what is a speech impediment definition

Language and Speech Disorders in Children

Helping children learn language, what to do if there are concerns.

• Detecting problems

Children are born ready to learn a language, but they need to learn the language or languages that their family and environment use. Learning a language takes time, and children vary in how quickly they master milestones in language and speech development. Typically developing children may have trouble with some sounds, words, and sentences while they are learning. However, most children can use language easily around 5 years of age.

Parents and caregivers are the most important teachers during a child’s early years. Children learn language by listening to others speak and by practicing. Even young babies notice when others repeat and respond to the noises and sounds they make. Children’s language and brain skills get stronger if they hear many different words. Parents can help their child learn in many different ways, such as

• Responding to the first sounds, gurgles, and gestures a baby makes.
• Repeating what the child says and adding to it.
• Talking about the things that a child sees.
• Asking questions and listening to the answers.
• Looking at or reading books.
• Telling stories.
• Singing songs and sharing rhymes.

This can happen both during playtime and during daily routines.

Parents can also observe the following:

• How their child hears and talks and compare it with typical milestones for communication skills external icon .
• How their child reacts to sounds and have their hearing tested if they have concerns .

Learn more about language milestones .  Watch milestones in action.

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Some languages are visual rather than spoken. American Sign Language uses visual signals, including gestures, facial expressions, and body movement to communicate.

Some children struggle with understanding and speaking and they need help. They may not master the language milestones at the same time as other children, and it may be a sign of a language or speech delay or disorder.

Language development has different parts, and children might have problems with one or more of the following:

• Not hearing the words (hearing loss).
• Not understanding the meaning of the words.
• Not knowing the words to use.
• Not knowing how to put words together.
• Knowing the words to use but not being able to express them.

Language and speech disorders can exist together or by themselves. Examples of problems with language and speech development include the following:

• Difficulty with forming specific words or sounds correctly.
• Difficulty with making words or sentences flow smoothly, like stuttering or stammering.
• Language delay – the ability to understand and speak develops more slowly than is typical
• Aphasia (difficulty understanding or speaking parts of language due to a brain injury or how the brain works).
• Auditory processing disorder (difficulty understanding the meaning of the sounds that the ear sends to the brain)

Learn more about language disorders external icon .

Language or speech disorders can occur with other learning disorders that affect reading and writing. Children with language disorders may feel frustrated that they cannot understand others or make themselves understood, and they may act out, act helpless, or withdraw. Language or speech disorders can also be present with emotional or behavioral disorders, such as attention-deficit/hyperactivity disorder (ADHD) or anxiety . Children with developmental disabilities including autism spectrum disorder may also have difficulties with speech and language. The combination of challenges can make it particularly hard for a child to succeed in school. Properly diagnosing a child’s disorder is crucial so that each child can get the right kind of help.

Detecting problems with language or speech

If a child has a problem with language or speech development, talk to a healthcare provider about an evaluation. An important first step is to find out if the child may have a hearing loss. Hearing loss may be difficult to notice particularly if a child has hearing loss only in one ear or has partial hearing loss, which means they can hear some sounds but not others. Learn more about hearing loss, screening, evaluation, and treatment .

A language development specialist like a speech-language pathologist external icon will conduct a careful assessment to determine what type of problem with language or speech the child may have.

Overall, learning more than one language does not cause language disorders, but children may not follow exactly the same developmental milestones as those who learn only one language. Developing the ability to understand and speak in two languages depends on how much practice the child has using both languages, and the kind of practice. If a child who is learning more than one language has difficulty with language development, careful assessment by a specialist who understands development of skills in more than one language may be needed.

Treatment for language or speech disorders and delays

Children with language problems often need extra help and special instruction. Speech-language pathologists can work directly with children and their parents, caregivers, and teachers.

Having a language or speech delay or disorder can qualify a child for early intervention external icon (for children up to 3 years of age) and special education services (for children aged 3 years and older). Schools can do their own testing for language or speech disorders to see if a child needs intervention. An evaluation by a healthcare professional is needed if there are other concerns about the child’s hearing, behavior, or emotions. Parents, healthcare providers, and the school can work together to find the right referrals and treatment.

What every parent should know

Children with specific learning disabilities, including language or speech disorders, are eligible for special education services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) external icon and Section 504 external icon , an anti-discrimination law.

Get help from your state’s Parent Training and Information Center external icon

The role of healthcare providers

Healthcare providers can play an important part in collaborating with schools to help a child with speech or language disorders and delay or other disabilities get the special services they need. The American Academy of Pediatrics has created a report that describes the roles that healthcare providers can have in helping children with disabilities external icon , including language or speech disorders.

More information

CDC Information on Hearing Loss

National Institute on Deafness and Other Communication Disorders external icon

Birth to 5: Watch me thrive external icon

The American Speech-Language-Hearing Association external icon

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

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

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

Common symptoms of a speech impediment

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

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

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

Key categories of speech impediments

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

Voice disorders

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

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

Fluency disorders

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

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

Articulation disorders and phonological disorders

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

Speech impediments versus language impairments

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

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

Examples of speech impediments

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

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

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

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

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

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

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

Dysarthria 

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

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

The importance of treatment

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

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

Seeking professional support

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

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

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

Counselor reviews

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

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

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

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

What are the 3 speech impediments?

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

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

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

What do you call a speech impediment?

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

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

How do I know if I have a speech impediment?

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

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

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

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

What are 5 causes of speech impairment?

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

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

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

Is speech impediment a disability?

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

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

Can I fix my speech impediment?

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

Can you treat a speech impediment?

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

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

Is a speech impediment mental?

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

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

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

Is autism a speech impediment?

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

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

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

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Meaning of speech impediment in English

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• speech and language therapist
• speech and language therapy
• stammeringly
• stutteringly

Examples of speech impediment

Translations of speech impediment.

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What is a speech impairment?

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

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

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

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Stuttering is a speech condition that disrupts the normal flow of speech. Fluency means having an easy and smooth flow and rhythm when speaking. With stuttering, the interruptions in flow happen often and cause problems for the speaker. Other names for stuttering are stammering and childhood-onset fluency disorder.

People who stutter know what they want to say, but they have a hard time saying it. For example, they may repeat or stretch out a word, a syllable, or a consonant or vowel sound. Or they may pause during speech because they've reached a word or sound that's hard to get out.

Stuttering is common among young children as a usual part of learning to speak. Some young children may stutter when their speech and language abilities aren't developed enough to keep up with what they want to say. Most children outgrow this type of stuttering, called developmental stuttering.

But sometimes stuttering is a long-term condition that remains into adulthood. This type of stuttering can affect self-esteem and communicating with other people.

Children and adults who stutter may be helped by treatments such as speech therapy, electronic devices to improve speech fluency or a form of mental health therapy called cognitive behavioral therapy.

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Stuttering symptoms may include:

• Having a hard time starting a word, phrase or sentence.
• Stretching out a word or sounds within a word.
• Repeating a sound, syllable or word.
• Brief silence for certain syllables or words, or pausing before or within a word.
• Adding extra words such as "um" if expecting to have problems moving to the next word.
• A lot of tension, tightness or movement of the face or upper body when saying a word.
• Anxiety about talking.
• Not being able to communicate well with others.

These actions may happen when stuttering:

• Rapid eye blinks.
• Trembling of the lips or jaw.
• Unusual face movements, sometimes called facial tics.
• Head nodding.
• Tightening of fists.

Stuttering may be worse when the person is excited, tired or under stress, or when feeling self-conscious, hurried or pressured. Situations such as speaking in front of a group or talking on the phone can be especially hard for people who stutter.

But most people who stutter can speak without stuttering when they talk to themselves and when they sing or speak along with someone else.

When to see a doctor or speech-language pathologist

It's common for children between the ages of 2 and 5 years to go through periods when they may stutter. For most children, this is part of learning to speak, and it gets better on its own. But stuttering that continues may need treatment to improve speech fluency.

Call your healthcare professional for a referral to a specialist in speech and language called a speech-language pathologist. Or you can contact the speech-language pathologist directly for an appointment. Ask for help if stuttering:

• Lasts more than six months.
• Happens along with other speech or language problems.
• Happens more often or continues as the child grows older.
• Includes muscle tightening or physically struggling when trying to speak.
• Affects the ability to effectively communicate at school or work or in social situations.
• Causes anxiety or emotional problems, such as fear of or not taking part in situations that require speaking.
• Begins as an adult.

Researchers continue to study the underlying causes of developmental stuttering. A combination of factors may be involved.

Developmental stuttering

Stuttering that happens in children while they're learning to speak is called developmental stuttering. Possible causes of developmental stuttering include:

• Problems with speech motor control. Some evidence shows that problems in speech motor control, such as timing, sensory and motor coordination, may be involved.
• Genetics. Stuttering tends to run in families. It appears that stuttering can happen from changes in genes passed down from parents to children.

Stuttering that happens from other causes

Speech fluency can be disrupted from causes other than developmental stuttering.

• Neurogenic stuttering. A stroke, traumatic brain injury or other brain disorders can cause speech that is slow or has pauses or repeated sounds.
• Emotional distress. Speech fluency can be disrupted during times of emotional distress. Speakers who usually do not stutter may experience problems with fluency when they are nervous or feel pressured. These situations also may cause speakers who stutter to have greater problems with fluency.
• Psychogenic stuttering. Speech difficulties that appear after an emotional trauma are uncommon and not the same as developmental stuttering.

Risk factors

Males are much more likely to stutter than females are. Things that raise the risk of stuttering include:

• Having a childhood developmental condition. Children who have developmental conditions, such as attention-deficit/hyperactivity disorder, autism or developmental delays, may be more likely to stutter. This is true for children with other speech problems too.
• Having relatives who stutter. Stuttering tends to run in families.
• Stress. Stress in the family and other types of stress or pressure can worsen existing stuttering.

Complications

Stuttering can lead to:

• Problems communicating with others.
• Not speaking or staying away from situations that require speaking.
• Not taking part in social, school or work activities and opportunities for success.
• Being bullied or teased.
• Low self-esteem.
• Stuttering. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/stuttering/. Accessed Feb. 2, 2024.
• Fluency disorders. American Speech-Language-Hearing Association. https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/. Accessed Feb. 2, 2024.
• Childhood-onset fluency disorder (stuttering). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. 5th ed. American Psychiatric Association; 2022. https://dsm.psychiatryonline.org. Accessed Feb. 2, 2024.
• Stuttering. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/stuttering. Accessed Feb. 2, 2024.
• Sander RW, et al. Stuttering: Understanding and treating a common disability. American Family Physician. 2019;100:556.
• Laiho A, et al. Stuttering interventions for children, adolescents and adults: A systematic review as part of the clinical guidelines. Journal of Communication Disorders. 2022; doi:10.1016/j.jcomdis.2022.106242.
• 6 tips for speaking with someone who stutters. The Stuttering Foundation. https://www.stutteringhelp.org/6-tips-speaking-someone-who-stutters-0. Accessed Feb. 2, 2024.
• 7 tips for talking with your child. The Stuttering Foundation. https://www.stutteringhelp.org/7-tips-talking-your-child-0. Accessed Feb. 2, 2024.
• Clark HM (expert opinion). Mayo Clinic. Feb. 11, 2024.

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In brief: what is speech therapy.

Created: August 12, 2020 ; Next update: 2024.

Speech therapy can help people who have difficulty speaking to communicate better and to break down the barriers that result from speech impediments. The goals of speech therapy include improving pronunciation, strengthening the muscles used in speech, and learning to speak correctly.

Speech therapy can be used for a lot of different speech problems and disorders, from smaller problems like a hoarse voice up to partial loss of speech due to brain damage. Depending on the type of disorder, other medical or psychological treatments may be used as well.

• What kinds of disorders can speech therapy treat?

Speech therapy can be used to treat language disorders, speech disorders and swallowing problems.

Language disorders

A childhood language disorder can affect the child’s ability to learn to speak, to name objects and build complete sentences. Although the causes of these disorders are often not clear, the main known risk factors include hearing problems , general developmental problems and disorders affecting the development of the brain.

Language disorders in adults are almost always the result of brain injury or disease. People who have had a stroke , for example, often have trouble forming sentences or remembering words. That type of disorder is called aphasia.

Speech disorders

People with speech disorders have difficulty producing the sounds of speech, saying words clearly or talking fluently.

Children often have trouble with pronunciation, and may have a lisp or swap certain sounds for others. Speech disorders may be the result of developmental disorders, but psychological factors might also play a role. Adults with neurological diseases sometimes have speech disorders too, often making it hard to understand them.

Another group of speech disorders, known as fluency disorders, involve problems with the flow or evenness of speech. People with this sort of disorder may stutter or “clutter,” for example. When people stutter, there are often silent pauses in their speech, or they repeat or lengthen certain sounds or syllables. Cluttering is abnormally fast speech that makes the pronunciation imprecise or leaves out sounds or parts of words.

Voice disorders (dysphonia)

A voice disorder is a persistent change in someone’s voice. They might sound hoarse, strained, raspy or nearly silent. Often the voice is somewhat weak – in other words, it cracks easily or the person is not able to speak loudly. Voice disorders may arise from speaking too much or too loudly, from using the wrong breathing technique, or from problems with the voice box (larynx) like vocal nodules . Psychological causes like depression or a reaction to a distressing event can change a person’s voice too.

Trouble swallowing

In people with swallowing problems, the movements of the muscles involved in swallowing are affected. This leads to problems transporting food through the mouth and throat. The cause is often a disease or disorder of the nervous system, such as Parkinson’s disease , multiple sclerosis, dementia , an infection like Lyme disease or tetanus, or a head injury. If food gets into the lungs because of a swallowing disorder, it can lead to life-threatening complications.

What treatments are used in speech therapy?

There are various speech therapy techniques for each of the areas described above – the ones that are considered depend on the particular disorder. A long series of treatment sessions is typically needed, with each lasting 30 to 60 minutes. They may take place in a group or one-on-one.

The treatment approaches used in speech therapy include:

• Perception exercises, for example to differentiate between individual sounds and syllables
• Exercises to produce certain sounds and improve the fluency of speech
• Exercises to improve breathing, swallowing and the voice
• Help with communication using things like sign language, communication boards and computer-assisted speech
• Advice for people who need speech therapy, their parents and other loved ones
• Support in implementing these measures in everyday life

For the treatment to help over the long term, it’s often important to also regularly practice the techniques at home.

• Where is speech therapy offered?

Speech therapy is offered at the following facilities:

• Speech therapy practices
• Rehabilitative care centers
• Special needs schools
• Children's day care facilities specializing in speech therapy

Besides speech therapists, there are a number of other specialists who also use similar methods. These include breathing, speech and voice coaches.

• Do statutory health insurers cover the costs of speech therapy?

Note: The procedures and requirements for applying for and receiving speech therapy may vary according to your country. This information describes the current situation in Germany.

To have outpatient treatment at a speech therapy practice, you need a prescription from a doctor. An initial prescription will generally include up to 10 treatments, each typically lasting 30 to 60 minutes. Appointments are usually offered one to three times per week.

For the medical conditions listed above, prescribed speech therapy is often covered by statutory health insurers (apart from a fixed amount that you have to pay yourself, known as a copayment). The copayment does not have to be paid when getting a treatment that has been prescribed for children. If speech therapy is given as a part of rehabilitative care, an accident insurer or pension fund will cover the costs.

The copayment that you have to pay for yourself is 10 euros per prescription plus 10% of the treatment costs. If each treatment costs 55 euros, for example, for ten treatments you would have to pay 65 euros (the basic fee of 10 euros per prescription plus 10 x 5.50 euros).

Some speech therapists may offer certain treatments without a prescription. You then have to pay for all of the costs yourself. In Germany, these are known as individual health care services (individuelle Gesundheitsleistungen, or IGeL for short).

The German Federal Association of Speech Therapists (DBL) has a search function for speech therapists on their website (in German).

• Bode H, Schröder H, Waltersbacher A (Ed). Heilmittel-Report 2008. Ergotherapie, Logopädie, Physiotherapie: Eine Bestandsaufnahme. Stuttgart: Schattauer; 2008.
• Deutsche Gesellschaft für Sprachheilpädagogik (DGS). Ausbildung in der Sprachheilpädagogik .
• Deutscher Bundesverband für akademische Sprachtherapie und Logopädie (dbs). Der Verband [ dbs homepage ]. 2020.
• Deutscher Bundesverband für Logopädie (dbl). Logopädie . 2020.
• Gemeinsamer Bundesausschuss (G-BA). Richtlinie über die Verordnung von Heilmitteln in der vertragsärztlichen Versorgung (Heilmittel-Richtlinie/HeilM-RL) . July 1, 2020.
• Verband der Ersatzkassen (vdek). Rahmenvertrag zwischen LOGO Deutschland und den Ersatzkassen über die Versorgung mit Leistungen der Stimm-, Sprech- und Sprachtherapie. Anlage 1: Leistungsbeschreibung . June 1, 2017.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

• Cite this Page InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. In brief: What is speech therapy? 2020 Aug 12.

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Apraxia of Speech

On this page:

What is apraxia of speech?

What are the types and causes of apraxia of speech, what are the symptoms of apraxia of speech, how is apraxia of speech diagnosed, how is apraxia of speech treated, what research is being done to better understand apraxia of speech, where can i find additional information about apraxia of speech.

Apraxia of speech (AOS)—also known as acquired apraxia of speech, verbal apraxia, or childhood apraxia of speech (CAS) when diagnosed in children—is a speech sound disorder. Someone with AOS has trouble saying what he or she wants to say correctly and consistently. AOS is a neurological disorder that affects the brain pathways involved in planning the sequence of movements involved in producing speech. The brain knows what it wants to say, but cannot properly plan and sequence the required speech sound movements.

AOS is not caused by weakness or paralysis of the speech muscles (the muscles of the jaw, tongue, or lips). Weakness or paralysis of the speech muscles results in a separate speech disorder, known as dysarthria . Some people have both dysarthria and AOS, which can make diagnosis of the two conditions more difficult.

The severity of AOS varies from person to person. It can be so mild that it causes trouble with only a few speech sounds or with pronunciation of words that have many syllables. In the most severe cases, someone with AOS might not be able to communicate effectively by speaking, and may need the help of alternative communication methods.

There are two main types of AOS: acquired apraxia of speech and childhood apraxia of speech.

• Acquired AOS can affect someone at any age, although it most typically occurs in adults. Acquired AOS is caused by damage to the parts of the brain that are involved in speaking and involves the loss or impairment of existing speech abilities. It may result from a stroke, head injury, tumor, or other illness affecting the brain. Acquired AOS may occur together with other conditions that are caused by damage to the nervous system. One of these is dysarthria, as mentioned earlier. Another is aphasia , which is a language disorder. (For more information, see the NIDCD fact sheet Aphasia .)
• Childhood AOS is present from birth. This condition is also known as developmental apraxia of speech, developmental verbal apraxia, or articulatory apraxia. Childhood AOS is not the same as developmental delays in speech, in which a child follows the typical path of speech development but does so more slowly than is typical. The causes of childhood AOS are not well understood. Imaging and other studies have not been able to find evidence of brain damage or differences in the brain structure of children with AOS. Children with AOS often have family members who have a history of a communication disorder or a learning disability. This observation and recent research findings suggest that genetic factors may play a role in the disorder. Childhood AOS appears to affect more boys than girls.

People with either form of AOS may have a number of different speech characteristics, or symptoms:

• Distorting sounds. People with AOS may have difficulty pronouncing words correctly. Sounds, especially vowels, are often distorted. Because the speaker may not place the speech structures (e.g., tongue, jaw) quite in the right place, the sound comes out wrong. Longer or more complex words are usually harder to say than shorter or simpler words. Sound substitutions might also occur when AOS is accompanied by aphasia.
• Making inconsistent errors in speech. For example, someone with AOS may say a difficult word correctly but then have trouble repeating it, or may be able to say a particular sound one day and have trouble with the same sound the next day.
• Groping for sounds. People with AOS often appear to be groping for the right sound or word, and may try saying a word several times before they say it correctly.
• Making errors in tone, stress, or rhythm. Another common characteristic of AOS is the incorrect use of prosody. Prosody is the rhythm and inflection of speech that we use to help express meaning. Someone who has trouble with prosody might use equal stress, segment syllables in a word, omit syllables in words and phrases, or pause inappropriately while speaking.

Children with AOS generally understand language much better than they are able to use it. Some children with the disorder may also have other speech problems, expressive language problems, or motor-skill problems.

Professionals known as speech-language pathologists play a key role in diagnosing and treating AOS. Because there is no single symptom or test that can be used to diagnose AOS, the person making the diagnosis generally looks for the presence of several of a group of symptoms, including those described earlier. Ruling out other conditions, such as muscle weakness or language production problems (e.g., aphasia), can help with the diagnostic process.

In some cases, people with acquired AOS recover some or all of their speech abilities on their own. This is called spontaneous recovery.

Children with AOS will not outgrow the problem on their own. They also do not acquire the basics of speech just by being around other children, such as in a classroom. Therefore, speech-language therapy is necessary for children with AOS as well as for people with acquired AOS who do not spontaneously recover all of their speech abilities.

Speech-language pathologists use different approaches to treat AOS, and no single approach has been proven to be the most effective. Therapy is tailored to the individual and is designed to treat other speech or language problems that may occur together with AOS. Frequent, intensive, one-on-one speech-language therapy sessions are needed for both children and adults with AOS. (The repetitive exercises and personal attention needed to improve AOS are difficult to deliver in group therapy.) Children with severe AOS may need intensive speech-language therapy for years, in parallel with normal schooling, to obtain adequate speech abilities.

In severe cases, adults and children with AOS may need to find other ways to express themselves. These might include formal or informal sign language; a notebook with pictures or written words that can be pointed to and shown to other people; or an electronic communication device—such as a smartphone, tablet, or laptop computer—that can be used to write or produce speech. Such assistive communication methods can also help children with AOS learn to read and better understand spoken language by stimulating areas of the brain involved in language and literacy.

Researchers are searching for the causes of childhood AOS, including the possible role of abnormalities in the brain or other parts of the nervous system. They are also looking for genetic factors that may play a role in childhood AOS. Other research on childhood AOS aims to identify more specific criteria and new techniques to diagnose the disorder and to distinguish it from other communication disorders.

Research on acquired AOS includes studies to pinpoint the specific areas of the brain that are involved in the disorder. In addition, researchers are studying the effectiveness of various treatment approaches for both acquired and childhood AOS.

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

For more information, contact us at:

NIDCD Information Clearinghouse 1 Communication Avenue Bethesda, MD 20892-3456 Toll-free voice: (800) 241-1044 Toll-free TTY: (800) 241-1055 Email: [email protected]

NIH Pub. No. 13-7466 September 2016

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Definition of impediment

Did you know.

Impediment comes from a Latin verb that meant "to interfere with" or "to get in the way of progress", as if by tripping up the feet of someone walking. In English, impediment still suggests an obstruction or obstacle along a path; for example, a lack of adequate roads and bridges would be called an impediment to economic development. Impediments usually get in the way of something we want. So we may speak of an impediment to communication, marriage, or progress--but something that slows the progress of aging, disease, or decay is rarely called an impediment.

• embarrassment
• encumbrance
• interference
• obstruction
• stumbling block

Examples of impediment in a Sentence

These examples are programmatically compiled from various online sources to illustrate current usage of the word 'impediment.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Word History

14th century, in the meaning defined at sense 1

Phrases Containing impediment

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Cite this Entry

“Impediment.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/impediment. Accessed 25 Apr. 2024.

Kids Definition

Kids definition of impediment, medical definition, medical definition of impediment, legal definition, legal definition of impediment, more from merriam-webster on impediment.

Nglish: Translation of impediment for Spanish Speakers

Britannica English: Translation of impediment for Arabic Speakers

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Rhotacism: A complete guide to this speech impediment

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

What is rhotacism?

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

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

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

How does rhotacism work in different languages?

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

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

Symptoms of rhotacism

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

Rhotacism as a speech impediment

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

–        The prevocalic R , such as “rain”

–        The RL , such as “girl”

–        The IRE, such as “tire”

–        The AR, such as “car”

–        The EAR , “such as “beer”

–        The OR , such as “seashore”

–        The ER , such as “butter”

–        The AIR , such as “software”

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

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

Examples of rhotacism

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

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

Causes of rhotacism

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

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

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

How the brain affects rhotacism

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

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

Treatment for rhotacism

Is rhotacism curable.

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

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

How to fix rhotacism

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

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

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

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

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Scotland's hate crime law: The problem with using public order laws to govern online speech

by Laura Higson-Bliss, The Conversation

Scotland's new hate crime law came into force on April 1, sparking immediate controversy over its potential effects on freedom of speech and expression, especially online. The Hate Crime and Public Order (Scotland) Act expands on current laws about crimes that have the possibility to stir up hatred, in Scotland only.

A " hate crime " itself is not its own specific offense under existing laws, or the new law. But if you are found to commit another crime (for example, assault) and it is proven that this was based on hostility against someone's protected characteristic (usually race, religion, disability or sexual orientation ) you can be given a harsher sentence.

The new law in Scotland introduces the offense of "stirring up hatred"—either in person or online—related to to age, disability, religion, sexual orientation, transgender identity or being intersex. This does not extend beyond Scotland.

A stirring up offense is committed if someone behaves in a way that the average person on the street would consider to be threatening or abusive, and that behavior is based on the victim's protected characteristic. To find someone guilty, it must be proven that their aim or purpose was to stir up hatred. This is a high threshold and difficult to prove.

Alongside threatening or abusive behavior in person, the law criminalizes sending such communications online. This has been the most controversial change. Critics fear it could harm free speech , especially online, where context is everything, but is often lost.

Of particular concern have been discussions over transgender identity—author JK Rowling challenged police to arrest her over a series of posts describing transgender women as men, though police say this did not amount to a crime.

But should a law like this even be used to govern online speech?

Stirring up offenses online

The rationale behind public order legislation, including the new Scottish law, has always been to maintain public order during a time of disorder. It is difficult to argue that online comments can amount to criminal offenses that threaten public order.

Public order prosecutions of people who make hateful or prejudicial comments online are rare —and successful convictions even rarer. There are only a handful of cases in the public domain to use as examples.

In 2012, Liam Stacey, a student, was sentenced to 56 days in jail under the Public Order Act 1986 for sending tweets intended to stir up racial hatred aimed at footballer Fabrice Muamba . As I and other legal scholars have argued , while Stacey's tweets were clearly abusive, they never threatened public order. And yet, he was convicted of a public order offense, under a law enacted 20 years before Twitter even existed.

The act was also successfully used to prosecute 45-year-old Wigan man Stuart Sutton , who received a 16-month custodial sentence in 2022 for posting anti-Semitic and racist commentary online.

Distinguishing between intent to stir up hatred and speech intended to inform rather than offend is incredibly complex, especially online where proving public order is under threat is near impossible. Indeed, speech intended to inform is protected under the European Convention of Human Rights , even if it could be construed as racist.

In most cases, online comments have been successfully prosecuted under other existing laws, such as communications offenses.

Following England's defeat in the 2020 Euros, three people were arrested for public order offenses relating to stirring up racial hatred. But, in the event, each was later charged and convicted of sending a grossly offensive message in violation of the Communications Act , as opposed to a public order offense.

Scotland had another law that dealt specifically with threatening communications, as well as behavior at football matches, with provisions in place to uplift sentencing for communications grounded in hate. This law was used 32 times , and was later repealed following concerns that it was illiberal and unfairly targeted football fans.

In England and Wales, provisions such as the Malicious Communications Act and the Protection from Harassment Act have been used to prosecute people for offensive comments online. The Sentencing Act also allows the courts to "uplift" a person's sentence under any criminal provision, if their offense is proven to be aggravated by hate. This is used much more commonly than specific public order offenses.

Fighting hate online

Scottish government officials have hailed the new law as a significant step forward in protecting people from hate and prejudice. The reporting of hate crimes across Scotland has been relatively low compared to other jurisdictions.

But there is little evidence that the offense of stirring up hatred itself is effective in tackling online hate , which is certainly on the rise . The reality is that prosecutions for harmful online speech are likely to fall under other existing laws.

If we really want to tackle the rise in hate online (which recent debates seem to suggest we do), public order legislation and the weight of the criminal law will never work. It is only through open and public debate and better education that we can enact change.

Provided by The Conversation

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