how to fix my speech problems

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What Is Dysarthria?

Dysarthria is a condition in which the part of your brain that controls your lips, tongue, vocal cords, and diaphragm doesn't work well. It's hard for you to move those muscles the right way.

This condition comes in two forms:

• Developmental dysarthria happens from damage to a growing baby's brain in the womb or at birth. Cerebral palsy is one possible cause. Developmental dysarthria affects children.
• Acquired dysarthria happens from damage to the brain later in life. A stroke, Parkinson's disease, or a brain tumor is the possible cause. This type affects adults.

People with dysarthria can think and understand language. But they have trouble talking because of weakness in the muscles that control speech .

Some people with dysarthria have only minor speech problems. Others have so much trouble getting their words out that other people may not be able to understand them very well. A speech-language therapist can help improve speaking skills.

Types of Dysarthria

The six types of dysarthria are divided by causes or symptoms. They include:

• Spastic dysarthria is caused by damage to nerve cells in the central nervous system that affect movement. It makes the voice sound harsh.
• Hypokinetic dysarthria happens from damage to a part of the brain called the basal ganglia that controls movement. Speech is slow and never changes pitch.
• Hyperkinetic dysarthria  is also from damage to the basal ganglia . In this case, speech is fast and changes a lot.
• Ataxic dysarthria happens from damage to the cerebellum, a part of the brain that helps muscles move. It can cause problems in the way you pronounce words.
• Flaccid dysarthria affects the lower motor neurons that send signals to your muscles to move. Your speech may sound nasal.
• Mixed dysarthria is the most common type. It's a mixture of other types, such as spastic plus flaccid.

Causes of Dysarthria

Damage to the parts of the brain that control speech causes dysarthria. Any of these conditions can cause this type of damage:

• Amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease
• Brain tumors
• Cerebral palsy
• Guillain-Barre syndrome
• Huntington's disease
• Lyme disease
• Multiple sclerosis (MS)
• Muscular dystrophy
• Myasthenia gravis
• Parkinson's disease
• Side effects of certain medicines, such as epilepsy drugs
• Traumatic brain injury
• Wilson's disease

Prevalence of dysarthria

The likelihood of getting dysarthria depends on the cause. This condition affects:

• 30% of people with ALS
• 25%-50% of people with MS
• 70%-100% of those with Parkinson's disease
• 8%-60% of people who have had a stroke
• 10%-65% of those with traumatic brain injury

Dysarthria Symptoms

Depending on the cause, dysarthria can make your speech:

• Have an uneven rhythm
• Higher- or lower-pitched than usual
• Nasal or whiny
• Slow or fast
• Soft like a whisper

Because dysarthria can make it harder to move your lips, tongue , and jaw, it can be harder for you to chew and swallow. Trouble swallowing can cause you to drool.

Dysarthria Diagnosis

If you suddenly have a hard time speaking, you might be having a stroke. Call 911 right away. But if it's been happening for a while, see a speech-language pathologist (SLP) . They'll ask about any diseases you have that could affect your speech.

They'll also want to check the strength of the muscles in your lips, tongue, and jaw as you talk. They might ask you to:

• Stick out your tongue
• Make different sounds
• Read a few sentences
• Count numbers
• Blow out a candle

Tests for dysarthria

You might need some tests , including:

• Imaging tests like MRI or CT scans
• Blood or urine tests
• Brain and nerve tests like electroencephalogram or electromyography
• Spinal tap to check for infection
• Swallowing study to check for problems when you swallow

Dysarthria Treatment

Treatment will depend on the cause of your dysarthria, the type, and your symptoms. Your speech might get better after you treat the cause.

If you still have dysarthria, you might see a SLP who will teach you:

• Exercises to strengthen the muscles of your mouth and jaw
• Ways to speak more clearly, such as talking more slowly or pausing to catch your breath
• How to control your breath to make your voice louder
• How to use devices like an amplifier to improve the sound of your voice

Your therapist also will give you tips to help you communicate, such as:

• Carry a notebook or smartphone with you. If someone doesn't understand you, write or type what you want to say.
• Make sure you have the other person's attention.
• Speak slowly.
• Talk face-to-face if you can. The other person will be able to understand you better if they can see your mouth move.
• Try not to talk in noisy places, like at a restaurant or party. Before you speak, turn down music or the TV or go outside.
• Use facial expressions or hand gestures to get your point across.
• Use short phrases and words that are easier for you to say.

Tips for Friends and Family of People With Dysarthria

Your therapist will work with your family to help them understand you better. They may suggest that your loved ones:

• Ask if they don't understand something
• Give you time to finish what you have to say
• Look at you when they talk with you
• Repeat the part they understood so you don't have to say the whole thing again
• Try not to finish your sentences for you
• Talk to you as they would with anyone else
• Continue to involve you in conversation

Dysarthria Complications

Dysarthria can affect many parts of your life. When you have trouble speaking clearly, you may be less able to communicate with loved ones. This can affect your relationships with family and friends.

It's common for people with dysarthria to feel alone and depressed. That's why it's so important to get treatment from a speech-language therapist and see a mental health professional if you feel alone or sad.

Dysarthria is a problem with parts of your nervous system that affects speech. It comes in several types that each affect speech in different ways. In speech therapy, you can learn exercises and tips to help you communicate more easily.

Dysarthria FAQs

What is the main cause of dysarthria?

Damage to the brain from a condition like Parkinson's disease, a stroke, an injury , or MS can cause dysarthria.

How do people with dysarthria speak?

How speech changes depends on the type of dysarthria. The voice might sound breathy, nasal, slurred, fast, slow, out of rhythm, very loud, or very quiet.

What is an example of dysarthria speech?

Someone with dysarthria may speak slowly, haltingly, and at the same pitch (monotone).

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Your health care provider will ask you about your voice problems and do an exam. Your provider might give you a numbing medicine before the exam. Your provider might use one or more of these tools:

• Mirror. Your provider might put into your mouth an instrument like a dental mirror. It's long, and the mirror is angled.
• Flexible laryngoscope. This is a bendable tube that holds a light and camera. A provider puts it in through the nose.
• Rigid laryngoscope. A provider puts this stiff viewing tube in through the mouth.
• Videostroboscope. A camera combined with a flashing light gives a slow-motion view of the vocal cords as they move.

A care provider may use other tests such as:

• Sound analysis. Using a computer, this test can measure anything unusual in the sound the vocal cords make.
• Laryngeal electromyography. Small needles put in through the skin measure the electric currents in the voice box muscles.
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Our caring team of Mayo Clinic experts can help you with your voice disorders-related health concerns Start Here

Depending on your diagnosis, your care provider might suggest one or more treatments:

• Rest, liquids and voice therapy. Like every part of the body, the vocal cords need regular rest and fluids. Speech pathology specialists teach how to use the voice better, how to clear the throat and how much liquid to drink.
• Allergy treatments. If an allergy is making too much mucus in the throat, a health care provider can find the allergy's cause and treat it.
• Stopping smoking. Quitting smoking can help improve the voice and many other areas of health. For example, it can boost heart health and lower cancer risk.
• Medicine. Many medicines can be used to treat voice disorders. Depending on the cause of the voice disorder, medicine can reduce swelling, or inflammation, treat gastroesophageal reflux or stop blood vessel regrowth. Medicine can be taken by mouth, injected into the vocal cords or applied to the surface of the vocal cords during surgery.

Removal of growths. Growths on the vocal cords, even growths that aren't cancer, may need to be removed during surgery. A surgeon can remove growths using microsurgery, carbon-dioxide laser surgery, and when appropriate, other laser treatments, including potassium titanyl phosphate (KTP) laser treatment.

KTP laser treatment is a state-of-the-art therapy that treats lesions on the vocal cords by cutting off the blood supply to the growth. This allows removal of the growth while leaving intact the most underlying tissue.

• Injections. Shots of tiny amounts of purified botulinum toxin into the skin of the neck can help stop muscle spasms or unusual movements. This drug treats a movement issue related to the brain and nervous system. This condition, called spasmodic dysphonia, affects the vocal muscles of the larynx.

Sometimes one vocal cord can't move. One paralyzed vocal cord can cause hoarseness. It also can cause choking when drinking liquids. But it rarely causes trouble when swallowing solid foods. Sometimes the problem goes away with time.

If the problem doesn't go away, one of two procedures can push the paralyzed vocal cord closer to the middle of the windpipe. Either procedure allows the vocal cords to meet and vibrate closer together. This improves the voice and allows the larynx to close when swallowing. Treatments include:

• Fat or collagen injection. Injecting body fat or human-made collagen, either through the mouth or the skin on the neck, adds bulk to the paralyzed vocal cord. It also treats vocal cord weakness.
• Thyroplasty. A small opening created in the tissue, also called cartilage, from the outside of the voice box. A surgeon puts an implant into the opening and pushes it against the paralyzed vocal cord.

Read more about vocal cord paralysis treatment and allergies at Mayo Clinic.

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Voice disorders care at Mayo Clinic

• Bruch JM, et al. Hoarseness in adults. https://www.uptodate.com/contents/search. Accessed Aug. 30, 2022.
• Vocal fold paralysis. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/vocal-fold-paralysis. Accessed Aug. 28, 2022.
• Learn more about your voice. American Academy of Otolaryngology — Head and Neck Surgery. https://www.enthealth.org/be_ent_smart/learn-more-about-your-voice/. Accessed Aug. 28, 2022.
• Kost KM, et al. Voice disorders in the elderly. Clinical Geriatric Medicine. 2018; doi:10.1016/j.cger.2018.01.010.
• What causes hoarseness? American Academy of Otolaryngology — Head and Neck Surgery. https://www.enthealth.org/conditions/hoarseness/. Accessed Aug. 28, 2022.
• Ma J, et al. A 532-nm KTP laser for vocal fold polyps: Efficacy and relative factors. Ear, Nose & Throat Journal. 2021;  doi:10.1177/0145561320946153.
• Ami T. Allscripts EPSi. Mayo Clinic; Sept. 19, 2022.

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Overcoming Speech Impediment: Symptoms to Treatment

There are many causes and solutions for impaired speech

• Types and Symptoms
• Speech Therapy
• Building Confidence

Speech impediments are conditions that can cause a variety of symptoms, such as an inability to understand language or speak with a stable sense of tone, speed, or fluidity. There are many different types of speech impediments, and they can begin during childhood or develop during adulthood.

Common causes include physical trauma, neurological disorders, or anxiety. If you or your child is experiencing signs of a speech impediment, you need to know that these conditions can be diagnosed and treated with professional speech therapy.

This article will discuss what you can do if you are concerned about a speech impediment and what you can expect during your diagnostic process and therapy.

FG Trade / Getty Images

Types and Symptoms of Speech Impediment

People can have speech problems due to developmental conditions that begin to show symptoms during early childhood or as a result of conditions that may occur during adulthood. 

The main classifications of speech impairment are aphasia (difficulty understanding or producing the correct words or phrases) or dysarthria (difficulty enunciating words).

Often, speech problems can be part of neurological or neurodevelopmental disorders that also cause other symptoms, such as multiple sclerosis (MS) or autism spectrum disorder .

There are several different symptoms of speech impediments, and you may experience one or more.

Can Symptoms Worsen?

Most speech disorders cause persistent symptoms and can temporarily get worse when you are tired, anxious, or sick.

Symptoms of dysarthria can include:

• Slurred speech
• Slow speech
• Choppy speech
• Hesitant speech
• Inability to control the volume of your speech
• Shaking or tremulous speech pattern
• Inability to pronounce certain sounds

Symptoms of aphasia may involve:

• Speech apraxia (difficulty coordinating speech)
• Difficulty understanding the meaning of what other people are saying
• Inability to use the correct words
• Inability to repeat words or phases
• Speech that has an irregular rhythm

You can have one or more of these speech patterns as part of your speech impediment, and their combination and frequency will help determine the type and cause of your speech problem.

Causes of Speech Impediment

The conditions that cause speech impediments can include developmental problems that are present from birth, neurological diseases such as Parkinson’s disease , or sudden neurological events, such as a stroke .

Some people can also experience temporary speech impairment due to anxiety, intoxication, medication side effects, postictal state (the time immediately after a seizure), or a change of consciousness.

Speech Impairment in Children

Children can have speech disorders associated with neurodevelopmental problems, which can interfere with speech development. Some childhood neurological or neurodevelopmental disorders may cause a regression (backsliding) of speech skills.

Common causes of childhood speech impediments include:

• Autism spectrum disorder : A neurodevelopmental disorder that affects social and interactive development
• Cerebral palsy :  A congenital (from birth) disorder that affects learning and control of physical movement
• Hearing loss : Can affect the way children hear and imitate speech
• Rett syndrome : A genetic neurodevelopmental condition that causes regression of physical and social skills beginning during the early school-age years.
• Adrenoleukodystrophy : A genetic disorder that causes a decline in motor and cognitive skills beginning during early childhood
• Childhood metabolic disorders : A group of conditions that affects the way children break down nutrients, often resulting in toxic damage to organs
• Brain tumor : A growth that may damage areas of the brain, including those that control speech or language
• Encephalitis : Brain inflammation or infection that may affect the way regions in the brain function
• Hydrocephalus : Excess fluid within the skull, which may develop after brain surgery and can cause brain damage

Do Childhood Speech Disorders Persist?

Speech disorders during childhood can have persistent effects throughout life. Therapy can often help improve speech skills.

Speech Impairment in Adulthood

Adult speech disorders develop due to conditions that damage the speech areas of the brain.

Common causes of adult speech impairment include:

• Head trauma 
• Nerve injury
• Throat tumor
• Stroke 
• Parkinson’s disease 
• Essential tremor
• Brain tumor
• Brain infection

Additionally, people may develop changes in speech with advancing age, even without a specific neurological cause. This can happen due to presbyphonia , which is a change in the volume and control of speech due to declining hormone levels and reduced elasticity and movement of the vocal cords.

Do Speech Disorders Resolve on Their Own?

Children and adults who have persistent speech disorders are unlikely to experience spontaneous improvement without therapy and should seek professional attention.

Steps to Treating Speech Impediment 

If you or your child has a speech impediment, your healthcare providers will work to diagnose the type of speech impediment as well as the underlying condition that caused it. Defining the cause and type of speech impediment will help determine your prognosis and treatment plan.

Sometimes the cause is known before symptoms begin, as is the case with trauma or MS. Impaired speech may first be a symptom of a condition, such as a stroke that causes aphasia as the primary symptom.

The diagnosis will include a comprehensive medical history, physical examination, and a thorough evaluation of speech and language. Diagnostic testing is directed by the medical history and clinical evaluation.

Diagnostic testing may include:

• Brain imaging , such as brain computerized tomography (CT) or magnetic residence imaging (MRI), if there’s concern about a disease process in the brain
• Swallowing evaluation if there’s concern about dysfunction of the muscles in the throat
• Electromyography (EMG) and nerve conduction studies (aka nerve conduction velocity, or NCV) if there’s concern about nerve and muscle damage
• Blood tests, which can help in diagnosing inflammatory disorders or infections

Your diagnostic tests will help pinpoint the cause of your speech problem. Your treatment will include specific therapy to help improve your speech, as well as medication or other interventions to treat the underlying disorder.

For example, if you are diagnosed with MS, you would likely receive disease-modifying therapy to help prevent MS progression. And if you are diagnosed with a brain tumor, you may need surgery, chemotherapy, or radiation to treat the tumor.

Therapy to Address Speech Impediment

Therapy for speech impairment is interactive and directed by a specialist who is experienced in treating speech problems . Sometimes, children receive speech therapy as part of a specialized learning program at school.

The duration and frequency of your speech therapy program depend on the underlying cause of your impediment, your improvement, and approval from your health insurance.

If you or your child has a serious speech problem, you may qualify for speech therapy. Working with your therapist can help you build confidence, particularly as you begin to see improvement.

Exercises during speech therapy may include:

• Pronouncing individual sounds, such as la la la or da da da
• Practicing pronunciation of words that you have trouble pronouncing
• Adjusting the rate or volume of your speech
• Mouth exercises
• Practicing language skills by naming objects or repeating what the therapist is saying

These therapies are meant to help achieve more fluent and understandable speech as well as an increased comfort level with speech and language.

Building Confidence With Speech Problems 

Some types of speech impairment might not qualify for therapy. If you have speech difficulties due to anxiety or a social phobia or if you don’t have access to therapy, you might benefit from activities that can help you practice your speech. 

You might consider one or more of the following for you or your child:

• Joining a local theater group
• Volunteering in a school or community activity that involves interaction with the public
• Signing up for a class that requires a significant amount of class participation
• Joining a support group for people who have problems with speech

Activities that you do on your own to improve your confidence with speaking can be most beneficial when you are in a non-judgmental and safe space.

Many different types of speech problems can affect children and adults. Some of these are congenital (present from birth), while others are acquired due to health conditions, medication side effects, substances, or mood and anxiety disorders. Because there are so many different types of speech problems, seeking a medical diagnosis so you can get the right therapy for your specific disorder is crucial.

Centers for Disease Control and Prevention. Language and speech disorders in children .

Han C, Tang J, Tang B, et al. The effectiveness and safety of noninvasive brain stimulation technology combined with speech training on aphasia after stroke: a systematic review and meta-analysis . Medicine (Baltimore). 2024;103(2):e36880. doi:10.1097/MD.0000000000036880

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, language .

Mackey J, McCulloch H, Scheiner G, et al. Speech pathologists' perspectives on the use of augmentative and alternative communication devices with people with acquired brain injury and reflections from lived experience . Brain Impair. 2023;24(2):168-184. doi:10.1017/BrImp.2023.9

Allison KM, Doherty KM. Relation of speech-language profile and communication modality to participation of children with cerebral palsy . Am J Speech Lang Pathol . 2024:1-11. doi:10.1044/2023_AJSLP-23-00267

Saccente-Kennedy B, Gillies F, Desjardins M, et al. A systematic review of speech-language pathology interventions for presbyphonia using the rehabilitation treatment specification system . J Voice. 2024:S0892-1997(23)00396-X. doi:10.1016/j.jvoice.2023.12.010

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.

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Stop Stammering: Easy-to-Follow Tips and Tricks to Smooth Your Speech

Last Updated: May 27, 2023 Fact Checked

Improving Your Speech

Working with a speech-language pathologist (slp), supporting someone who stammers, expert q&a.

This article was co-authored by Devin Fisher, CCC-SLP and by wikiHow staff writer, Jennifer Mueller, JD . Devin Fisher is a Speech-Language Pathologist based in Las Vegas, Nevada. Devin specializes in speech and language therapy for individuals with aphasia, swallowing, voice, articulation, phonological social-pragmatic, motor speech, and fluency disorders. Furthermore, Devin treats cognitive-communication impairment, language delay, and Parkinson's Disease. He holds a BS and MS in Speech-Language Pathology from Fontbonne University. Devin also runs a related website and blog that offers speech-language therapy resources and information for clinicians and clients. There are 13 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 390,326 times.

Not being able to get your words out properly can wreak havoc on your self-esteem. Just know that you're not alone—more than 80 million people worldwide stammer or stutter, including famously eloquent people, such as Winston Churchill. [1] X Research source While there's no cure for a stammer, there are ways you can make it happen less often and make it less noticeable when it does happen. Read on to learn specific things you can do to improve your speech, as well as when you should get a professional involved. If you're here because you have a friend or family member who stutters, you can also learn how to support them.

Things You Should Know

• Speak slowly and deliberately, focusing on each word as you're saying it.
• Use breathing exercises to control your breath and decrease stress and anxiety, which can make a stammer worse.
• Talk to a speech-language pathologist if you're not noticing any improvement or your stammer is seriously interfering with your life.
• Join a support group to work with others who stutter and improve your speech together.

• People who stutter often stutter less when they're reading. If this is true for you, reading aloud can help you practice speaking. [3] X Research source
• You might also try this with tongue twisters. To really give yourself a challenge, use tongue twisters that repeat a sound you have a lot of trouble with.

• It's good to practice this on your own until you're comfortable with the rhythm and the pauses become second nature. Then it'll feel less awkward to talk like this with other people.

• For example, instead of making the "p" sound with your lips, you might make it with the tip or even the sides of your tongue. It won't sound exactly like other people's "p," but they probably won't notice.
• You might also try intentionally stuttering with sounds you don't normally have a problem with. This might sound counter-intuitive, but when you do it voluntarily, you have control over it—you can learn how to better control the muscles in your mouth.

• Song lyrics naturally have a different rhythm and lots of pauses between words, which helps you control speed and pacing.
• When you go to speak, pretend you're in a musical and you're going to sing the sentence rather than saying it—then say it. You're tricking your brain into thinking you're singing, which can keep you from stuttering. [7] X Research source

• There are lots of apps and YouTube videos that can help you start meditating . Just a few minutes a day can really improve your state of mind.

• The audio playback also gives you a record of your progress. You might make a short recording once a week reading the same passage so you can mark your improvement.

• Many famous actors have a stutter or once stuttered, including Emily Blunt and James Earl Jones. [13] X Research source

• You might say, "I just want to let you know that I speak with a slight stutter, so if I get caught on a word, all I need is a little time to get it out."

• Your SLP will also give you exercises to do on your own at home in between appointments. Keep up with these exercises to get the most out of speech therapy.
• Speech therapy remains the most well-established treatment for stuttering, with a lot of research to back up its effectiveness.
• Looking for an SLP? Try checking out the resources linked by the National Stuttering Association at https://westutter.org/who-we-help/find-speech-therapist/ .

• Talk to your doctor if you're interested in CBT. They'll likely refer you to a therapist. It might help to make sure any therapist you use has experience working with people who stutter.

• These devices are relatively new and researchers are still evaluating their long-term effectiveness.
• If you're interested in this device, talk to your SLP. They'll know how to get you set up with one.

• If you're interested in trying medication, talk to your doctor about it. They'll evaluate your other symptoms and get you started on something that might work for you.
• Keep in mind that these medications don't usually work right away—it might be several weeks before you start to notice any difference, but that doesn't mean the medication isn't working.

• If you're working with an SLP, ask them about support groups in your area—they'll likely know of one they can recommend.
• Support groups can be freeing because it's a true judgment-free zone—everyone there understands what you're going through because they're going through it too. [20] X Research source

• If they get excited and start stuttering because they're trying to speak too quickly, don't tell them to slow down—this comes across as demeaning. Instead, show patience and let them take control of their words on their own.

• When you see someone you care for struggling, it's natural to want to help. Just remember that finishing their sentences or speaking for them isn't usually helping.
• If your friend or family member who stutters is open to talking to you about their stutter, take their words to heart—they'll tell you what helps them and what they want you to do.

• If you don't understand them, it's better to ask a clarifying question than to ask them to repeat what they said, which they might interpret as making fun of their stutter.

• Reflect what they say back to them in a calm and relaxed manner to demonstrate that they don't need to rush. This works especially well with little kids, who will naturally mimic your speaking pace. [25] X Research source

• "Stammer" is more common in British English, while "stutter" is used in American English. Both words mean the same thing. [28] X Research source Thanks Helpful 6 Not Helpful 0

• If you are an adult who has recently developed a stammer, contact your doctor immediately. It could be a result of head trauma or a symptom of a serious central nervous system disease or disorder. [29] X Research source Thanks Helpful 8 Not Helpful 2

You Might Also Like

• ↑ https://www.stutteringhelp.org/faq
• ↑ https://www.stutteringhelp.org/talking-slowly-and-deliberately
• ↑ https://www.nidcd.nih.gov/health/stuttering
• ↑ https://slpstephen.com/blogs/news/the-complete-list-of-stuttering-treatment-techniques
• ↑ https://www.stuttering.co.nz/news/why-dont-we-stutter-when-we-sing/
• ↑ https://journals.sagepub.com/doi/abs/10.1177/1525740118783516?journalCode=cdqc&
• ↑ Patrick Muñoz. Voice & Speech Coach. Expert Interview. 12 November 2019.
• ↑ https://www.stutteringhelp.org/content/rowan-atkinson
• ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118465/
• ↑ https://www.stutteringhelp.org/6-tips-speaking-someone-who-stutters-0
• ↑ Devin Fisher, CCC-SLP. Speech Language Pathologist. Expert Interview. 15 January 2021.
• ↑ https://www.stuttering.co.nz/news/stuttering-vs-stammering-whats-the-difference/
• ↑ https://www.michiganspeechhearing.org/docs/Copy_of_Psychogenic_Stuttering_-_Diagnosis_and_Treatment.handoutpptx.pdf

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The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

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To stop stammering, try to slow down your speech and talk at your own pace, which will make you less likely to stammer. Also, practice speaking and make note of any words or phrases that you struggle with. Then, devote extra time to practicing those words so they don't trip you up when you're talking. If you're having trouble overcoming stammering on your own, talk to your doctor or a speech-language pathologist so they can help. To learn about the different potential causes of stammering, keep reading. Did this summary help you? Yes No

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How to actually fix a lost voice, according to science (hint: lemon and honey doesn’t work)

Speech pathologist and Lecturer in Voice Disorders, Department of Speech Pathology, Orthopedics & Audiology, La Trobe University

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Sandra Rojas does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Losing our voice, having a hoarse voice, or having any difficulties with our voice can be challenging, especially for those who need to use it for work.

For centuries, and across different cultures, people have believed home remedies to be a handy solution for different illnesses. Losing our voice isn’t an exception.

Websites abound with proposed solutions including ginger, lemon, salt water gargles, and tea with honey.

However, put simply, there’s no evidence these home remedies work to recover a lost voice. And there’s a dearth of information out there on what actually works for treating voice issues.

As a speech pathologist and lecturer in voice disorders, I help people with voice issues every day. Here’s what actually helps you recover a lost voice.

Read more: Curious Kids: why might you wake up without a voice?

Why have I lost my voice?

Research suggests up to 30% of us will develop some form of voice disorder in our lifetimes.

There are many reasons we can develop problems with our voice. Voice quality issues can be brought on by viral infections, overuse or misuse of our voice, damage to the vocal folds, or nodules and polyps which are benign, noncancerous growths than can form on the vocal folds.

Some people such as teachers, singers, actors, clergy and lawyers are at a greater risk of developing voice difficulties. This is because they talk a lot for a living, often very loudly.

More often than not, what you might call “losing your voice” is the result of laryngitis, which is inflammation of the voice box (larynx). It’s often caused by a virus or overuse, and will tend to resolve in a couple of weeks.

Most home remedies don’t work for your voice

Home remedies like salt water gargles and tea with honey are mostly harmless, although there’s no evidence they work for fixing laryngitis . If you have a sore throat, they might temporarily alleviate some of this pain. But they definitely won’t reduce the roughness, hoarseness or “breathiness” of your voice.

These remedies can’t improve our voice because our vocal folds are protected by the epiglottis , so when swallowing tea or honey (or anything!), the epiglottis comes down and covers the vocal folds. The epiglottis also prevents food and drink from entering our lungs. Nothing should have direct contact with your vocal folds — if something did, it could get into the lungs and cause aspiration and pneumonia.

One thing to beware, especially if you have a reflux disorder , is consuming excessive amounts of tea and lemon. Lemon is acidic, and so are some teas, so having a lot of them could actually lead to acid reflux coming up the oesophagus and irritating your throat and vocal folds.

Read more: Explainer: what is gastric reflux?

What’s more, if you’re using home remedies, you might delay seeking professional medical attention, for example from a speech pathologist or an ear, nose and throat specialist (ENT). Delaying treatment could have further negative consequences if your voice issues are due to something more sinister than a cold or flu.

If your voice takes more than a week or two to recover, or you’re worried about your voice, it’s good to seek medical advice. Make sure to visit your GP at first, who may recommend a speech pathologist or ENT specialist.

So what does work for a lost voice?

Research suggests using a humidifier might be an effective option. This can help by keeping vocal folds hydrated, helping with the vibration of the vocal folds and therefore reducing roughness and hoarseness. Because the tiny water droplets in humidified air are inhaled rather than swallowed, they can bypass the epiglottis and have direct contact with our vocal folds.

Drinking lots of water can also benefit our vocal folds . Even though water doesn’t have direct contact with our voice box, it hydrates the cells in our body.

You should also rest your voice, although it depends on what’s causing your symptoms. In a case of acute laryngitis caused by an infection, your doctor might suggest you completely rest your voice. Similarly, if you’ve had trauma or surgery to your voice box, your doctor might suggest refraining from talking at all for a certain period.

But some ENTs won’t recommend completely resting your voice in other instances. For some voice disorders, your specialist might recommend you start doing voice exercises. One example is “straw phonation”, where you put a straw into a glass of water and speak through it in various ways, depending on the desired outcomes of the treatment.

If you have a hoarse voice but cannot rest it, it’s better to talk at a low volume in a consistent tone — but don’t whisper! Whispering too much can put more strain on your voice box than regular speech.

So if you lose your voice, don’t forget: drink lots of water, use a humidifier if you can, rest your voice, and don’t worry about gargling salt water or drinking lemon and honey tea.

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What Can Cause Speech Problems in Adults? Causes, Signs & Diagnosis

• Explores the various factors and conditions that can contribute to speech problems in adults.
• Discusses potential causes of speech problems, such as neurological conditions (e.g., stroke, brain injury), degenerative diseases (e.g., Parkinson's disease, multiple sclerosis), vocal cord disorders, and psychological factors.
• Provides insights into how each condition or factor can affect speech production, articulation, fluency, voice quality, and overall communication abilities.
• Offers an overview of common speech disorders and conditions that may impact adult speech, including aphasia, dysarthria, apraxia of speech, and stuttering.
• Discusses the importance of seeking professional assessment and diagnosis from speech-language pathologists (SLPs) for accurate identification of speech problems and personalized treatment plans.
• Highlights the potential impact of speech problems on individuals' daily life, social interactions, and self-confidence.
• Provides information on available treatment approaches for speech problems in adults, including speech therapy techniques, voice therapy, assistive technology, and counseling.
• Offers tips and strategies for improving communication skills and managing speech difficulties in daily life, such as practicing clear and slow speech, using visual aids, and engaging in self-care practices to support vocal health.
• Discusses the potential benefits of support groups and online resources for individuals experiencing speech problems.
• Aims to increase awareness and understanding of the various causes of speech problems in adults, encouraging individuals to seek professional help and explore appropriate interventions to improve their communication abilities and overall quality of life.

Topics covered in this article:

If you or a loved one struggling with a stutter or recovering from a stroke and noticing issues with your speech, it could be time to seek the help of an adult speech therapist .

Here, we’re going over common speech problems faced by adults, what causes them, and how you can get started with a speech pathologist near you.

What Are The Common Speech Problems in Adults?

It’s true that many speech problems are related to adolescence. However, adults can suffer from speech impairments as well, requiring assistance from a professional speech therapist .

Below, we’re going over some of the more common speech issues you loved one might come across.

Articulation Disorders

Articulation disorders represent the inability to form certain words or sounds. A person with an articulation disorder might drop, swap, distort, or add words or sounds. A lisp is an example of an articulation disorder.

Fluency Disorders

Fluency disorders affect the speed, flow, and rhythm of speech. Examples of fluency disorders include stutters or cluttering.

People with a stutter may either have trouble making sounds, their speech is blocked or otherwise interrupted, or they’ll repeat part or all of a word.

Cluttering is a disorder where a person speaks incredibly fast while merging their words together.

Resonance Disorders

Resonance disorders occur when a blockage obstructs airflow in the nasal or oral cavities. They can also occur if the velopharyngeal gland won’t properly close. Both of these disorders can alter the vibrations responsible for voice quality.

Resonance disorders are a speech issue most often associated with cleft palate, neurological disorders, and swollen tonsils.

Receptive Disorders

Receptive disorders occur when a person has trouble receiving and processing the speech of others. Symptoms of receptive disorders include coming across as uninterested and rude, having trouble following directions, or a limited vocabulary.

Receptive disorders are often associated with autism, hearing loss, other language disorders, or head injury.

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Expressive Disorders

Expressive disorders are when language becomes difficult to convey or express. With an expressive disorder, people have trouble forming correct sentences like, for example, using the correct grammar.

Expressive disorders are often associated with Down syndrome and hearing loss but can also be caused by a traumatic head injury or another medical condition.

Cognitive-Communication Disorders

Cognitive-communication disorders are caused by an injury to the part of the brain that controls your ability to think. Cognitive-communication disorders cause issues with memory, problem-solving, and difficulty speaking or hearing.

Cognitive-communication disorders might be caused by a biological defect such as abnormal brain development, some neurological conditions, brain injury, or stroke.

Aphasia is an acquired speech disorder most often caused by a stroke. It’s a communication issue that affects someone’s ability to speak, understand the speech of others, and, sometimes, affects whether they can read and write.

Again, stroke is the most common cause but can be brought about by other brain disorders as well.

Dysarthria is characterised by slow or slurred speech. It is caused by a weakness or loss of control of the muscles required for proper speech. Nervous system disorders that cause facial paralysis or throat and tongue weakness are usually the cause.

Dysarthria is most commonly associated with stroke, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS).

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What can cause speech problems in adults?

Before we go into how speech therapy works in the case of adults, let’s first go into what causes slurred speech in adults and other speech problems beyond childhood.

In some cases, the issues are purely mechanical such as the case with certain resonance disorders and cognitive-communication disorders. This means physical issues with the nasal cavity or perhaps some sort of facial paralysis could be causing a speech impediment.

In others, mental health plays a role. For example, some adults experience a stutter only when they’re nervous or anxious in social situations making it difficult to express themselves.

Furthermore, brain injury is another common cause of certain speech issues requiring an adult speech pathologist. Plus, many adults who’ve experienced a stroke often require speech therapy since strokes cause many of the aforementioned speech disorders.

So, while many speech issues are picked up in childhood, there are still many reasons why an adult might need speech therapy.

How Speech Therapy Works?

When you go to see a speech therapist as an adult, your first appointment will begin with an assessment to determine your needs. Then, you’ll work together to come up with a plan for your treatment.

Depending on your goals, your adult speech therapist will work with you through a variety of vocal exercises. These speech therapy exercises might include:

• Problem-solving, memory, and organisational activities with the aim of improving cognitive-communication
• Conversational strategies to improve social interactions
• Breathing exercises for resonance disorders
• Exercises that strengthen the oral muscles

Your speech pathologist may also recommend speech therapy apps, language development games, workbooks, and exercises to practise at home.

More Articles Related to Adult Speech Pathology

Maximising Your NDIS Plan with Therapeutic Supports

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Understanding Physical and Sensory Disabilities: Examples and Types

How Can a Speech Therapist Help?

If you have a serious and unmanageable speech impediment, there’s a lot a speech therapist can help you with as an adult.

A adult speech therapist can help adults with all of the common speech disorders we mentioned earlier. However, even without some of the more serious speech issues some adults may face, a speech pathologist can also assist with less severe speech-related concerns.

Speech therapy for adults can also help with:

• Projecting voice more efficiently
• Language and non-verbal communication strategies to improve small-talk
• Reducing mumbling
• Curbing unhelpful habitual speech patterns like low, grumbling or high-pitched “Valley girl” tones
• Social anxiety
• Interview preparation and professional communication skills
• Transgender communication training
• Public speaking strategies
• Accent modification
• Adult stutter

What neurological disorders cause speech problems?

Neurological disorders that can cause speech problems include:

• Amyotrophic lateral sclerosis (also known as ALD or Lou Gherig’s disease)
• Cerebral palsy
• Brain injury or brain tumor
• Guillain-Barre syndrome
• Huntington’s disease
• Multiple sclerosis
• Parkinson’s disease

Neurological disorders are those affecting the central and peripheral nervous system including the brain, spinal cord, nerves and muscles.

However, speech problems can also be caused by non-neurological conditions such as a head injury, Lyme disease, Myasthenia dystrophy, Wilson’s disease and stroke.

Still, even though these conditions are not considered neurological in onset, they still somehow affect the nervous system. Hence, most speech problems stem from neurological interference of some kind.

What can cause sudden speech problems?

Sudden speech problems can be caused by stress and exhaustion, excess alcohol consumption, stroke, migraines, neurological disorders or certain medications.

When you suddenly lose the ability to communicate through speech, it can certainly be a troubling experience. However, one of the above reasons could be the culprit.

Stress and exhaustion can make it difficult to put your thoughts into words. Additionally, when you’re stressed about what to say or anxious about speaking to others or large groups, getting tongue-tied is a common experience.

Getting enough sleep will help you think and communicate clearly and working with a dedicated adult speech pathologis t can help you work through your social anxiety to alleviate some of these speech problems you might be facing.

Excess alcohol consumption slows down the communication between your brain and your body. Alcohol is a depressant and drinking too much of it can lead to a slew of issues including slurred speech. It’s important to seek help if you’re worried about your levels of alcohol consumption.

A stroke occurs when oxygen is cut off to the brain. It causes impaired speech, numbness on one side and drooping of one side of the face. A stroke is incredibly serious requiring immediate care. Call 000 at the first signs of stroke to get immediate help and to avoid permanent speech problems called aphasia.

Migraines can also cause speech problems as well as causing issues to all of your senses. These speech problems go away after the migraine subsides but if you experience frequent migraines, see a doctor in case of a deeper neurological disorder.

Neurological disorders affect your brain, spinal cord and nerves which affects your brain’s ability to connect with your body. Various neurological disorders can cause speech problems due to this disconnection.

Certain medications can cause speech problems due to allergies, sedative ingredients or side effects such as drying out your vocal cords. If you’ve recently started a new medication and are experience speech problems, speak to your doctor immediately.

How do I fix slurred speech?

Working with a speech pathologist is the best way to fix slurred speech. Especially if your speech problems are caused by a neurological disorder, anxiety or stroke, a speech pathologist can assist in re-building those neurological connections and improve any mechanical speech issues you may be facing.

Additionally, discontinuing whatever may be causing your speech problems is another way to fix slurred speech. For example, getting enough rest, avoiding alcohol and discontinuing any medications that cause slurred speech should also help fix slurred speech.

Book an appointment with one of our incredible team of adult speech pathologists across Australia. At Physio Inq, our adult speech pathology therapists are here to help you with all your speaking needs from stutters to social anxiety.

Take advantage of our dedicated team of adult Speech Pathology mobile services that come to you, or complete your speech therapy sessions remotely with our telehealth offerings.

Why worry about the stresses of parking and traffic when you simply don't have to anymore with our home visits?

Don’t let your speech problems hold you or a loved one back Make an online appointment  or referral today. Alternatively get in touch with our intake team on 1300 731 733.

Date Published: Wednesday, June 23, 2021

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• Slurred Speech

6 Causes of Slurred Speech

• Most common questions

What is slurred speech?

Slurred speech quiz.

Take a quiz to find out what's causing your slurred speech.

6 most common cause(s)

Slurred speech is when you have trouble speaking, your words are slow or garbled, or your words run together. When you talk, many components of your nervous system work together to form words. When these parts don’t work correctly, your speech can become distorted, or “slurred.” The medical term for slurred speech is dysarthria.

Slurred speech includes problems pronouncing words and regulating the speed or pace of your speech. It can range from a barely noticeable problem to one that’s so severe that others can’t understand what you’re saying.

People often describe slurred speech as feeling like you’re trying to talk with your mouth full of marbles.

Common causes of slurred or slow speech include drinking too much alcohol and not getting enough sleep. In these cases, the slurring will stop once you’re sober again and have gotten rest, respectively.

There are also other causes of slurred speech such as a stroke (a medical emergency), brain tumor, Bell’s palsy, or a serious migraine.

Does slurred speech always need to be treated?

"People often think slurred speech is a minor symptom that does not need a medical evaluation. As our speech and ability to speak is our main form of communication, it is important to look for correctable causes." — Dr. Karen Hoerst

Should I go to the ER for slurred speech?

You should call 911 if:

• Your slurred speech starts suddenly.
• You have other symptoms, such as a sudden or severe headache and weakness or numbness of one side of your body.
• Your tongue, face, or lips are swelling, which could mean you’re having an allergic reaction.

Slurred speech emergency quiz

Take a quiz to find out if your symptoms are an emergency.

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1. Stroke or TIA (transient ischemic attack)

• Slurred speech
• Drooping of one side of the face
• Weakness or trouble controlling one side of the body
• Numbness in the face , arm , or leg
• Difficulty walking
• Sudden loss of vision or double vision
• Sudden, severe headache

A stroke occurs in the brain because the blow flow in a blood vessel is blocked. It can also happen when a blood vessel ruptures or leaks. This affects the blood supply to parts of the brain, which leads long-term damage. If it affects the area of the brain responsible for speech, it can cause slurred speech.

A transient ischemic attack , or TIA, is sometimes called a "mini stroke." A TIA is a temporary interruption of blood flow that causes the same symptoms as a stroke, but improves without any permanent damage to the brain or symptoms.

For example, if you have slurred speech because of a TIA, once the blood flow is restored to that area of the brain, the slurred speech goes away. But people who have a TIA are at a high risk of having a stroke in the future, especially if their risk factors are not treated. Risk factors are the same for stroke and TIA and include smoking, obesity, and cardiovascular disease.

It’s extremely important to call 911 right away if you suddenly have slurred speech. Getting immediate treatment is critical to minimizing permanent damage. Paramedics can begin treating you in the ambulance on the way to the hospital, so it’s better to call 911 than go to the ER yourself.

Treatments for strokes and TIAs include medications to break up blood clots and surgery to remove blood clots from the vessels. If your stroke is from bleeding in the brain, you may need surgery to repair a blood vessel.

Following treatment, your doctor will recommend medications to prevent another TIA or stroke. These typically include drugs that prevent clots from forming in the blood (like aspirin or other blood thinners) and cholesterol medication to prevent plaque from building up on the walls of the blood vessels. You may also need to take medication to control your blood pressure.

Speech therapy is recommended to help treat problems with speech.

It may not be a stroke

"There are so many possible causes of slurred speech. Most of the time we need a detailed history and physical exam to guide the diagnosis and treatment." — Dr. Hoerst

Take symptoms quiz

2. Bell’s palsy

• Drooping of the face
• Drooping of the eye
• Changes in taste or hearing

Bell’s palsy is a relatively common condition that affects the facial nerve, which is responsible for movement of your face.

In Bell’s palsy, the nerve gets inflamed typically because of a recent viral infection. This inflammation can cause the facial nerve to not work as well, leading to drooping and slurred speech.

Bell’s palsy usually improves in a few months, but medications such as steroids and antiviral drugs are typically given to help speed the process. If nerve problems continue, physical therapy is recommended. In rare instances, surgery may be needed to help improve facial muscle function.

3. Brain tumor

• Slurred speech or speech difficulties
• New or changing headaches
• Weakness or coordination and balance problems
• Abnormal vision

A brain tumor is an abnormal growth of cells in the brain. A brain tumor may be cancerous (malignant) or noncancerous (benign). Both types can cause symptoms including slurred speech.

The diagnosis of a tumor in the brain or spinal cord is based on an exam and imaging of the brain, such as an MRI or CT scan. A biopsy (tissue sample) may be needed to determine what type of tumor it is.

Some tumors, such as a small noncancerous tumor, do not need treatment, though your doctor will recommend periodic MRI scans to make sure it hasn’t changed.

Most larger or cancerous tumors do require treatment, which may consist of chemotherapy, radiation, or surgery. If you develop physical or cognitive (mental) problems from the tumor, rehabilitation such as physical therapy, occupational therapy, or speech therapy may be needed.

4. Multiple sclerosis

• Blurred vision or decreased vision, typically in one eye
• Weakness or trouble walking
• Numbness or pins-and-needles sensation on your face, arm, or leg (typically on one side)
• A band-like squeezing sensation around the chest or abdomen
• Difficulty focusing

Multiple sclerosis, or MS, is a central-nervous system disease that affects the cells of the brain and spinal cord. In MS, a fatty tissue that surrounds nerve fibers (myelin) is attacked. Myelin helps to insulate the electrical signals sent through the nerves. When there is a problem with this fatty tissue, information sent to and from the brain can be disrupted.

MS is most common in young adults between the ages of 20 and 50, according to the National MS Society .

MS is not curable , but treatments have dramatically improved the ability to control MS, so people usually have fewer symptoms and less disability.

Treatment includes medications that may be taken orally or injected or infused through an IV line. Physical therapy and speech therapy are commonly used to help in physical recovery, and medications can be used to treat other symptoms, such as depression, pain, and fatigue.

5. Amyotrophic lateral sclerosis (ALS)

• Difficulty with speech, including slurred speech
• Progressive weakness and difficulty balancing
• Muscle cramps, twitching, and stiffness
• Difficulty swallowing

Amyotrophic lateral sclerosis (ALS) is also known as Lou Gehrig’s disease. It affects nerve cells called motor neurons that control your movement.

The disease primarily causes a loss of strength, impaired swallowing and speech, and in most cases, difficulty breathing because of impaired respiratory muscles. It is a progressive disease, meaning that symptoms are mild at first and worsen over time.

Previously, it was thought that ALS doesn’t affect a person’s mental ability. But it’s now known that people with ALS can get a specific type of dementia called frontotemporal dementia (FTD). That condition can affect behavior, mood, and speech.

Symptoms of ALS can develop in adults of any age, but it’s most commonly diagnosed in people who are between the ages of 40 and 70, according to the ALS Association .

While there are some medications that can be used to delay the progression of the disease, there is currently no cure for ALS. Treatment includes rehabilitation with physical therapy, occupational therapy, speech therapy, and respiratory therapy.

6. Migraine

• Sensitivity to light and sound
• Visual disturbances

A migraine causes a severe headache that is often accompanied by nausea and sensitivity to light or sound. But some migraines don’t cause head pain.

Other symptoms that involve the nervous system can occur. Some of these sensory symptoms are called “auras.” These distortions can cause visual changes , including flashing lights or distorted vision. People may feel tingling or numbness of their face, arm, or leg.

In some types of migraine, people may even develop slurred speech and weakness of the face, arm, or leg. These are also symptoms of a stroke, so it may be hard to figure out which condition you have. If you develop sudden slurred speech or weakness, go to the ER immediately.

In an acute migraine attack, medications can be used to stop a migraine that has already started, such as triptans or newer medications called CGRP inhibitors. These medications can be in pill form, inhaled form, or injectable medications.

Migraine prevention can include taking medications for blood pressure, anticonvulsants, or even antidepressants. In some instances, Botox treatments are used to prevent migraine.

Behavior and lifestyle changes such as exercise, improved sleep, and healthy diet or weight loss are also often recommended to help decrease the number of migraine headaches you experience.

Other possible causes

Slurred speech may occur from alcohol intoxication or tiredness. It can also be a side effect of medications like high dose pain medications, antipsychotic medications or even some allergy medications like antihistamines. Other causes include:

• Infections such as urinary tract infections or electrolyte imbalances (particularly in elderly people).
• Brain infections such as meningitis or encephalitis.
• Problems that affect your mouth or throat, such as poorly fitting dentures, dental infections, dental numbing medications, swelling in your throat, or muscle or nerve problems.
• An allergic reaction , especially if you notice slurred speech along with tongue swelling , lip swelling, or shortness of breath.

"Early speech therapy can not only help with early improvement but also with diagnosis. Speech-language pathologists have special training in detecting the various types of slurred speech, which helps to determine the possible causes."— Dr. Hoerst

Specialty treatment options

• Speech therapy is the most common treatment for slurred speech.
• Injected medications such as Botox are sometimes used, depending on the cause of slurred speech.
• Medications to improve nerve and muscle function.

While it's important to follow your healthcare provider's guidance, here are some over-the-counter (OTC) options that might provide extra support.

• Proper nutrition supports overall health, including nerve function. Supplements like B vitamins may support neurological health.
• Staying hydrated is key, especially if speech difficulties make it hard to drink. Consider a no-spill, easy-sip water bottle designed for easy grip.
• Engaging in exercises to improve speech clarity can be helpful. Explore speech therapy tools and resources that you can use at home.

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Dysarthria (difficulty speaking)

Dysarthria is where you have difficulty speaking because the muscles you use for speech are weak. It can be caused by conditions that damage your brain or nerves and some medicines. Speech and language therapy can help.

Immediate action required: Call 999 if:

• somebody's face droops on 1 side (the mouth or eye may have drooped)
• a person cannot lift up both arms and keep them there
• a person has difficulty speaking (speech may be slurred or garbled)

These can be signs of a stroke, which is a medical emergency. The symptoms of a stroke usually come on suddenly.

Do not drive yourself to A&E.

The person you speak to at 999 will give you advice about what to do.

Check if it's dysarthria

The main symptom of dysarthria is unclear speech. This can make it difficult for you to make yourself understood.

Your speech may only be slightly unclear, or you may not be able to speak clearly at all.

Other symptoms include:

• difficulty moving your mouth, tongue or lips
• slurred or slow speech
• difficulty controlling the volume of your voice, making you talk too loudly or quietly
• a change in your voice, making it nasal, strained or monotone
• hesitating a lot when talking, or speaking in short bursts instead of full sentences

Being stressed or tired may make your symptoms worse.

Dysarthria is not the same as dysphasia, although you can have both conditions at the same time. Dysphasia, also known as aphasia , is where you have difficulty understanding words or putting them together in a sentence.

Non-urgent advice: See a GP if:

• you've noticed gradual changes to your or your child's speech and you're worried

They'll examine you and may refer you to a specialist for further tests.

Causes of dysarthria

Dysarthria is usually caused by damage to the brain or conditions that affect the nervous system. It can happen at any age.

Common causes include:

• stroke , severe head injury and brain tumours
• Parkinson's disease , multiple sclerosis and motor neurone disease
• cerebral palsy and Down's syndrome

It can also be a side effect of certain medicines, such as some medicines to treat epilepsy.

Treatment for dysarthria

If you have dysarthria, you'll usually be referred to a speech and language therapist. They'll offer therapy to help your speech and communication.

The therapy you're offered will be different depending on the cause of your dysarthria and how severe it is.

Some people may find therapy does not help their symptoms, or their speech may get worse as their condition progresses. Their therapy may focus on helping communication in other ways.

Speech and language therapy may include:

• exercises to strengthen the muscles used for speech
• strategies to make your speech easier to understand, such as slowing down when you're talking
• using communication aids, such as an alphabet board or a voice amplifier

Find out more

• Headway: communication problems after brain injury
• Stroke Association: communication tools

Page last reviewed: 17 February 2023 Next review due: 17 February 2026

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The Top 5 Pronunciation Problems and How to Fix Them

1. Stressing individual words incorrectly If you usually speak with native English speakers, this will be the number one reason why they misunderstand you. It’s very hard for native English speakers to ‘translate’ a word spoken as ‘caLENdar’ to the way they would pronounce it, ‘CALendar’.

Non-native English speakers don’t have as much of a problem with this, and will probably still understand what you’re trying to say.

Quick fix: Listen carefully to the way people around you pronounce their words. If you hear a pronunciation that is different from yours, check the dictionary (even if it’s a common word) to be sure that you’re stressing it correctly. Some commonly mis-stressed words that I hear (with proper stress in capitals) include: PURchase, COLleague, phoTOGraphy and ecoNOMic. You will also find a number of commonly mispronounced words listed in the ‘How to Pronounce…’ section of this blog.

2. Stressing the wrong words in a sentence. Remember that you can completely change the meaning of a sentence by stressing different words in that sentence. For example, you could say this sentence in a number of different ways:

“I didn’t say we should drive this way.”

If you stress I , you emphasize that taking that route wasn’t your idea. On the other hand, if you stress drive , you emphasize the mode of transport.

If you don’t pay close attention to the words that you stress, you could end up sending a completely different message than the one you intended.

Quick fix: Think about placing added emphasis on the word that is most important to your meaning. You can add emphasis by lengthening the word, saying it slightly louder and/or changing the pitch of your voice slightly. Listen to Part 8 of the Pronunciation Short Course for further discussion.

3. Pronouncing certain consonant sounds incorrectly If people are misunderstanding you, it could very well be due to you confusing what we call ‘voiced’ and ‘unvoiced’ sounds. You might substitute ‘p’ for ‘b’ or ‘t’ for ‘d’, for example. These sounds are so easily confused because their only difference is whether or not you use your voice to produce them. If you aren’t careful, you could be making mistakes like saying ‘tuck’ for ‘duck’ or ‘pay’ for ‘bay’.

Quick fix: Pay attention to how you use your voice when you speak. You should be able to feel the vibration of your vocal cords when you make voiced sounds (b, d, g, v, z, r, l, m, n, ng, dge, zh, and voiced th). You can also try to make lists of pairs of words that use the sounds you find challenging and practice repeating those. Record yourself so you can hear whether you’re making any progress.

4. Mixing up short and long vowel sounds Vowel sounds , like consonant sounds, can also be confused easily. The main problem with vowels happens when you mix up long and short vowel sounds. For example, the long ‘ee’ sound in ‘seat’ with the short ‘i’ sound in ‘sit.’ If you confuse these sounds, you end up saying completely different words. This can get confusing in conversation and forces people to draw much more from the context of your speech than the speech itself.

Quick fix: Make practice word lists like the ones you made for the consonant sounds and practice the sounds that are difficult for you.

5. Forgetting to finish your words Do you have a tendency to let your word endings drop? I often hear people drop the ‘ed’ ending off of words in the past tense, for example. This is a dangerous mistake because not only is your pronunciation wrong, but it also sounds like you’re making a grammatical mistake. People could judge you based on this type of error.

Quick fix: Do everything you can to articulate your word endings. One exercise that might help is to move the word ending onto the front of the following word. This will only work if the following word begins with a vowel sound. For example, try saying ‘talk tuh lot’ instead of ‘talked a lot’.  Check out Part 5 of the FREE, 8-part Pronunciation Short Course at http://bit.ly/free8-partproncourse  for more information on linking.

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Reader Interactions

March 15, 2011 at 12:25 am

Spot on Heather! If we paid more attention to to the last stop in our communication process, we’d have a lot more clarity and confidence in our representation of the ideas that we’re getting across to other people. I especially like your point (3) about ‘voiced’ and ‘unvoiced’ sounds! I had a ball going through the letters! Oooh … I also like your blog – I’ve been meaning to do one up as well. Perhaps I can ‘bribe’ you with lunch and you bring along your laptop and show me how? 🙂

March 16, 2011 at 1:17 am

Hey Ricky! Thanks for your comments! Glad you enjoyed the voiced and unvoiced sounds! I’ll get back to you over email regarding lunch. 😉

August 10, 2012 at 9:59 pm

This is a great summary of the important points that foreign speakers get stuck on. I am a TESOL graduate student specialising in L2 pronunciation, it’s an emotionally charged issue in addition to be a difficult part of language learning. I see so many students beat themselves up over their pronunciation problems. Thank you for sharing this information.

September 1, 2012 at 2:11 pm

So many people mispronounce Australia. You should have a sixty second guide on how to pronounce Australia.

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Oops, I messed up! 7 common public speaking issues — and how to fix them

Kyle Norris

Audrey Nguyen

It can be nerve-wracking to deliver a speech in front of people. What the heck do you say? How do you capture people's attention? And what do you do if you ... mess up?

With the right skills and enough practice, anyone can overcome these challenges and be a good speaker, says Lauren Dominguez Chan of West Wing Writers, a group of writers who create speeches and messages for government officials, business leaders and athletes.

"The end goal is to prepare people to speak in a way where they're free to connect with their audience in the moment," she says.

To do that, you'll need to know a few basics about the art of public speaking. Dominguez Chan and Eva Margarita, assistant director of Texas Speech , the speech team at the University of Texas at Austin, share seven common problems that people face when speaking in public — and how to fix them.

1. Problem: My speech is unfocused

Solution: Identify your core message

Before you dive into your speech, figure out your core message, says Dominguez Chan.

"If my audience could walk out of this room with one thing, what would that one thing be?" she asks. It can be an idea, a feeling "like wanting your audience to walk away feeling appreciated" or a call to action — like inspiring someone to vote.

During the early years of the pandemic, she was the speechwriter for the U.S. Surgeon General Dr. Vivek Murthy. She wrote his weekly remarks on COVID for the White House and other important speeches, including his 2021 commencement speech at the U.C. Berkeley School of Public Health.

Her aim in that speech was to elevate the students and make them feel like they could lean on the people around them. Here's an excerpt:

"I leave you today with a practice you can turn to during those moments of doubt that will inevitably surface during the years ahead. Take your right hand and place it gently over your heart. And close your eyes. Take a deep breath. And think about the people in your life who have supported you on your journey to this moment."

Through this exercise, "Dr. Murthy guides your attention inward in this moment of reflection and then outward again in gratitude to these people that you're imagining in your head," says Dominguez Chan — helping to achieve the core messaging goal.

2. Problem: I don't know what to include in my speech

Solution: Point everything back to the central idea

Now that you have your core message, make sure all the ideas in your speech point back to it, says Dominguez Chan.

It makes it easier to decide what to say and it "helps you make every other decision, from the structure to the specific stories and concrete images that you include," she adds.

Let's say you're preparing to speak at a town hall meeting about book bans and you have three minutes to do so. Figure out your stance on the topic — that's your core message — then come up with stories and anecdotes that support that message. Don't stray by mentioning unrelated things.

3. Problem: It feels like I'm talking at my audience

Solution: Use vivid imagery and storytelling

Dominguez Chan likes using what she calls "sticky stories" in her speeches — honest, vivid anecdotes with details that engage the senses of sight, sound, smell, taste and touch.

They "are going to make your presentation memorable. People remember stories and images," she says.

For example, instead of saying, "I was terrified," you could say "my hands were shaking so much that I couldn't hold the steering wheel," she adds.

4. Problem: My speech doesn't sound natural

Solution: Write for the ear

A big part of great speechwriting, says Dominguez Chan, is "writing for the ear." That means using "short, simple words and sentences. They are often the most powerful."

Let's take a look at an excerpt from Murthy's commencement speech again:

"All of you graduating today have been on quite a journey together ... I know you didn't expect your education in public health to be disrupted by, of all things, a public health emergency. Yet in the midst of the change and suffering our world has endured, this gathering of public health leaders – and yes, I'm referring to you — is a testament to all the reasons we have to be hopeful about the future." 

Notice how he uses relatively simple words to talk about a complex topic like the COVID pandemic. "You don't have to use the biggest word in a speech," she says.

5. Problem: My message isn't connecting with the audience

Solution: Practice in front of people

Practicing your speech can ease feelings of nervousness and help you fine tune your presentation. And it can ensure that your message is reaching people.

"Ask a friend or a family member to listen to you as you practice," says Dominguez Chan. "Ask them, 'Does it sound like me?' 'How was the pace?' You can also take a voice memo with your phone and play it back to yourself."

If you want feedback from strangers, you could join a speech club like Toastmasters International . It's an organization that's been around for almost 100 years and has 14,200 clubs all over the world, so there's likely a club near you.

Toastmasters' meetings are very structured and timed down to the minute, with plenty of opportunities to get supportive feedback on your grammar, overall presentation and how many times you used filler words like "um," "ya know" and "ah." There's also a chance to practice improvising short speeches on an impromptu topic.

6. Problem: I'm so nervous

Solution: Take a deep breath

In the moments leading up to your speech, take some deep breaths, says Margarita of the University of Texas at Austin. She coaches college students on how to research, write and deliver speeches.

She recommends doing a "self-regulating breath," a breath with "an inhale that allows the belly to expand — and audible exhaling." It will give your body and mind a moment to calm down before you actually speak out loud.

7. Problem: Oops, I messed up!

Solution: Slow down and start again

If something unexpected happens in the moment — say you stumble or lose your place — pause or slow down. "If you get tongue tied, take a beat," says Margarita. Take a deep breath and go back to the beginning of a sentence or restate the word you stumbled on.

And don't worry, people don't notice those pauses as much as you think they do, says Dominguez Chan. "Even if someone does notice, that's OK too."

The point is to set yourself up for success, not perfection, she adds.

This episode of Life Kit was produced and fact checked by Audrey Nguyen, with engineering support from Phil Edfors. It was edited by Meghan Keane. The digital story was edited by Malaka Gharib. The visual producer is Kaz Fantone.

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BioMicrobics Guide to Septic Drain Field Maintenance and Repair

BioMicrobics Guide to Septic Drain Field Maintenance and Repair — Septic system drainfield maintenance and repair play a crucial role in preserving the health and longevity of your septic system. A properly functioning drainfield, also known as a leach field, ensures efficient drainage of effluent from the septic tank.

However, issues such as root intrusion and soil compaction can hinder the drain field’s performance, leading to costly repairs. In this comprehensive guide, homeowners will discover essential information about septic drainfield maintenance, common problems, and effective repair strategies. Keep reading to learn how to protect your investment and maintain a healthy septic system for years to come.

Understanding the Components of Your Septic System

How wastewater is treated in the drain field, materials used in constructing drain fields, the role of perforated pipes and gravel, factors influencing the lifespan of a drain field, tips for extending the life of your drain field, recognizing signs of drain field failure, solutions for overcoming drain field malfunctions, best practices for landscaping around drain fields.

• Do's and Don'ts for Drain Field Maintenance

What Is a Drain Field & How Does It Work?

A drain field, also known as a leach field, is a crucial component of an onsite sewage facility that works in tandem with a septic tank to treat wastewater. This system serves as an alternative to a centralized sanitary sewer, particularly in areas where municipal sewage treatment is unavailable. The drain field’s primary function is to filter and purify effluent from the septic tank as it percolates through layers of soil, effectively removing harmful contaminants before the water rejoins the natural groundwater supply.

A septic system consists of several key components that work together to treat and dispose of household wastewater. The septic tank, a large underground container, serves as the initial stage of sewage treatment by separating solids from liquids and allowing beneficial bacteria to break down organic matter.

From the septic tank, partially treated effluent flows into the septic drain field for further purification. The drain field, comprised of a network of perforated pipes buried in gravel-filled trenches, distributes the effluent evenly throughout the soil. This process effectively filters out remaining contaminants before the water rejoins the groundwater supply:

• Household plumbing carries wastewater to the septic tank
• Septic tank separates solids and begins treatment process
• Effluent flows into the drain field for final filtration
• Treated water percolates through soil layers
• Clean water rejoins the natural groundwater supply

The drain field treats wastewater through a combination of physical, chemical, and biological processes as it percolates through soil layers. Perforated pipes distribute effluent evenly across the field, allowing it to filter through gravel and soil, which act as natural purifiers. Beneficial microorganisms in the soil break down harmful pathogens and nutrients, protecting groundwater and promoting overall environmental health .

As the treated water moves through the soil, it nourishes the surrounding plant life, creating a lush lawn above the drain field. This symbiotic relationship between the septic system and the landscape helps maintain a healthy ecosystem while effectively managing household wastewater. Proper maintenance of the drain field ensures optimal performance and longevity of the entire septic system.

Drain fields play a crucial role in septic systems, but what exactly are they made of? Let’s explore the components that make up these essential wastewater treatment structures.

What Is a Septic Drain Field Made Of?

Septic drain fields consist of carefully selected materials designed to efficiently filter and purify wastewater. These components work together to prevent groundwater contamination and protect the environment from harmful waste. Understanding the construction of a drain field is crucial for homeowners who rely on septic systems, as it helps them avoid activities that could damage the system, such as planting trees with invasive roots near the field or driving heavy vehicles over it.

Proper maintenance, including regular pumping of the septic tank and avoiding flushing non-biodegradable items down the toilet, can prevent flooding and ensure the drain field’s longevity. This section explores the materials used in drain field construction and the essential role of perforated pipes and gravel in the wastewater treatment process.

Septic drain fields utilize a combination of materials to facilitate efficient wastewater treatment . Gravel forms the foundation of the drain field, providing a porous medium for filtration and promoting the growth of beneficial bacteria. These materials work together to create an environment that supports the natural breakdown of contaminants in the effluent.

The soil surrounding the drain field plays a crucial role in the final stages of wastewater treatment . It acts as a natural filter, removing remaining pollutants and pathogens as the effluent percolates through its layers. The soil also helps regulate heat, which is essential for maintaining optimal bacterial activity throughout the year.

Perforated pipes play a crucial role in distributing wastewater evenly throughout the drain field trench. These pipes allow effluent to seep into the surrounding gravel and soil, initiating the filtration process. The perforations also facilitate oxygen exchange, promoting aerobic bacterial activity essential for breaking down contaminants.

Gravel surrounding the pipes acts as a buffer between the effluent and soil, preventing solids from clogging the system. This arrangement helps maintain proper drainage and reduces the risk of water table contamination. The gravel layer also provides additional surface area for beneficial bacteria to thrive, enhancing the overall treatment efficiency of the drain field:

Septic drain fields are essential, but they don’t last forever. Let’s explore how long these vital systems typically function before needing replacement.

How Long Do Drain Fields Last?

The longevity of a septic drain field depends on various factors, including proper maintenance, soil conditions, and usage patterns. While a well-designed and maintained drain field can last 20 to 30 years or more, several elements can impact its lifespan. Understanding these factors and implementing effective maintenance strategies can help homeowners extend the functionality of their drain fields.

Proper care ensures the efficient removal of pathogens, nutrients, and other contaminants from liquid waste as it percolates through layers of sand and soil, protecting surface water and groundwater resources. By following best practices and addressing potential issues promptly, property owners can maximize the lifespan of their septic systems and avoid costly repairs or replacements.

Regular septic tank pumping plays a crucial role in extending the lifespan of a drain field by preventing excess solids from entering the system. Proper maintenance of the septic tank ensures that only septic tank effluent flows into the drain field, reducing the risk of clogging and promoting efficient filtration. The quality of soil surrounding the drain field also impacts its longevity, as certain soil types better support the natural processes of anaerobic digestion and filtration.

Environmental factors, such as excessive rainfall or drought, can affect the drain field’s performance and lifespan. Homeowners should monitor their lawns for signs of potential issues, such as unusually green grass over the drain field area, which may indicate a leak or system overload. Additionally, the household’s water usage patterns and the types of substances introduced into the septic system can significantly influence the drain field’s longevity and effectiveness.

Homeowners can extend the life of their drain fields by implementing strategies to prevent contamination and minimize stress on the decentralized wastewater system. Proper landscaping plays a crucial role in maintaining drain field health, as it helps manage surface runoff and prevents erosion. Avoid planting trees or large shrubs near the drain field, as their roots can damage pipes and disrupt soil composition.

Regular soil testing can help identify potential issues, such as excessive clay content, which may impede proper drainage and filtration. Addressing soil composition problems early can prevent long-term damage to the drain field and ensure optimal performance of the septic system. Additionally, redirecting downspouts and other sources of excess water away from the drain field area can help maintain proper soil moisture levels and prevent system overload.

Drain fields don’t last forever, and problems can arise unexpectedly. Let’s explore common issues that can plague these vital components of septic systems.

Common Drain Field Problems

Septic drain fields play a crucial role in treating wastewater, but they can encounter various problems that affect their efficiency and longevity. From excessive rainfall to improper disposal of vegetable waste, numerous factors can contribute to drain field issues. Recognizing early signs of failure, such as soggy areas in the yard or the formation of small ponds, is essential for preventing more severe damage. This section explores common drain field problems and provides practical solutions for overcoming malfunctions, ensuring homeowners can maintain a healthy and functional septic system.

Homeowners should remain vigilant for signs of drain field failure to prevent water pollution and maintain a functional septic system. Unusual odors, particularly near the drain field area, may indicate sewage sludge accumulation or improper treatment. Wet, spongy areas in the yard, especially during dry periods, suggest potential leaks or system overload.

Slow-draining fixtures and gurgling sounds in pipes often signal drain field issues, requiring prompt maintenance. The presence of algae blooms in nearby wetlands or water bodies can indicate nutrient leaching from a failing system. Homeowners should avoid using the drain field area for irrigation to prevent further stress on the system and potential contamination.

Addressing drain field malfunctions requires a multi-faceted approach to prevent disease transmission and protect water supply sources. Implementing a constructed wetland system can provide additional treatment capacity, reducing the load on the existing drain field and improving overall wastewater purification. This natural solution mimics the filtration processes of natural wetlands, effectively removing contaminants from human waste before it reaches groundwater resources.

Regular maintenance of the septic system, including inspection of the distribution box and lateral lines, ensures proper effluent flow and prevents overloading. Homeowners should consider installing water-saving fixtures and repairing leaky faucets to reduce the volume of wastewater entering the system. In cases of severe malfunction, installing an aerobic treatment unit can act as a secondary “engine” to enhance wastewater treatment before it reaches the drain field, potentially reviving a failing system.

Homeowners can take proactive steps to prevent these common drain field issues. Protecting your drain field not only extends its lifespan but also safeguards your property and the environment.

What Are Some Ways to Protect Your Drain Fields?

Protecting septic drain fields requires a comprehensive approach that considers soil microbiology, gravity-fed systems, and potential backup issues. Proper landscaping practices and regular maintenance are essential for preserving the integrity of concrete structures and preventing cement-related problems.

By understanding the delicate balance between natural processes and engineered systems, homeowners can implement effective strategies to safeguard their drain fields. This section explores best practices for landscaping around drain fields and provides crucial do’s and don’ts for maintaining these vital components of septic systems.

Proper landscaping around drain fields helps prevent erosion and maintains the system’s functionality. Homeowners should avoid planting trees or deep-rooted plants near the drain field, as roots can damage pipes and disrupt soil composition. Instead, shallow-rooted grasses and native plants provide effective ground cover without compromising the septic system’s integrity. For more on maintaining septic system health, including drain fields, explore septic system drainfield repair services.

Regular inspections of the drain field area ensure early detection of potential issues, such as soggy spots or unusual plant growth. Homeowners should refrain from installing metal structures, garden features, or javascript-controlled irrigation systems over the drain field to prevent soil compaction and maintain proper drainage. By following these guidelines, property owners can protect their drain fields while maintaining an attractive landscape.

Do’s and Don’ts for Drain Field Maintenance

Proper drain field maintenance preserves the system’s infiltration capacity and prevents contamination. Homeowners should avoid activities that compact soil, such as parking vehicles or constructing structures over the drain field area. Regular inspections help identify potential issues early, allowing for timely repairs and preventing costly failures. Planting perennial grasses over the drain field promotes healthy soil structure and aids in water absorption.

Homeowners must refrain from activities that could harm the drain field’s delicate ecosystem. Avoid disposing of petroleum products, chemicals, or animal waste in the septic system, as these substances can disrupt bacterial activity and contaminate groundwater. Similarly, mining or excavation near the drain field area can damage pipes and alter soil composition, compromising the system’s effectiveness. By following these guidelines, property owners can ensure their drain fields function optimally for years to come.

Despite best efforts, drain fields can still fail over time. Learn how to address this critical issue and restore your septic system’s functionality with tips from this blog on the importance of septic system drainfield leach field repair .

BioMicrobics serves a variety of industries and is known as a premier residential wastewater treatment system company , and a commercial wastewater treatment system company for multi-family housing — not to mention small municipal settings. Our multi-family wastewater treatment system company is a global leader in sophisticated systems.

Our creative ideas are made to address the problems of wastewater management in various environments. The company’s advanced methods guarantee successful and efficient outcomes for everything from high-strength wastewater treatments to septic system drainfield leach field repairs . The business’s prestigious products, such as Aerobic Treatment ATU Units, are the result of years of experience in actual operations.

Additionally, BioMicrobics offers customized wastewater treatment solutions to niche markets like wineries. The staff at our winery wastewater treatment company is dedicated to creating robust infrastructures for on-site wastewater treatment. This is demonstrative of the FITT®-for-purpose philosophy. Of course, this is necessary to keep both communities and the environment healthy. BioMicrobics is well-positioned to bring together international projects and partners to offer a client-focused service thanks to its developing global distributor network.

For more information about our company, contact us here or call (800) 753-3278 .

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