taking frequent pauses when talking
• distorting sounds when talking
• hoarseness , or speaking with a raspy or gravelly-sounding voice

How are speech disorders diagnosed?

Many tests are available to diagnose speech disorders.

Denver articulation screening exam

The Denver articulation screening examination (DASE) is a commonly used testing system to diagnose articulation disorders. This test evaluates the clarity in pronunciation in children between the ages of 2 and 7. This five-minute test uses various exercises to assess the child’s speech.

Early language milestones scale 2

This test , created by neurodevelopmental pediatrician James Coplan, determines a child’s language development. This test can quickly identify delayed speech or language disorders.

Peabody picture vocabulary test, revised

This test measures a person’s vocabulary and ability to speak. The person will listen to various words and choose pictures that describe the words. People who have severe intellectual disabilities and those who are blind won’t able to take this assessment. The Peabody picture vocabulary test has been revised many times since its first version was administered in 1959.

How are speech disorders treated?

Mild speech disorders may not require any treatment. Some speech disorders may simply go away. Others can improve with speech therapy.

Treatment varies and depends on the type of disorder. In speech therapy, a professional therapist will guide you through exercises that work to strengthen the muscles in your face and throat.

You’ll learn to control your breathing while speaking. Muscle-strengthening exercises and controlled breathing help improve the way your words sound. You’ll also learn ways to practice smoother, more fluent speech.

Some people with speech disorders experience nervousness, embarrassment, or depression. Talk therapy may be helpful in these situations. A therapist will discuss ways to cope with the condition and ways to improve the outlook of your condition.

If your depression is severe, antidepressant medications can help.

What are the potential complications of speech disorders?

Untreated speech disorders may cause a person to experience a great deal of anxiety . Over time, this anxiety can trigger anxiety disorders or a phobia of speaking in public . Early treatment for anxiety can help prevent the development of anxiety disorders or phobias.

Treatment options include talk therapy and anti-anxiety medications .

What is the long-term outlook?

The outlook improves for people who seek early treatment. Early treatment helps prevent a speech disorder from worsening. The outlook for those with permanent disabilities depends upon the severity of the disability.

How we reviewed this article:

• Apraxiaof speech in adults. (n.d.). http://www.asha.org/public/speech/disorders/Apraxia-of-Speech-in-Adults/
• Childhoodapraxia of speech. (n.d.). http://www.asha.org/public/speech/disorders/ChildhoodApraxia/
• CoplanJ. (n.d.). Early language milestone scale - 2 [Video]. http://www.drcoplan.com/early-language-milestone-scale-2
• Peabodypicture vocabulary test: Revised. (n.d.). https://www.nlsinfo.org/content/cohorts/nlsy79-children/topical-guide/assessments/peabody-picture-vocabulary-test-revised
• Screening and assessment. (n.d.). https://www.elcbigbend.org/site/Providers/Early-Care-and-Education/Professional-Development/Screening-and-Assessment

Share this article

More in Managing Friedreich’s Ataxia

• Friedreich’s Ataxia
• What Is Ataxia?
• What Is Episodic Ataxia?
• Acute Cerebellar Ataxia (ACA)

Read this next

Friedreich’s ataxia is a rare genetic disease that causes difficulty walking, a loss of sensation in the arms and legs, and impaired speech.

Ataxia involves a lack of muscle coordination and control. There are many types. Learn more about ataxia's causes, symptoms, and treatments.

Episodic ataxia (EA) is a rare neurological condition that impairs movement. We'll look at the different types, symptoms, and treatments.

Acute cerebellar ataxia (ACA) is a disorder that occurs when the cerebellum becomes inflamed or damaged. The cerebellum is the area of the brain…

• Bipolar Disorder
• Therapy Center
• When To See a Therapist
• Types of Therapy
• Best Online Therapy
• Best Couples Therapy
• Managing Stress
• Sleep and Dreaming
• Understanding Emotions
• Self-Improvement
• Healthy Relationships
• Student Resources
• Personality Types
• Sweepstakes
• Guided Meditations
• Verywell Mind Insights
• 2024 Verywell Mind 25
• Mental Health in the Classroom
• Editorial Process
• Meet Our Review Board
• Crisis Support

Types of Speech Impediments

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.

• Bachelor’s Degrees
• Master’s Degrees
• Doctorate Degrees
• Certificate Programs
• Nursing Degrees
• Cybersecurity
• Human Services
• Science & Mathematics
• Communication
• Liberal Arts
• Social Sciences
• Computer Science
• Admissions Overview
• Tuition and Financial Aid
• Incoming Freshman and Graduate Students
• Transfer Students
• Military Students
• International Students
• Early Access Program
• About Maryville
• Our Faculty
• Our Approach
• Our History
• Accreditation
• Tales of the Brave
• Student Support Overview
• Online Learning Tools
• Infographics

Home / Blog

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.

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.

Back To Top

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.  

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”

Bring us your ambition and we’ll guide you along a personalized path to a quality education that’s designed to change your life.

Take Your Next Brave Step

Receive information about the benefits of our programs, the courses you'll take, and what you need to apply.

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.

• Type 2 Diabetes
• Heart Disease
• Digestive Health
• Multiple Sclerosis
• Diet & Nutrition
• Health Insurance
• Public Health
• Patient Rights
• Caregivers & Loved Ones
• End of Life Concerns
• Health News
• Thyroid Test Analyzer
• Doctor Discussion Guides
• Hemoglobin A1c Test Analyzer
• Lipid Test Analyzer
• Complete Blood Count (CBC) Analyzer
• What to Buy
• Editorial Process
• Meet Our Medical Expert Board

What Is Apraxia of Speech?

A Challenging Language Disorder

Apraxia of speech is a language impairment that occurs due to brain damage. The underlying causes of apraxia of speech are usually different for children than for adults. Speech apraxia is difficult to cope with, and speech therapy can help improve communication.

Diagnosis of the underlying cause is crucial, both to help direct treatment for speech difficulties and to treat and prevent further neurological problems.

Illustration by Zoe Hansen for Verywell Health

Apraxia of Speech Symptoms 

Speech apraxia leads to significant difficulties in communicating. This condition usually causes persistent symptoms and typically doesn't change.

People with apraxia of speech are cognitively and physically able to produce words and sentences. Language comprehension should not be affected by apraxia of speech, and words are not slurred in apraxia of speech.

Features of apraxia of speech include the following:

• Distortion of sounds : The sounds of words and phrases are often wrong in speech apraxia. For example, the vowels or consonants might be drawn out for too long.
• Inconsistency in pronouncing words and sounds : The mispronunciation of words with speech apraxia is not necessarily consistent. For example, you could have difficulty with the first part of a word, and the next time you say that word, you might have difficulty with the middle or the end.
• Struggling for words : If you have apraxia of speech, you will work hard to say the words you want to say.
• Errors in speech : You might use the wrong words and phrases if you have apraxia of speech, despite knowing what you mean to say.

Other cognitive or physical problems can often occur with speech apraxia, depending on the underlying cause.

Apraxia vs. Other Speech and Language Disorders

Apraxia of speech is a type of language disorder. Aphasia is the most common language impairment, and dysarthria is a speech impairment caused by difficulty with motor speech function. Apraxia is distinct from these disorders, although they may share some similarities. Common speech disorders include:

• Receptive aphasia : Usually referred to as Wernicke’s aphasia, this type of language impairment is characterized by fluid speech that usually doesn’t make sense, often with word substitutions. Language comprehension is typically impaired with Wernicke’s aphasia.
• Impaired fluency : Often described as Broca’s aphasia , this is a language problem that causes people to have choppy speech without a normal rhythm. Usually, speech comprehension is not substantially affected by Broca’s aphasia.
• Conduction aphasia : In conduction aphasia, the problem is the ability to repeat a short sentence. Expression and comprehension of speech are spared.
• Dysarthria : This condition is characterized by slurred speech or difficulty making certain sounds. Usually, people with dysarthria without aphasia can understand language and may know which words they want to say but have difficulty pronouncing them.

Speech apraxia is caused by damage to regions in the brain that mediate communication between language regions in the brain and between the left and right hemispheres of the brain.

This can occur with developmental conditions, such as autism, or it may result from harm to the brain, such as from head trauma.

Conditions associated with apraxia of speech include:

• Autism spectrum disorder
• Cerebral palsy
• Head trauma
• Brain tumors
• Brain surgery

These conditions are not always associated with apraxia of speech. But they can sometimes cause damage or dysfunction to regions of the brain that allow communication between the right and left hemispheres—and then they could be associated with speech apraxia.

Speech apraxia is diagnosed based on a clinical evaluation, usually by a physician or a speech therapist . A detailed examination of speech and cognitive abilities is necessary to define apraxia of speech and to rule out other disorders that can cause similar speech and language patterns, such as dysarthria and aphasia.

Speech patterns noted in apraxia of speech include the following:

• Phonemic error frequency : This involves assessment of the frequency of mistakes while pronouncing words.
• Distortion error frequency : This is a count of how often sounds are altered during speech.
• Word syllable duration : This involves assessment of the extra time in saying a word, usually due to struggling.

The Apraxia of Speech Rating Scale (ASRS) is one of the ways that speech apraxia can be defined. Healthcare providers can use this scale to communicate with each other and follow the improvement of apraxia of speech with therapy. The ASRS includes 16 components, such as repetition of sounds or inaccurate sounds, that are rated on a scale from zero to four.

If you’ve been diagnosed with speech apraxia or any communication problem, healthcare providers will work to determine the underlying cause. Issues such as childhood neurodevelopmental problems, stroke, brain tumors, or damage from a head injury need to be identified and treated.

Diagnostic testing may include:

• Brain imaging tests : These tests can help identify common causes of apraxia of speech, such as a stroke or head trauma.
• Cognitive testing : These tests may be used as part of the assessment for autism, dementia, or psychiatric conditions, which may be related to speech challenges.
• Blood tests : Medical problems such as infections, electrolyte disturbances , or organ failure may cause communication difficulties.

In addition to diagnosing speech apraxia, your healthcare providers will also work to determine whether you have other neurological deficits that could be caused by the underlying issue causing your speech apraxia. These can include learning difficulties, behavioral problems, or body weakness.

Apraxia of speech is treated with speech therapy . This type of therapy will follow patterns of treatment that are well-established for improving speech and will also provide an individualized treatment plan.

Therapy may need to be ongoing, and the frequency and specific exercises used during your therapy can be adjusted as you improve. For example, if your speech improves substantially, you might be able to work with your speech therapist less frequently, or you may be able to do some speech exercises at home, as directed by your therapist.

It’s not possible to predict with absolute certainty whether a person will recover from apraxia of speech and how much they might improve. However, there are some diagnostic clues that can help in anticipating the extent of recovery. 

If you or a loved one has apraxia of speech, it can help to know that the ability to participate in speech therapy can lead to better outcomes. If your cognitive function is not affected or is only mildly impaired, this can help you take an active role in your therapy.

Research About Prognosis and Treatment

Stronger connectivity between certain areas of the right and left hemispheres of the brain is associated with better recovery.

For example, one research study showed that early connectivity of the inferior frontal gyrus (an area that processes speech and language) within two weeks after a stroke may be a strong predictor of recovery of apraxia of speech.  

And at six months, lower severity of speech apraxia was associated with stronger connectivity of the anterior insula (which supports subjective feelings) on the right and left hemispheres and the ventral premotor cortex (which is involved in grasping and manipulating objects) of the right and left hemispheres.

This type of connectivity can be identified with metabolic brain testing, which is time-consuming and often impractical. However, this research can help scientists learn about ways to improve treatment for people with apraxia of speech.

Living with a language impairment can be difficult. Communication challenges interfere with relationships and day-to-day life. This can require extra effort from family, friends, and everybody else who interacts with a person who has apraxia of speech.

Patience is essential to managing this communication difficulty. It is important to work with your speech therapist in order to identify ways to communicate as you work to recover. This can include using pictures, gestures, and other ways of expressing your needs.

Apraxia of speech is a type of language impairment that is caused by damage to the brain, either during fetal development, childhood, or adulthood. This condition can occur along with other neurological deficits that are associated with damage to the brain.

There are many different causes, and a diagnosis of the cause is essential for a comprehensive treatment of speech apraxia, as well as any associated physical and cognitive deficits. Speech therapy is the treatment for the speech impairment seen in this condition.

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

Vogindroukas I, Stankova M, Chelas EN, Proedrou A. Language and speech characteristics in autism . Neuropsychiatr Dis Treat . 2022;18:2367-2377. doi:10.2147/NDT.S331987

Haley KL, Jacks A. Three-dimensional speech profiles in stroke aphasia and apraxia of speech . Am J Speech Lang Pathol. 2023:1-10. doi:10.1044/2022_AJSLP-22-00170

Hybbinette H, Östberg P, Schalling E, et al. Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke . Front Neurol. 2022;13:1013652. doi:10.3389/fneur.2022.1013652

Duffy JR, Martin PR, Clark HM, et al. The apraxia of speech rating scale: reliability, validity, and utility . Am J Speech Lang Pathol. 2023;32(2):469-491. doi:10.1044/2022_AJSLP-22-00148

Zhao J, Li Y, Zhang X, et al. Alteration of network connectivity in stroke patients with apraxia of speech after tDCS: a randomized controlled study . Front Neurol. 2022;13:969786. doi:10.3389/fneur.2022.969786

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.

• Children's Health
• Common Symptoms
• Common Conditions
• Chronic Conditions
• View Full Guide

Common Speech and Language Disorders

Speech and language problems may make it hard for your child to understand and speak with others, or make the sounds of speech. They're common, affecting as many as one in 12 kids and teens in the U.S.

Kids with these disorders often have trouble when they learn to read and write, or when they try to be social and make friends. But treatment helps most children improve, especially if they start it early.

Adults can also have these disorders. It may have started in childhood, or they may have them because of other problems such as brain injuries, stroke , cancer , or dementia .

Speech Disorders

For children with speech disorders, it can be tough forming the sounds that make up speech or putting sentences together. Signs of a speech disorder include:

• Trouble with p, b, m, h, and w sounds at 1 to 2 years of age
• Problems with k, g, f, t, d, and n sounds between the ages of 2 and 3
• When people who know the child well find it hard to understand them

The causes of most speech disorders are unknown.

There are three major types:

Articulation: It’s hard for your child to pronounce words. They may drop sounds or use the wrong sounds and say things like “wabbit” instead of “rabbit.” Letters such as p, b, and m are easier to learn. Most kids can master those sounds by age 2. But r, l, and th sounds take longer to get right.

Fluency: Your child may have problems with how their words and sentences flow. Stuttering is a fluency disorder. That’s when your child repeats words, parts of words, or uses odd pauses. It’s common as kids approach 3 years of age. That’s when a child thinks faster than they can speak. If it lasts longer than 6 months, or if your child is more than 3.5 years old, get help.

Voice: If your child speaks too loudly, too softly, or is often hoarse, they may have a voice disorder. This can happen if your child speaks loudly and with too much force. Another cause is small growths on the vocal cords called nodules or polyps. They’re also due to too much voice stress.

Language Disorders

Does your child use fewer words and simpler sentences than their friends? These issues may be signs of a language disorder. For kids with this disorder, it’s hard to find the right words or speak in complete sentences. It may be tough for them to make sense of what others say. Your child may have this disorder if they:

• Don’t babble by 7 months
• Only speak a few words by 17 months
• Can’t put two words together by 2 years
• Have problems when they play and talk with other kids from the ages of 2 to 3

There are two major types of language disorders. It’s possible for a child to have both.

Receptive: This is when your child finds it hard to understand speech. They may find it hard to:

• Follow directions
• Answer questions
• Point to objects when asked

Expressive : If your child has trouble finding the right words to express themselves, they may have this type of language disorder. Kids with an expressive disorder may find it tough to:

• Ask questions
• String words into sentences
• Start and continue a conversation

It’s not always possible to trace the cause of language disorders. Physical causes of this type of disorder can include head injuries , illness, or ear infections . These are sometimes called acquired language disorders.

Other things that make it more likely include:

• A family history of language problems
• Being born early
• Down syndrome
• Poor nutrition

Doctors don’t always know what causes your child’s condition. Remember, these kinds of disorders have nothing to do with how smart your child is. Often, kids with language disorders are smarter than average.

Diagnosis and Treatment

Speech and language disorders are legally defined disabilities. Your child may get testing and treatment through your state’s early intervention program or local public schools. Some services are free.

Your child may see a speech language pathologist, or SLP. The SLP may try to find out if your child:

• Can follow directions
• Is able to name common objects
• Knows how to play with toys
• Can hold books the right way

The SLP will first check your child’s hearing. If that’s OK, the SLP will do tests to find out what kind of disorder may be present, if it’s a short-term problem or one that needs treatment, and what treatment plan to recommend.

How to Help Your Child

Children learn and grow at their own pace. The younger they are, the more likely they are to make mistakes. So you’ll want to learn the milestones. Know what skills your child should be able to master at a given age.

To help your child with their speech and language skills:

• Talk to your child, even as a newborn .
• Point to objects and name them.
• When your child is ready, ask them questions.
• Respond to what they say, but don’t correct mistakes.
• Read to your child at least 15 minutes a day.

If your child has one of these disorders, don’t assume they’ll outgrow it. But treatment does help most kids get better. The sooner they get it, the better the results.

Top doctors in ,

Find more top doctors on, related links.

• Children's Health News
• Children's Health Reference
• Children's Health Slideshows
• Children's Health Quizzes
• Children's Health Videos
• Find a Pediatrician
• ADHD in Children
• Baby Development
• BMI Calculator for Parents
• Children's Vaccines
• Kids' Dental Care
• Newborn & Baby
• Teen Health
• More Related Topics

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

• Health Topics
• Drugs & Supplements
• Medical Tests
• Medical Encyclopedia
• About MedlinePlus
• Customer Support

Speech disorders - children

A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others. This can make the person's speech difficult to understand.

Common speech disorders are:

• Articulation disorders
• Phonological disorders
• Voice disorders or resonance disorders

Speech disorders are different from language disorders in children . Language disorders refer to someone having difficulty with:

• Getting their meaning or message across to others (expressive language)
• Understanding the message coming from others (receptive language)

Speech is one of the main ways in which we communicate with those around us. It develops naturally, along with other signs of normal growth and development . Disorders of speech and language are common in preschool age children.

Disfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be the most serious disfluency. It may be caused by:

• Genetic abnormalities
• Emotional stress
• Any trauma to the brain or infection

Articulation and phonological disorders may occur in other family members. Other causes include:

• Problems or changes in the structure or shape of the muscles and bones used to make speech sounds. These changes may include cleft palate and tooth problems.
• Damage to parts of the brain or the nerves (such as from cerebral palsy ) that control how the muscles work together to create speech.
• Hearing loss.

Voice disorders are caused by problems when air passes from the lungs, through the vocal cords, and then through the throat, nose, mouth, and lips. A voice disorder may be due to:

• Acid from the stomach moving upward ( GERD )
• Cancer of the throat
• Cleft palate or other problems with the palate
• Conditions that damage the nerves that supply the muscles of the vocal cords
• Laryngeal webs or clefts (a birth defect in which a thin layer of tissue is between the vocal cords)
• Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or ulcers) on the vocal cords
• Overuse of the vocal cords from screaming, constantly clearing the throat, or singing
• Hearing loss

Stuttering is the most common type of disfluency.

Symptoms of disfluency can include:

• Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my doll. I...I see you.)
• Putting in (interjecting) extra sounds or words (We went to the...uh...store.)
• Making words longer (I am Boooobbby Jones.)
• Pausing during a sentence or words, often with the lips together
• Tension in the voice or sounds
• Frustration with attempts to communicate
• Head jerking while talking
• Eye blinking while talking
• Embarrassment with speech

ARTICULATION DISORDER

The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."

• Certain sounds (like "r", "l", or "s") may be consistently distorted or changed (such as making the 's' sound with a whistle).
• Errors may make it hard for people to understand the person (only family members may be able to understand a child).

PHONOLOGICAL DISORDER

The child does not use some or all of the speech sounds to form words as expected for their age.

• The last or first sound of words (most often consonants) may be left out or changed.
• The child may have no problem pronouncing the same sound in other words (a child may say "boo" for "book" and "pi" for "pig", but may have no problem saying "key" or "go").

VOICE DISORDERS

Other speech problems include:

• Hoarseness or raspiness to the voice
• Voice may break in or out
• Pitch of the voice may change suddenly
• Voice may be too loud or too soft
• Person may run out of air during a sentence
• Speech may sound odd because too much air is escaping through the nose (hypernasality) or too little air is coming out through the nose (hyponasality)

Exams and Tests

Your health care provider will ask about your child's developmental and family history. The provider will do some neurological screening and check for:

• Fluency of speech
• Any emotional stress
• Any underlying condition
• Effect of speech disorder on daily life

Some other evaluation tools used to identify and diagnose speech disorders are:

• Denver Articulation Screening Examination.
• Leiter International Performance scale-3.
• Goldman-Fristoe Test of Articulation 3 (GFTA-3).
• Arizona Articulation and Phonology Scale 4th Revision (Arizona-4).
• Prosody-voice screening profile.

A hearing test may also be done to check for hearing loss as a cause of the speech disorder.

Children may outgrow milder forms of speech disorders. The type of treatment will depend on the severity of the speech disorder and its cause.

Speech therapy may help with more severe symptoms or any speech problems that do not improve.

In therapy, the therapist may teach your child how to use their tongue to create certain sounds.

If a child has a speech disorder, parents are encouraged to:

• Avoid expressing too much concern about the problem, which can make matters worse by making the child more self-conscious.
• Avoid stressful social situations whenever possible.
• Listen patiently to the child, make eye contact, don't interrupt, and show love and acceptance. Avoid finishing sentences for them.
• Set aside time for talking.

Support Groups

More information and support for people with stuttering and their families can be found at:

• American Institute for Stuttering -- stutteringtreatment.org
• American Speech-Language-Hearing Association (ASHA) -- www.asha.org/
• The Stuttering Foundation -- www.stutteringhelp.org
• National Stuttering Association (NSA) -- westutter.org

Outlook (Prognosis)

The outlook depends on the cause of the disorder. Speech can often be improved with speech therapy. Early treatment is likely to have better results.

Possible Complications

Speech disorders may lead to challenges with social interactions due to difficulty communicating.

When to Contact a Medical Professional

Contact your provider if:

• Your child's speech is not developing according to normal milestones.
• You think your child is in a high-risk group.
• Your child is showing signs of a speech disorder.

Hearing loss is a risk factor for speech disorders. At-risk infants should be referred to an audiologist for a hearing test. Hearing and speech therapy can then be started, if necessary.

As young children begin to speak, some disfluency is common, and most of the time, it goes away without treatment. If you place too much attention on the disfluency, a stuttering pattern may develop.

Alternative Names

Articulation deficiency; Articulation disorder; Phonological disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering; Cluttering; Stammering; Childhood onset fluency disorder

American Speech-Language-Hearing Association website. Voice disorders. www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/ . Accessed February 22, 2024.

Driver LE, Nelson ME. Pediatric speech disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery . 7th ed. Philadelphia, PA: Elsevier; 2021:chap 183.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics . 21st ed. Philadelphia, PA: Elsevier; 2020:chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice . 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

Zajac DJ. Evaluation and management of speech disorders for the patient with cleft palate. In: Fonseca RJ, ed. Oral and Maxillofacial Surgery . 3rd ed. St Louis, MO: Elsevier; 2018:chap 32.

Review Date 2/17/2024

Updated by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

• Speech and Language Problems in Children

The Royal Children's Hospital Melbourne

• My RCH Portal

• Health Professionals
• Patients and Families
• Departments and Services
•  Health Professionals
•  Departments and Services
•  Patients and Families
•  Research

Kids Health Information

• About Kids Health Info
• Fact sheets
• Translated fact sheets
• RCH TV for kids
• Kids Health Info podcast
• First aid training

In this section

Speech problems – articulation and phonological disorders

Articulation and phonology ( fon-ol-oji ) refer to the way sound is produced. A child with an articulation disorder has problems forming speech sounds properly. A child with a phonological disorder can produce the sounds correctly, but may use them in the wrong place.

When young children are growing, they develop speech sounds in a predictable order. It is normal for young children to make speech errors as their language develops; however, children with an articulation or phonological disorder will be difficult to understand when other children their age are already speaking clearly.

A qualified speech pathologist should assess your child if there are any concerns about the quality of the sounds they make, the way they talk, or their ability to be understood.

Signs and symptoms of articulation and phonological disorders 

Articulation disorders.

Articulation refers to making sounds. The production of sounds involves the coordinated movements of the lips, tongue, teeth, palate (top of the mouth) and respiratory system (lungs). There are also many different nerves and muscles used for speech.

If your child has an articulation disorder, they:

• have problems making sounds and forming particular speech sounds properly (e.g. they may lisp, so that s sounds like th )
• may not be able to produce a particular sound (e.g. they can't make the r sound, and say 'wabbit' instead of 'rabbit'). 

Phonological disorders

Phonology refers to the pattern in which sounds are put together to make words.

If your child has a phonological disorder, they:

• are able to make the sounds correctly, but they may use it in the wrong position in a word, or in the wrong word, e.g. a child may use the d sound instead of the g sound, and so they say 'doe' instead of 'go'
• make mistakes with the particular sounds in words, e.g. they can say k in 'kite' but with certain words, will leave it out e.g. 'lie' instead of 'like'. 

Phonological disorders and phonemic awareness disorders (the understanding of sounds and sound rules in words) have been linked to ongoing problems with language and literacy. It is therefore important to make sure that your child gets the most appropriate treatment.

It can be much more difficult to understand children with phonological disorders compared to children with pure articulation disorders. Children with phonological disorders often have problems with many different sounds, not just one.

When to see a doctor

If you (or anyone else in regular contact with your child, such as their teacher) have any concerns about your child's speech, ask your GP or paediatrician to arrange an assessment with a speech pathologist. You can also arrange to see a speech pathologist directly; however, the fees may be higher.

A qualified speech pathologist should assess your child if there are any concerns about their speech. A speech pathologist can identify the cause, and plan treatment with your child and family. Treatment may include regular appointments and exercises for you to do with your child at home.

With appropriate speech therapy, many children with articulation or phonological disorders will have significant improvement in their speech.

Brain injuries

Articulation or phonological difficulties are generally not a direct result of brain injury. Children with an acquired brain injury may have different difficulties with their speech patterns. These are generally caused by  dyspraxia or dysarthria. Some children with acquired brain injuries may also have difficulties with literacy and language. See our fact sheets Dysarthria and  Dyspraxia .

Key points to remember

• Articulation and phonology refer to the making of speech sounds.
• Children with phonological disorders or phonemic awareness disorders may have ongoing problems with language and literacy. 
• If there are any concerns about your child's speech, ask your GP to arrange an assessment with a qualified speech pathologist.
• With appropriate speech therapy, many children with articulation or phonological disorders will have a big improvement in their speech.

For more information

• Kids Health Info fact sheet: Verbal dyspraxia
• Kids Health Info fact sheet: Word-finding difficulties
• Speech Pathology Australia: Resources for the public
• See your GP or speech pathologist.

Common questions our doctors are asked

Could my child just catch up eventually and grow out of an articulation/phonological disorder?

Some speech disorders can persist well into teenage and adult life. When a person is older, it is much more difficult to correct these problems. Most children with a diagnosed articulation/phonological disorder will need speech therapy.

What causes articulation and phonological disorders?

In most children, there is no known cause for articulation and phonological disorders. In some, the disorder may be due to a structural problem or from imitating behaviours and the creation of bad habits. Regardless of the cause, your child's speech therapist will be able to assist with the recommended treatment.

Developed by The Royal Children's Hospital Paediatric Rehabilitation Service and Speech Pathology department. Adapted with permission from a fact sheet from the Brain Injury Service at Westmead Children's Hospital. We acknowledge the input of RCH consumers and carers. 

Reviewed July 2018.  

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au . 

This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.

On this page

When to see a doctor, complications.

Aphasia is a disorder that affects how you communicate. It can impact your speech, as well as the way you write and understand both spoken and written language.

Aphasia usually happens suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). The severity of aphasia depends on a number of things, including the cause and the extent of the brain damage.

The main treatment for aphasia involves treating the condition that causes it, as well as speech and language therapy. The person with aphasia relearns and practices language skills and learns to use other ways to communicate. Family members often participate in the process, helping the person communicate.

Products & Services

• A Book: Mayo Clinic Family Health Book
• Newsletter: Mayo Clinic Health Letter — Digital Edition

Aphasia is a symptom of some other condition, such as a stroke or a brain tumor.

A person with aphasia may:

• Speak in short or incomplete sentences
• Speak in sentences that don't make sense
• Substitute one word for another or one sound for another
• Speak unrecognizable words
• Have difficulty finding words
• Not understand other people's conversation
• Not understand what they read
• Write sentences that don't make sense

Patterns of aphasia

People with aphasia may have different strengths and weaknesses in their speech patterns. Sometimes these patterns are labeled as different types of aphasia, including:

• Broca's aphasia
• Wernicke aphasia
• Transcortical aphasia
• Conduction aphasia
• Mixed aphasia
• Global aphasia

These patterns describe how well the person can understand what others say. They also describe how easy it is for the person to speak or to correctly repeat what someone else says.

Aphasia may develop slowly over time. When that happens, the aphasia may be labeled with one of these names:

• Logopenic aphasia
• Semantic aphasia
• Agrammatism

Many people with aphasia have patterns of speech difficulty that don't match these types. It may help to consider that each person with aphasia has unique symptoms, strengths and weaknesses rather than trying to label a particular type of aphasia.

Because aphasia is often a sign of a serious problem, such as a stroke, seek emergency medical care if you or a loved one suddenly develop:

• Difficulty speaking
• Trouble understanding speech
• Difficulty with word recall
• Problems with reading or writing

From Mayo Clinic to your inbox

The most common cause of aphasia is brain damage resulting from a stroke — the blockage or rupture of a blood vessel in the brain. Loss of blood to the brain leads to brain cell death or damage in areas that control language.

Brain damage caused by a severe head injury, a tumor, an infection or a degenerative process also can cause aphasia. In these cases, the aphasia usually occurs with other types of cognitive problems, such as memory problems or confusion.

Primary progressive aphasia is the term used for language difficulty that develops gradually. This is due to the gradual degeneration of brain cells located in the language networks. Sometimes this type of aphasia will progress to a more generalized dementia.

Sometimes temporary episodes of aphasia can occur. These can be due to migraines, seizures or a transient ischemic attack (TIA). A transient ischemic attack (TIA) occurs when blood flow is temporarily blocked to an area of the brain. People who've had a are at an increased risk of having a stroke in the near future.

Aphasia can create numerous quality-of-life problems because communication is so much a part of your life. Communication difficulty may affect your:

• Relationships
• Day-to-day function

Difficulty expressing wants and needs can result in embarrassment, frustration, isolation and depression. Other problems may occur together, such as more difficulty moving around and problems with memory and thinking.

Jun 11, 2022

• Clark DG. Approach to the patient with aphasia. https://www.uptodate.com/contents/search. Accessed May 24, 2022.
• Aphasia. Merck Manual Professional Edition. http://www.merckmanuals.com/professional/neurologic_disorders/function_and_dysfunction_of_the_cerebral_lobes/aphasia.html#v1034169. Accessed May 24, 2022.
• Clark DG. Aphasia: Prognosis and treatment. https://www.uptodate.com/contents/search. Accessed May 24, 2022.
• Aphasia. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/aphasia/. Accessed May 24, 2022.
• Aphasia. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/Pages/aphasia.aspx. Accessed May 24, 2022.
• Crosson B, et al. Neuroplasticity and aphasia treatments: New approaches for an old problem. Journal of Neurology, Neurosurgery and Psychiatry. 2019; doi:10.1136/jnnp-2018-319649.
• Elsner B, et al. Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. Cochrane Database of Systematic Reviews. 2019; doi:10.1002/14651858.CD009760.pub4.
• Botha H, et al. Classification and clinicoradiologic features of primary progressive aphasia (PPA) and apraxia of speech. Cortex. 2015. doi:10.1016/j.cortex.2015.05.013.
• Kasselimis DS, et al. The unbridged gap between clinical diagnosis and contemporary research on aphasia: A short discussion on the validity and clinical utility of taxonomic categories. Brain and Language. 2017; doi:10.1016/j.bandl.2016.10.005.
• Clark H (expert opinion). Mayo Clinic. May 30, 2022.
• Diseases & Conditions
• Aphasia symptoms & causes

News from Mayo Clinic

Associated Procedures

CON-XXXXXXXX

5X Challenge

Thanks to generous benefactors, your gift today can have 5X the impact to advance AI innovation at Mayo Clinic.