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Types of Speech Impediments

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Phynart Studio / Getty Images

Articulation Errors

Ankyloglossia, treating speech disorders.

A speech impediment, also known as a speech disorder , is a condition that can affect a person’s ability to form sounds and words, making their speech difficult to understand.

Speech disorders generally become evident in early childhood, as children start speaking and learning language. While many children initially have trouble with certain sounds and words, most are able to speak easily by the time they are five years old. However, some speech disorders persist. Approximately 5% of children aged three to 17 in the United States experience speech disorders.

There are many different types of speech impediments, including:

• Articulation errors

This article explores the causes, symptoms, and treatment of the different types of speech disorders.

Speech impediments that break the flow of speech are known as disfluencies. Stuttering is the most common form of disfluency, however there are other types as well.

Symptoms and Characteristics of Disfluencies

These are some of the characteristics of disfluencies:

• Repeating certain phrases, words, or sounds after the age of 4 (For example: “O…orange,” “I like…like orange juice,” “I want…I want orange juice”)
• Adding in extra sounds or words into sentences (For example: “We…uh…went to buy…um…orange juice”)
• Elongating words (For example: Saying “orange joooose” instead of "orange juice")
• Replacing words (For example: “What…Where is the orange juice?”)
• Hesitating while speaking (For example: A long pause while thinking)
• Pausing mid-speech (For example: Stopping abruptly mid-speech, due to lack of airflow, causing no sounds to come out, leading to a tense pause)

In addition, someone with disfluencies may also experience the following symptoms while speaking:

• Vocal tension and strain
• Head jerking
• Eye blinking
• Lip trembling

Causes of Disfluencies

People with disfluencies tend to have neurological differences in areas of the brain that control language processing and coordinate speech, which may be caused by:

• Genetic factors
• Trauma or infection to the brain
• Environmental stressors that cause anxiety or emotional distress
• Neurodevelopmental conditions like attention-deficit hyperactivity disorder (ADHD)

Articulation disorders occur when a person has trouble placing their tongue in the correct position to form certain speech sounds. Lisping is the most common type of articulation disorder.

Symptoms and Characteristics of Articulation Errors

These are some of the characteristics of articulation disorders:

• Substituting one sound for another . People typically have trouble with ‘r’ and ‘l’ sounds. (For example: Being unable to say “rabbit” and saying “wabbit” instead)
• Lisping , which refers specifically to difficulty with ‘s’ and ‘z’ sounds. (For example: Saying “thugar” instead of “sugar” or producing a whistling sound while trying to pronounce these letters)
• Omitting sounds (For example: Saying “coo” instead of “school”)
• Adding sounds (For example: Saying “pinanio” instead of “piano”)
• Making other speech errors that can make it difficult to decipher what the person is saying. For instance, only family members may be able to understand what they’re trying to say.

Causes of Articulation Errors

Articulation errors may be caused by:

• Genetic factors, as it can run in families
• Hearing loss , as mishearing sounds can affect the person’s ability to reproduce the sound
• Changes in the bones or muscles that are needed for speech, including a cleft palate (a hole in the roof of the mouth) and tooth problems
• Damage to the nerves or parts of the brain that coordinate speech, caused by conditions such as cerebral palsy , for instance

Ankyloglossia, also known as tongue-tie, is a condition where the person’s tongue is attached to the bottom of their mouth. This can restrict the tongue’s movement and make it hard for the person to move their tongue.

Symptoms and Characteristics of Ankyloglossia

Ankyloglossia is characterized by difficulty pronouncing ‘d,’ ‘n,’ ‘s,’ ‘t,’ ‘th,’ and ‘z’ sounds that require the person’s tongue to touch the roof of their mouth or their upper teeth, as their tongue may not be able to reach there.

Apart from speech impediments, people with ankyloglossia may also experience other symptoms as a result of their tongue-tie. These symptoms include:

• Difficulty breastfeeding in newborns
• Trouble swallowing
• Limited ability to move the tongue from side to side or stick it out
• Difficulty with activities like playing wind instruments, licking ice cream, or kissing
• Mouth breathing

Causes of Ankyloglossia

Ankyloglossia is a congenital condition, which means it is present from birth. A tissue known as the lingual frenulum attaches the tongue to the base of the mouth. People with ankyloglossia have a shorter lingual frenulum, or it is attached further along their tongue than most people’s.

Dysarthria is a condition where people slur their words because they cannot control the muscles that are required for speech, due to brain, nerve, or organ damage.

Symptoms and Characteristics of Dysarthria

Dysarthria is characterized by:

• Slurred, choppy, or robotic speech
• Rapid, slow, or soft speech
• Breathy, hoarse, or nasal voice

Additionally, someone with dysarthria may also have other symptoms such as difficulty swallowing and inability to move their tongue, lips, or jaw easily.

Causes of Dysarthria

Dysarthria is caused by paralysis or weakness of the speech muscles. The causes of the weakness can vary depending on the type of dysarthria the person has:

• Central dysarthria is caused by brain damage. It may be the result of neuromuscular diseases, such as cerebral palsy, Huntington’s disease, multiple sclerosis, muscular dystrophy, Huntington’s disease, Parkinson’s disease, or Lou Gehrig’s disease. Central dysarthria may also be caused by injuries or illnesses that damage the brain, such as dementia, stroke, brain tumor, or traumatic brain injury .
• Peripheral dysarthria is caused by damage to the organs involved in speech. It may be caused by congenital structural problems, trauma to the mouth or face, or surgery to the tongue, mouth, head, neck, or voice box.

Apraxia, also known as dyspraxia, verbal apraxia, or apraxia of speech, is a neurological condition that can cause a person to have trouble moving the muscles they need to create sounds or words. The person’s brain knows what they want to say, but is unable to plan and sequence the words accordingly.

Symptoms and Characteristics of Apraxia

These are some of the characteristics of apraxia:

• Distorting sounds: The person may have trouble pronouncing certain sounds, particularly vowels, because they may be unable to move their tongue or jaw in the manner required to produce the right sound. Longer or more complex words may be especially harder to manage.
• Being inconsistent in their speech: For instance, the person may be able to pronounce a word correctly once, but may not be able to repeat it. Or, they may pronounce it correctly today and differently on another day.
• Grasping for words: The person may appear to be searching for the right word or sound, or attempt the pronunciation several times before getting it right.
• Making errors with the rhythm or tone of speech: The person may struggle with using tone and inflection to communicate meaning. For instance, they may not stress any of the words in a sentence, have trouble going from one syllable in a word to another, or pause at an inappropriate part of a sentence.

Causes of Apraxia

Apraxia occurs when nerve pathways in the brain are interrupted, which can make it difficult for the brain to send messages to the organs involved in speaking. The causes of these neurological disturbances can vary depending on the type of apraxia the person has:

• Childhood apraxia of speech (CAS): This condition is present from birth and is often hereditary. A person may be more likely to have it if a biological relative has a learning disability or communication disorder.
• Acquired apraxia of speech (AOS): This condition can occur in adults, due to brain damage as a result of a tumor, head injury , stroke, or other illness that affects the parts of the brain involved in speech.

If you have a speech impediment, or suspect your child might have one, it can be helpful to visit your healthcare provider. Your primary care physician can refer you to a speech-language pathologist, who can evaluate speech, diagnose speech disorders, and recommend treatment options.

The diagnostic process may involve a physical examination as well as psychological, neurological, or hearing tests, in order to confirm the diagnosis and rule out other causes.

Treatment for speech disorders often involves speech therapy, which can help you learn how to move your muscles and position your tongue correctly in order to create specific sounds. It can be quite effective in improving your speech.

Children often grow out of milder speech disorders; however, special education and speech therapy can help with more serious ones.

For ankyloglossia, or tongue-tie, a minor surgery known as a frenectomy can help detach the tongue from the bottom of the mouth.

A Word From Verywell

A speech impediment can make it difficult to pronounce certain sounds, speak clearly, or communicate fluently. 

Living with a speech disorder can be frustrating because people may cut you off while you’re speaking, try to finish your sentences, or treat you differently. It can be helpful to talk to your healthcare providers about how to cope with these situations.

You may also benefit from joining a support group, where you can connect with others living with speech disorders.

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Nemours Foundation. Speech problems .

Penn Medicine. Speech and language disorders .

Cleveland Clinic. Tongue-tie .

University of Rochester Medical Center. Ankyloglossia .

Cleveland Clinic. Dysarthria .

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

Cleveland Clinic. Childhood apraxia of speech .

Stanford Children’s Hospital. Speech sound disorders in children .

Abbastabar H, Alizadeh A, Darparesh M, Mohseni S, Roozbeh N. Spatial distribution and the prevalence of speech disorders in the provinces of Iran . J Med Life . 2015;8(Spec Iss 2):99-104.

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

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

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

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

Common symptoms of a speech impediment

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

Elongating words

Quiet or muffled speech

Blinking frequently

Distorted sounds while talking

Frequent changes in pitch

Poor voice quality

Visible frustration when trying to communicate

Overall difficulty communicating and expressing thoughts and ideas

Inability to repeat words

Inability to pronounce words the same way twice

A phobia of speaking in public

Speaking slowly and carefully

Speech delay

Frequent pauses when talking

Limited vocabulary over several years, delayed language development

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

Key categories of speech impediments

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

Voice disorders

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

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

Fluency disorders

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

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

Articulation disorders and phonological disorders

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

Speech impediments versus language impairments

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

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

Examples of speech impediments

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

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

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

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

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

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

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

Dysarthria 

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

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

The importance of treatment

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

Poor academic performance/dropping out of school

Decrease in quality of life

Social anxiety and an inability to connect with people

Damaged relationships

Social isolation

Hospitalization

Seeking professional support

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

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

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

Counselor reviews

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

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

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

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

What are the 3 speech impediments?

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

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

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

What do you call a speech impediment?

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

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

How do I know if I have a speech impediment?

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

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

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

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

What are 5 causes of speech impairment?

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

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

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

Is speech impediment a disability?

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

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

Can I fix my speech impediment?

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

Can you treat a speech impediment?

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

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

Is a speech impediment mental?

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

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

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

Is autism a speech impediment?

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

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

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

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Home / Blog

Speech Impediment Guide: Definition, Causes, and Resources

December 8, 2020 

Tables of Contents

What Is a Speech Impediment?

Types of speech disorders, speech impediment causes, how to fix a speech impediment, making a difference in speech disorders.

Communication is a cornerstone of human relationships. When an individual struggles to verbalize information, thoughts, and feelings, it can cause major barriers in personal, learning, and business interactions.

Speech impediments, or speech disorders, can lead to feelings of insecurity and frustration. They can also cause worry for family members and friends who don’t know how to help their loved ones express themselves.

Fortunately, there are a number of ways that speech disorders can be treated, and in many cases, cured. Health professionals in fields including speech-language pathology and audiology can work with patients to overcome communication disorders, and individuals and families can learn techniques to help.

Commonly referred to as a speech disorder, a speech impediment is a condition that impacts an individual’s ability to speak fluently, correctly, or with clear resonance or tone. Individuals with speech disorders have problems creating understandable sounds or forming words, leading to communication difficulties.

Some 7.7% of U.S. children — or 1 in 12 youths between the ages of 3 and 17 — have speech, voice, language, or swallowing disorders, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). About 70 million people worldwide, including some 3 million Americans, experience stuttering difficulties, according to the Stuttering Foundation.

Common signs of a speech disorder

There are several symptoms and indicators that can point to a speech disorder.

• Unintelligible speech — A speech disorder may be present when others have difficulty understanding a person’s verbalizations.
• Omitted sounds — This symptom can include the omission of part of a word, such as saying “bo” instead of “boat,” and may include omission of consonants or syllables.
• Added sounds — This can involve adding extra sounds in a word, such as “buhlack” instead of “black,” or repeating sounds like “b-b-b-ball.”
• Substituted sounds — When sounds are substituted or distorted, such as saying “wabbit” instead of “rabbit,” it may indicate a speech disorder.
• Use of gestures — When individuals use gestures to communicate instead of words, a speech impediment may be the cause.
• Inappropriate pitch — This symptom is characterized by speaking with a strange pitch or volume.

In children, signs might also include a lack of babbling or making limited sounds. Symptoms may also include the incorrect use of specific sounds in words, according to the American Speech-Language-Hearing Association (ASHA). This may include the sounds p, m, b, w, and h among children aged 1-2, and k, f, g, d, n, and t for children aged 2-3.

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Categories of Speech Impediments

Speech impediments can range from speech sound disorders (articulation and phonological disorders) to voice disorders. Speech sound disorders may be organic — resulting from a motor or sensory cause — or may be functional with no known cause. Voice disorders deal with physical problems that limit speech. The main categories of speech impediments include the following:

Fluency disorders occur when a patient has trouble with speech timing or rhythms. This can lead to hesitations, repetitions, or prolonged sounds. Fluency disorders include stuttering (repetition of sounds) or   (rapid or irregular rate of speech).

Resonance disorders are related to voice quality that is impacted by the shape of the nose, throat, and/or mouth. Examples of resonance disorders include hyponasality and cul-de-sac resonance.

Articulation disorders occur when a patient has difficulty producing speech sounds. These disorders may stem from physical or anatomical limitations such as muscular, neuromuscular, or skeletal support. Examples of articulation speech impairments include sound omissions, substitutions, and distortions.

Phonological disorders result in the misuse of certain speech sounds to form words. Conditions include fronting, stopping, and the omission of final consonants.

Voice disorders are the result of problems in the larynx that harm the quality or use of an individual’s voice. This can impact pitch, resonance, and loudness.

Impact of Speech Disorders

Some speech disorders have little impact on socialization and daily activities, but other conditions can make some tasks difficult for individuals. Following are a few of the impacts of speech impediments.

• Poor communication — Children may be unable to participate in certain learning activities, such as answering questions or reading out loud, due to communication difficulties. Adults may avoid work or social activities such as giving speeches or attending parties.
• Mental health and confidence — Speech disorders may cause children or adults to feel different from peers, leading to a lack of self-confidence and, potentially, self-isolation.

Resources on Speech Disorders

The following resources may help those who are seeking more information about speech impediments.

Health Information : Information and statistics on common voice and speech disorders from the NIDCD

Speech Disorders : Information on childhood speech disorders from Cincinnati Children’s Hospital Medical Center

Speech, Language, and Swallowing : Resources about speech and language development from the ASHA

Children and adults can suffer from a variety of speech impairments that may have mild to severe impacts on their ability to communicate. The following 10 conditions are examples of specific types of speech disorders and voice disorders.

1. Stuttering

This condition is one of the most common speech disorders. Stuttering is the repetition of syllables or words, interruptions in speech, or prolonged use of a sound.

This organic speech disorder is a result of damage to the neural pathways that connect the brain to speech-producing muscles. This results in a person knowing what they want to say, but being unable to speak the words.

This consists of the lost ability to speak, understand, or write languages. It is common in stroke, brain tumor, or traumatic brain injury patients.

4. Dysarthria

This condition is an organic speech sound disorder that involves difficulty expressing certain noises. This may involve slurring, or poor pronunciation, and rhythm differences related to nerve or brain disorders.

The condition of lisping is the replacing of sounds in words, including “th” for “s.” Lisping is a functional speech impediment.

6. Hyponasality

This condition is a resonance disorder related to limited sound coming through the nose, causing a “stopped up” quality to speech.

7. Cul-de-sac resonance

This speech disorder is the result of blockage in the mouth, throat, or nose that results in quiet or muffled speech.

8. Orofacial myofunctional disorders

These conditions involve abnormal patterns of mouth and face movement. Conditions include tongue thrusting (fronting), where individuals push out their tongue while eating or talking.

9. Spasmodic Dysphonia

This condition is a voice disorder in which spasms in the vocal cords produce speech that is hoarse, strained, or jittery.

10. Other voice disorders

These conditions can include having a voice that sounds breathy, hoarse, or scratchy. Some disorders deal with vocal folds closing when they should open (paradoxical vocal fold movement) or the presence of polyps or nodules in the vocal folds.

Speech Disorders vs. Language Disorders

Speech disorders deal with difficulty in creating sounds due to articulation, fluency, phonology, and voice problems. These problems are typically related to physical, motor, sensory, neurological, or mental health issues.

Language disorders, on the other hand, occur when individuals have difficulty communicating the meaning of what they want to express. Common in children, these disorders may result in low vocabulary and difficulty saying complex sentences. Such a disorder may reflect difficulty in comprehending school lessons or adopting new words, or it may be related to a learning disability such as dyslexia. Language disorders can also involve receptive language difficulties, where individuals have trouble understanding the messages that others are trying to convey.  

Resources on Types of Speech Disorders

The following resources may provide additional information on the types of speech impediments.

Common Speech Disorders: A guide to the most common speech impediments from GreatSpeech

Speech impairment in adults: Descriptions of common adult speech issues from MedlinePlus

Stuttering Facts: Information on stuttering indications and causes from the Stuttering Foundation

Speech disorders may be caused by a variety of factors related to physical features, neurological ailments, or mental health conditions. In children, they may be related to developmental issues or unknown causes and may go away naturally over time.

Physical and neurological issues. Speech impediment causes related to physical characteristics may include:

• Brain damage
• Nervous system damage
• Respiratory system damage
• Hearing difficulties
• Cancerous or noncancerous growths
• Muscle and bone problems such as dental issues or cleft palate

Mental health issues. Some speech disorders are related to clinical conditions such as:

• Autism spectrum disorder
• Down syndrome or other genetic syndromes
• Cerebral palsy or other neurological disorders
• Multiple sclerosis

Some speech impairments may also have to do with family history, such as when parents or siblings have experienced language or speech difficulties. Other causes may include premature birth, pregnancy complications, or delivery difficulties. Voice overuse and chronic coughs can also cause speech issues.

The most common way that speech disorders are treated involves seeking professional help. If patients and families feel that symptoms warrant therapy, health professionals can help determine how to fix a speech impediment. Early treatment is best to curb speech disorders, but impairments can also be treated later in life.

Professionals in the speech therapy field include speech-language pathologists (SLPs) . These practitioners assess, diagnose, and treat communication disorders including speech, language, social, cognitive, and swallowing disorders in both adults and children. They may have an SLP assistant to help with diagnostic and therapy activities.

Speech-language pathologists may also share a practice with audiologists and audiology assistants. Audiologists help identify and treat hearing, balance, and other auditory disorders.

How Are Speech Disorders Diagnosed?

Typically, a pediatrician, social worker, teacher, or other concerned party will recognize the symptoms of a speech disorder in children. These individuals, who frequently deal with speech and language conditions and are more familiar with symptoms, will recommend that parents have their child evaluated. Adults who struggle with speech problems may seek direct guidance from a physician or speech evaluation specialist.

When evaluating a patient for a potential speech impediment, a physician will:

• Conduct hearing and vision tests
• Evaluate patient records
• Observe patient symptoms

A speech-language pathologist will conduct an initial screening that might include:

• An evaluation of speech sounds in words and sentences
• An evaluation of oral motor function
• An orofacial examination
• An assessment of language comprehension

The initial screening might result in no action if speech symptoms are determined to be developmentally appropriate. If a disorder is suspected, the initial screening might result in a referral for a comprehensive speech sound assessment, comprehensive language assessment, audiology evaluation, or other medical services.

Initial assessments and more in-depth screenings might occur in a private speech therapy practice, rehabilitation center, school, childcare program, or early intervention center. For older adults, skilled nursing centers and nursing homes may assess patients for speech, hearing, and language disorders.

How Are Speech Impediments Treated?

Once an evaluation determines precisely what type of speech sound disorder is present, patients can begin treatment. Speech-language pathologists use a combination of therapy, exercise, and assistive devices to treat speech disorders.

Speech therapy might focus on motor production (articulation) or linguistic (phonological or language-based) elements of speech, according to ASHA. There are various types of speech therapy available to patients.

Contextual Utilization  — This therapeutic approach teaches methods for producing sounds consistently in different syllable-based contexts, such as phonemic or phonetic contexts. These methods are helpful for patients who produce sounds inconsistently.

Phonological Contrast — This approach focuses on improving speech through emphasis of phonemic contrasts that serve to differentiate words. Examples might include minimal opposition words (pot vs. spot) or maximal oppositions (mall vs. call). These therapy methods can help patients who use phonological error patterns.

Distinctive Feature — In this category of therapy, SLPs focus on elements that are missing in speech, such as articulation or nasality. This helps patients who substitute sounds by teaching them to distinguish target sounds from substituted sounds.

Core Vocabulary — This therapeutic approach involves practicing whole words that are commonly used in a specific patient’s communications. It is effective for patients with inconsistent sound production.

Metaphon — In this type of therapy, patients are taught to identify phonological language structures. The technique focuses on contrasting sound elements, such as loud vs. quiet, and helps patients with unintelligible speech issues.

Oral-Motor — This approach uses non-speech exercises to supplement sound therapies. This helps patients gain oral-motor strength and control to improve articulation.

Other methods professionals may use to help fix speech impediments include relaxation, breathing, muscle strengthening, and voice exercises. They may also recommend assistive devices, which may include:

• Radio transmission systems
• Personal amplifiers
• Picture boards
• Touch screens
• Text displays
• Speech-generating devices
• Hearing aids
• Cochlear implants

Resources for Professionals on How to Fix a Speech Impediment

The following resources provide information for speech therapists and other health professionals.

Assistive Devices: Information on hearing and speech aids from the NIDCD

Information for Audiologists: Publications, news, and practice aids for audiologists from ASHA

Information for Speech-Language Pathologists: Publications, news, and practice aids for SLPs from ASHA

Speech Disorder Tips for Families

For parents who are concerned that their child might have a speech disorder — or who want to prevent the development of a disorder — there are a number of activities that can help. The following are tasks that parents can engage in on a regular basis to develop literacy and speech skills.

• Introducing new vocabulary words
• Reading picture and story books with various sounds and patterns
• Talking to children about objects and events
• Answering children’s questions during routine activities
• Encouraging drawing and scribbling
• Pointing to words while reading books
• Pointing out words and sentences in objects and signs

Parents can take the following steps to make sure that potential speech impediments are identified early on.

• Discussing concerns with physicians
• Asking for hearing, vision, and speech screenings from doctors
• Requesting special education assessments from school officials
• Requesting a referral to a speech-language pathologist, audiologist, or other specialist

When a child is engaged in speech therapy, speech-language pathologists will typically establish collaborative relationships with families, sharing information and encouraging parents to participate in therapy decisions and practices.

SLPs will work with patients and their families to set goals for therapy outcomes. In addition to therapy sessions, they may develop activities and exercises for families to work on at home. It is important that caregivers are encouraging and patient with children during therapy.  

Resources for Parents on How to Fix a Speech Impediment

The following resources provide additional information on treatment options for speech disorders.

Speech, Language, and Swallowing Disorders Groups: Listing of self-help groups from ASHA

ProFind: Search tool for finding certified SLPs and audiologists from ASHA

Baby’s Hearing and Communication Development Checklist: Listing of milestones that children should meet by certain ages from the NIDCD

If identified during childhood, speech disorders can be corrected efficiently, giving children greater communication opportunities. If left untreated, speech impediments can cause a variety of problems in adulthood, and may be more difficult to diagnose and treat.

Parents, teachers, doctors, speech and language professionals, and other concerned parties all have unique responsibilities in recognizing and treating speech disorders. Through professional therapy, family engagement, positive encouragement and a strong support network, individuals with speech impediments can overcome their challenges and develop essential communication skills.

Additional Sources

American Speech-Language-Hearing Association, Speech Sound Disorders

Identify the Signs, Signs of Speech and Language Disorders

Intermountain Healthcare, Phonological Disorders

MedlinePlus, Speech disorders – children

National Institutes of Health, National Institutes on Deafness and Other Communication Disorders, “Quick Statistics About Voice, Speech, Language”

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What Is Apraxia of Speech?

A Challenging Language Disorder

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

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

Illustration by Zoe Hansen for Verywell Health

Apraxia of Speech Symptoms 

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

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

Features of apraxia of speech include the following:

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

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

Apraxia vs. Other Speech and Language Disorders

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

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

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

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

Conditions associated with apraxia of speech include:

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

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

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

Speech patterns noted in apraxia of speech include the following:

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

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

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

Diagnostic testing may include:

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

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

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

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

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

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

Research About Prognosis and Treatment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By Heidi Moawad, MD Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.  

Monica Marzinske, CCC-SLP

Speech-language therapy.

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Speaking clearly: Help for people with speech and language disorders

• Speech-Language

Speaking and language abilities vary from person to person. Some people can quickly articulate exactly what they are thinking or feeling, while others struggle being understood or finding the right words.

These struggles could be due to a speech or language disorder if communication struggles cause ongoing communication challenges and frustrations. Speech and language disorders are common.

It's estimated that 5% to 10% of people in the U.S. have a communication disorder. By the first grade, about 5% of U.S. children have a noticeable speech disorder. About 3 million U.S. adults struggle with stuttering and about 1 million U.S. adults have aphasia. These conditions make reading, speaking, writing and comprehending difficult.

People with speech and language disorders can find hope in rehabilitation. Speech-language pathologists can evaluate and treat these disorders. This can lead to a happier, healthier and more expressive life.

Types of speech and language disorders

Speech and language disorders come in many forms, each with its own characteristics:.

• Aphasia People with aphasia have difficulty with reading, writing, speaking or understanding information they've heard. The intelligence of a person with aphasia is not affected.
• Dysarthria People with dysarthria demonstrate slurred or imprecise speech patterns that can affect the understanding of speech.
• Apraxia A person with this disorder has difficulty coordinating lip and tongue movements to produce understandable speech.
• Dysphagia This condition refers to swallowing difficulties, including food sticking in the throat, coughing or choking while eating or drinking, and other difficulties.
• Stuttering This speech disorder involves frequent and significant problems with normal fluency and flow of speech. People who stutter know what they want to say but have difficulty saying it.
• Articulation disorder People with this disorder have trouble learning how to make specific sounds. They may substitute sounds, such as saying "fum" instead of "thumb".
• Phonological disorder Phonological processes are patterns of errors children use to simplify language as they learn to speak. A phonological disorder may be present if these errors persist beyond the age when most other children stop using them. An example is saying "duh" instead of "duck."
• Voice Voice disorders include vocal cord paralysis, vocal abuse and vocal nodules, which could result in vocal hoarseness, changes in vocal volume and vocal fatigue.
• Cognitive communication impairment People with cognitive communication impairment have difficulty with concentration, memory, problem-solving, and completion of tasks for daily and medical needs.

Speech and language disorders are more common in children. It can take time to develop the ability to speak and communicate clearly. Some children struggle with finding the right word or getting their jaws, lips or tongues in the correct positions to make the right sounds.

In adults, speech and language disorders often are the result of a medical condition or injury. The most common of these conditions or injuries are a stroke, brain tumor, brain injury, cancer, Parkinson's disease, multiple sclerosis, Lou Gehrig's disease or other underlying health complications.

Treatment options

Speech and language disorders can be concerning, but speech-language pathologists can work with patients to evaluate and treat these conditions. Each treatment plan is specifically tailored to the patient.

Treatment plans can address difficulties with:

• Speech sounds, fluency or voice
• Understanding language
• Sharing thoughts, ideas and feelings
• Organizing thoughts, paying attention, remembering, planning or problem-solving
• Feeding and swallowing
• Vocabulary or improper grammar use

Treatment typically includes training to compensate for deficiencies; patient and family education; at-home exercises; or neurological rehabilitation to address impairments due to medical conditions, illnesses or injury.

Treatment options are extensive and not limited by age. Children and adults can experience the benefits of treatment.

If you or a loved one are struggling with speech and language issues, you are not alone. Millions of people experience similar daily challenges. Better yet, help is available.

Monica Marzinske is a speech-language pathologist  in New Prague , Minnesota.

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Speech Impairment: Symptoms, Causes, and When to See Your Doctor

Speech impairment in adults is a symptom that causes difficulty in speaking or pronouncing words. This can be a temporary condition, or it can be a symptom of a severe medical condition. This guide will show you what to look for and when to see a doctor.

9 minute read

Last Updated September 20, 2021

Speech impairment in adults is any symptom that causes difficulty in speaking or pronouncing words. Speech impairments can include slurred, rapid, stuttered, hoarse, or slowed speech, and they can be caused by any number of factors. 

Some cases of impaired speech may be temporary, while others are caused by an underlying medical condition. When speech impairment is sudden, then it is a symptom of a serious problem , such as a heart attack or stroke, and requires immediate medical attention.

Symptoms of Speech impairment

Along with an inability to clearly communicate verbally, you can also experience other symptoms with speech impairment. 

♦ Weakened facial muscles ♦ Difficulty remembering words ♦ Deficits with expressive language ♦ Drooling ♦ Sudden contraction of vocal muscles

Causes of Speech Impairment

The different types of speech impairment have different causes, and you can develop speech impairment suddenly or gradually. 

♦ Aphasia: This is when you have difficulty thinking of words or pronouncing them, and the potential causes of this type include head trauma, brain tumors, and degenerative diseases such as Alzheimer’s disease. 

♦ Dysarthria: This is when you have trouble moving your lips, tongue, vocal folds, or diaphragm. This typically results from degenerative muscle conditions such as multiple sclerosis as well as stroke, head trauma, Bell’s palsy, Lyme disease, and excessive alcohol consumption.

♦ Vocal disorders: This affects your ability to speak and is caused by injuries to the area, throat cancer, polyps or nodules on the vocal cords, and consumption of drugs like antidepressants. 

♦ Spasmodic dysphonia: This involves involuntary movements of the vocal cords. The exact cause is unknown, but this impairment is linked to abnormal brain functioning. 

Diseases Associated with Speech Impairment

There can be temporary causes of speech impairment, but in most cases, there is an underlying condition impacting the speech region of the brain. Sudden speech impairment can be a sign of a serious medical condition that requires immediate medical attention.

♦  Stroke : Speech impairment and disorders are common after a stroke, but they can also be signs of an impending stroke. Slurred speech, along with facial muscle changes, can indicate a stroke and should not be ignored.

♦ Cardiovascular disease : Heart disease can cause structural changes in the brain as a result of reduced blood flow. Cognitive abilities and communication can be impacted as a result.

♦ Multiple sclerosis : This condition causes lesions that damaged parts of the brain, which can impair speech patterns.

♦ Infections : Viral and bacterial infections that reach the brain can cause damage to the areas that process language, causing temporary speech impairment. 

♦ Huntington’s Disease : This disease mostly affects movement, but the majority of patients with Huntington’s also report speech difficulties.

♦ Alzheimer’s disease : Speech impairment can develop as a result of plaques in the brain that are associated with Alzheimer’s disease. 

♦ Parkinson’s : Difficulty speaking and swallowing is common with Parkinson’s disease and gets worse as the disease progresses. 

♦ Cholesterol : High cholesterol can lead to the formation of plaques in the arteries, and without treatment, these increase your risk for stroke, which can cause speech impairment.

♦ Cancer : A tumor in your brain located near the speech center will cause speech impairments as well as changes in memory, seizures, and severe headaches.

♦ Head trauma : Injury, internal bleeding, or bruising to the brain, as a result of head trauma can impact speech. Depending on the severity and location of the trauma, speech impairment may be temporary or permanent.

Diagnosis of Speech Impairment

When speech impairment appears suddenly, seek immediate medical attention . When it develops more gradually, you need to see your doctor for testing, in case there is an underlying condition as the cause. 

You may experience speech impairment after using your voice too much or after an infection, but prolonged impairment requires attention and testing for diagnosis. Your doctor will start with a physical examination and discuss your medical history and symptoms. They will also talk with you to evaluate your speech during a discussion and to determine your level of comprehension and speaking ability. 

In addition to this, testing can be done to attempt to identify possible underlying causes. The most common tests include:

♦ Blood tests ♦ Electrical current tests ♦ MRI, CT, and x-Ray scans ♦ Urine tests

It may also be necessary for you to follow up with specialists such as a neurologist, speech pathologist, or otolaryngologist for more detailed testing and analysis.

Treatment for Speech impairment

The treatment will depend on the cause and severity of your speech impairment. In all cases of speech impairment, the underlying cause needs to be treated in order to restore speech. 

Exercises can be done to help strengthen vocal cords and improve articulation. You can also use assistive communication devices. Only in certain situations will surgery or any other invasive procedure be required. If the cause of your speech impairment is a stroke or heart disease, medications are prescribed as well as surgery. Your doctor will also recommend a heart-healthy lifestyle to follow.

In addition to any medical treatment plan given to you by your doctor, there are things you can try to help protect your voice, and prevent or limit the severity of a speech impairment. 

♦ Always wear protective headgear to prevent brain injuries. ♦ Quit or avoid smoking and second-hand smoke to reduce the risk of throat cancer. ♦ Limit consumption of alcohol. ♦ Get regular exercise to reduce the risk of stroke. ♦ Follow a balanced diet to protect against hypertension and high cholesterol.

Natural Treatment for Speech Impairment

Most of the causes of speech impairment will require medical treatment. However, there are certain conditions related to heart health that you can prevent naturally. Stroke and atherosclerosis are both related to high cholesterol and clogged arteries. 

By incorporating specific natural ingredients into your diet, you can promote overall heart health by reducing cholesterol levels. This will reduce your risk of heart-related conditions that can cause speech impairment. The top ingredients to try include:

♦ Berberine bark extract both lowers cholesterol and fights inflammation to protect against heart disease.  ♦ Chromium benefits the heart by reducing the risk of high cholesterol and arterial clogs . This significantly reduces the risk of stroke. ♦ Lion’s mane mushroom improves the good-to-bad ratio of cholesterol in your blood to protect against stroke. ♦ Niacin works to lower cholesterol and blood lipid levels to reduce the risk of heart attack and stroke. Studies have found that it works more effectively than cholesterol-lowering statins.  ♦ Pine bark extract helps lower bad cholesterol, which prevents clogged arteries and reduces the risk of stroke. This extract also reduces inflammation that can cause platelets to clump together, forming dangerous clots known to increase stroke risk.

When to See Your Doctor

The gradual development of speech impairment can be caused by a number of conditions or factors that can be effectively treated once identified. 

If you notice the sudden onset of any speech impairment, you need to seek immediate medical attention, as this is a common sign of a stroke. Without treatment, a stroke can cause permanent damage to your heart and brain and even death. 

While speech impairment may develop from a relatively harmless condition, the risk of stroke cannot be ignored, so be sure to seek help if impairment appears suddenly.

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Speech Impediment: Definition, Causes, Types and Treatment

02 may speech impediment: definition, causes, types and treatment.

One of life’s joys as a parent is watching your kids grow and change. You see them learn new things, meet new friends, and explore the world around them. But sometimes, you also witness them struggle – like when they have their first fight with a friend or don’t do as well as they wanted to on a test. And while it’s never easy to see your child suffer, one of the hardest things to watch is when your child has difficulty communicating. If your child has a speech impediment, you know that feeling all too well. It can be frustrating and heartbreaking to see your little one struggling to be understood. But take heart – you’re not alone. Many children have difficulties with speech, and with the right pediatric speech therapist in Chicago , your child can learn to overcome their impediment. This blog post will define a speech impediment, discuss some of the most common types and causes, and provide information on treatment options.

What is a speech impediment?

A speech impediment is a condition that affects a person’s ability to produce sound correctly. The term can refer to any difficulties that impede a person’s speech, from mild sound errors to severe problems with articulation. All individuals with speech impediments have difficulty producing certain sounds, depending on one sound. Some people may only have trouble with one sound, while others may have difficulty producing multiple sounds.

What causes speech impediments?

Some people are born with speech impediments, while others develop them later in life. There are many different causes of speech impediment, as you will see below.

1. Congenital defects Congenital defects are abnormalities that are present at birth. They can affect any part of the body, including the mouth and vocal cords. In some cases, congenital defects can cause problems with the tongue moving or the formation of teeth. Many different types of congenital defects can cause a speech impediment, including : Cleft lip and palate is a condition where there is an opening in the lip and/or roof of the mouth. This opening can cause problems with the way the mouth forms words, as well as with eating and drinking. Cleft lip and palate can also cause hearing problems. Vocal cord paralysis is a condition where the vocal cords are unable to move correctly. This can make it difficult to produce sound, as well as to breathe properly. Tongue-tie is a condition where the tongue is tethered to the floor of the mouth. This can make it difficult to move the tongue and can cause problems with eating, drinking, and speaking.

2. Neurological disorders Neurological disorders are conditions that affect the nervous system. These disorders can cause problems with the way the brain sends signals to the muscles, which can lead to difficulties with movement and speech. Some of the more common neurological disorders include: Cerebral palsy is a condition that affects movement and muscle coordination. It is caused by damage to the brain, usually before or during birth. Cerebral palsy can cause problems with the way a person walks, talks, and eats. Multiple sclerosis is a disease of the nervous system that causes the immune system to attack the nerves. This can lead to problems with muscle control and vision, hearing, and speech.

3. Hearing loss Hearing loss can be caused by many different things, including exposure to loud noise, certain medications, and aging. Hearing loss can make it difficult to understand what other people are saying, which can lead to problems with speech. There are many different types of hearing loss, and the severity can vary from person to person. Some people with hearing loss may only have trouble hearing certain sounds, while others may not be able to hear anything at all. Hearing loss can be temporary or permanent. Temporary hearing loss can be caused by things like earwax buildup or infection. Permanent hearing loss can be caused by things like damage to the inner ear or a genetic disorder.

4. Language disorders Language disorders are conditions that affect a person’s ability to understand or use language. These disorders can make it difficult to produce or comprehend speech. Some of the more common language disorders include dyslexia and aphasia.

5. Emotional disorders Emotional disorders are conditions that affect a person’s emotions or mood. These disorders can cause problems with speech due to anxiety or stress. Some of the more common emotional disorders include anxiety disorders and depression. lip

Types of speech disorder

There are many different types of speech disorders, and the symptoms can vary from person to person. Some of the more common types of speech disorders include:

1. Articulation disorder An articulation disorder is a problem with the way the mouth, teeth, or tongue move to make sounds. This can make it difficult to produce certain sounds correctly. People with articulation disorders may have trouble saying certain words correctly, or they may leave out parts of words when they speak.

2. Fluency disorder A fluency disorder is a problem with the flow of speech. People with fluency disorders may have trouble putting their thoughts into words, and they may stutter when they speak. Stuttering is a type of fluency disorder that is characterized by pauses, repetitions, or prolongations of sounds.

3. Resonance disorder A resonance disorder is a problem with the way sound resonates in the mouth and throat. This can make it difficult to produce certain sounds correctly. People with resonance disorders may have trouble producing vowel sounds, or they may speak with a nasal tone.

4. Voice disorder A voice disorder is a problem with the way the voice sounds. This can be caused by things like vocal cord damage or misuse of the voice. People with voice disorders may have trouble speaking loudly or speaking in a hoarse or breathy voice.

Treatment of speech impediments

There are many different treatments for speech disorders, and the best treatment will depend on the individual and the cause of the disorder. Some of the more common treatments include:

1. Speech therapy Speech therapy is a type of treatment that helps people with speech disorders improve their abilities. Speech therapists can help people with articulation disorders learn to produce sounds correctly, people with fluency disorders reduce their stuttering, and people with resonance disorders improve their vowel production.

2. Surgery Surgery can be used to correct some anatomical defects that cause speech disorders. For example, surgery can be used to correct cleft lip and palate, vocal cord paralysis, and tongue tie.

3. Medication Medication can be used to treat some neurological disorders that cause speech disorders. For example, medication can be used to treat conditions like cerebral palsy and multiple sclerosis.

4. Hearing aids Hearing aids can be used to treat hearing loss that causes speech disorders. Hearing aids amplify sound so that people with hearing loss can better understand what other people are saying.

5. Communication devices Communication devices can be used to help people with language disorders or severe speech disorders communicate. These devices can include things like picture boards and computer software that helps people generate speech.

6. Counseling Counseling can be used to treat emotional disorders that cause speech disorders. Counseling can help people manage their anxiety and stress and learn coping mechanisms to deal with their disorders.

7. Alternative treatments There are many different alternative treatments for speech disorders. Some of these treatments include acupuncture, aromatherapy, and massage therapy. It is important to speak with a doctor before starting any alternative treatment.

Speech disorders can cause a variety of problems for people, ranging from difficulty understanding what other people are saying to difficulty producing speech. There are many different causes of speech disorders, and the best treatment will depend on the individual and the cause of the disorder. Visit https://functionalspeechtherapy.com/ to learn more about pediatric speech disorders and treatment options.

Functional Speech Therapy Co., 960 Route 22, Unit 216 Fox River Grove Illinois 60021, (224) 219-1924

Find us on Social Media https://www.facebook.com/FUNctionalSpeechClinic/ https://www.youtube.com/channel/UCJyXslNcwUw-ABZ5myhERTQ https://www.instagram.com/functional\_speechtherapy

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Speech and Language Impairments

The Individuals with Disabilities Education Act, or IDEA, defines the term “speech or language impairment” as follows:

“(11)  Speech or language impairment  means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.” [34 CFR §300.8(c)(11]

(Parent Information and Resources Center, 2015)

Table of Contents

What is a Speech and Language Impairment?

Characteristics of speech or language impairments, interventions and strategies, related service provider-slp.

• A Day in the Life of an SLP

Assistive Technology

Speech and language impairment  are basic categories that might be drawn in issues of communication involve hearing, speech, language, and fluency.

A speech impairment is characterized by difficulty in articulation of words. Examples include stuttering or problems producing particular sounds. Articulation refers to the sounds, syllables, and phonology produced by the individual. Voice, however, may refer to the characteristics of the sounds produced—specifically, the pitch, quality, and intensity of the sound. Often, fluency will also be considered a category under speech, encompassing the characteristics of rhythm, rate, and emphasis of the sound produced.

A language impairment is a specific impairment in understanding and sharing thoughts and ideas, i.e. a disorder that involves the processing of linguistic information. Problems that may be experienced can involve the form of language, including grammar, morphology, syntax; and the functional aspects of language, including semantics and pragmatics.

(Wikipedia, n.d./ Speech and Language Impairment)

*It’s important to realize that a language delay isn’t the same thing as a speech or language impairment. Language delay is a very common developmental problem—in fact, the most common, affecting 5-10% of children in preschool.  With language delay, children’s language is developing in the expected sequence, only at a slower rate. In contrast, speech and language disorder refers to abnormal language development.  Distinguishing between the two is most reliably done by a certified speech-language pathologist.  (CPIR, 2015)

The characteristics of speech or language impairments will vary depending upon the type of impairment involved. There may also be a combination of several problems.

When a child has an  articulation disorder , he or she has difficulty making certain sounds. These sounds may be left off, added, changed, or distorted, which makes it hard for people to understand the child.

Leaving out or changing certain sounds is common when young children are learning to talk, of course. A good example of this is saying “wabbit” for “rabbit.” The incorrect articulation isn’t necessarily a cause for concern unless it continues past the age where children are expected to produce such sounds correctly

Fluency  refers to the flow of speech. A fluency disorder means that something is disrupting the rhythmic and forward flow of speech—usually, a stutter. As a result, the child’s speech contains an “abnormal number of repetitions, hesitations, prolongations, or disturbances. Tension may also be seen in the face, neck, shoulders, or fists.”

Voice  is the sound that’s produced when air from the lungs pushes through the voice box in the throat (also called the larnyx), making the vocal folds within vibrate. From there, the sound generated travels up through the spaces of the throat, nose, and mouth, and emerges as our “voice.”

A voice disorder involves problems with the pitch, loudness, resonance, or quality of the voice. The voice may be hoarse, raspy, or harsh. For some, it may sound quite nasal; others might seem as if they are “stuffed up.” People with voice problems often notice changes in pitch, loss of voice, loss of endurance, and sometimes a sharp or dull pain associated with voice use.

Language  has to do with meanings, rather than sounds.  A language disorder refers to an impaired ability to understand and/or use words in context. A child may have an expressive language disorder (difficulty in expressing ideas or needs), a receptive language disorder (difficulty in understanding what others are saying), or a mixed language disorder (which involves both).

Some characteristics of language disorders include:

• improper use of words and their meanings,
• inability to express ideas,
• inappropriate grammatical patterns,
• reduced vocabulary, and
• inability to follow directions.

Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate. These symptoms can easily be mistaken for other disabilities such as autism or learning disabilities, so it’s very important to ensure that the child receives a thorough evaluation by a certified speech-language pathologist.

(CPIR, 2015)

• Use the (Cash, Wilson, and DeLaCruz, n.d) reading and/or the [ESU 8 Wednesday Webinar] to develop this section of the summary. 

Cash, A, Wilson, R. and De LaCruz, E.(n,d.) Practical Recommendations for Teachers: Language Disorders. https://www.education.udel.edu/wp-content/uploads/2013/01/LanguageDisorders.pdf 

[ESU 8 Wednesday Webinar] Speech Language Strategies for Classroom Teachers.- video below

Video: Speech Language Strategies for Classroom Teachers (15:51 minutes)’

[ESU 8 Wednesday Webinars]. (2015, Nov. 19) . Speech Language Strategies for Classroom Teachers. [Video FIle]. From https://youtu.be/Un2eeM7DVK8

Most, if not all, students with a speech or language impairment will need  speech-language pathology services . This related service is defined by IDEA as follows:

(15)  Speech-language pathology services  include—

(i) Identification of children with speech or language impairments;

(ii) Diagnosis and appraisal of specific speech or language impairments;

(iii) Referral for medical or other professional attention necessary for the habilitation of speech or language impairments;

(iv) Provision of speech and language services for the habilitation or prevention of communicative impairments; and

(v) Counseling and guidance of parents, children, and teachers regarding speech and language impairments. [34 CFR §300.34(c)(15)]

Thus, in addition to diagnosing the nature of a child’s speech-language difficulties, speech-language pathologists also provide:

• individual therapy for the child;
• consult with the child’s teacher about the most effective ways to facilitate the child’s communication in the class setting; and
• work closely with the family to develop goals and techniques for effective therapy in class and at home.

Speech and/or language therapy may continue throughout a student’s school years either in the form of direct therapy or on a consultant basis.

A Day in the Life of an SLP

Christina is a speech-language pathologist.  She works with children and adults who have impairments in their speech, voice, or language skills. These impairments can take many forms, as her schedule today shows.

First comes Robbie.  He’s a cutie pie in the first grade and has recently been diagnosed with childhood apraxia of speech—or CAS. CAS is a speech disorder marked by choppy speech. Robbie also talks in a monotone, making odd pauses as he tries to form words. Sometimes she can see him struggle. It’s not that the muscles of his tongue, lips, and jaw are weak. The difficulty lies in the brain and how it communicates to the muscles involved in producing speech. The muscles need to move in precise ways for speech to be intelligible. And that’s what she and Robbie are working on.

Next, Christina goes down the hall and meets with Pearl  in her third grade classroom. While the other students are reading in small groups, she works with Pearl one on one, using the same storybook. Pearl has a speech disorder, too, but hers is called dysarthria. It causes Pearl’s speech to be slurred, very soft, breathy, and slow. Here, the cause is weak muscles of the tongue, lips, palate, and jaw. So that’s what Christina and Pearl work on—strengthening the muscles used to form sounds, words, and sentences, and improving Pearl’s articulation.

One more student to see—4th grader Mario , who has a stutter. She’s helping Mario learn to slow down his speech and control his breathing as he talks. Christina already sees improvement in his fluency.

Tomorrow she’ll go to a different school, and meet with different students. But for today, her day is…Robbie, Pearl, and Mario.

Assistive technology (AT) can also be very helpful to students, especially those whose physical conditions make communication difficult. Each student’s IEP team will need to consider if the student would benefit from AT such as an electronic communication system or other device. AT is often the key that helps students engage in the give and take of shared thought, complete school work, and demonstrate their learning. (CPIR, 2015)

Project IDEAL , suggests two major categories of AT computer software packages to develop the child’s speech and language skills and augmentative or alternative communication (AAC).

Augmentative and alternative communication  ( AAC ) encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. Augmentative and alternative communication may used by individuals to compensate for severe speech-language impairments in the expression or comprehension of spoken or written language. AAC can be a permanent addition to a person’s communication or a temporary aid.

(Wikipedia, (n.d. /Augmentative and alternative communication)

Center for Parent Information and Resources (CPIR)  (2015), Speech and Language Impairments, Newark, NJ, Author, Retrieved 4.1.19 from https://www.parentcenterhub.org/speechlanguage/

Wikipedia (n.d.) Augmentative and alternative communication. From https://en.wikipedia.org/wiki/Augmentative_and_alternative_communication 

Wikipedia, (n.d.) Speech and Language Impairment. From  https://en.wikipedia.org/wiki/Speech_and_language_impairment 

Updated 8.8.23

Understanding and Supporting Learners with Disabilities Copyright © 2019 by Paula Lombardi is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

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Parent's Academy › Speech Disorders › Speech Impediments › 6 Types of Speech Impediments

6 Types of Speech Impediments

Stacie bennett.

Speech-Language Pathologist , Trenton , New Jersey

Jan 28, 2022 ‘Speech and language impediment’ is a very broad term that refers to a communication disorder in an individual that has depressed social, language, communication, hearing, or fluency skills.

In This Article

Speech therapy exercises with speech blubs, apraxia of speech, speech sound disorder, specific language impairment, language-based learning disabilities, key takeaways about speech impediments.

A speech impediment relates to the way an individual produces or articulates specific sounds. One example of this is stuttering. Under the umbrella of a speech impairment lies several different types of disorders with which a child or adult can be diagnosed.

A language impairment involves understanding and sharing thoughts and ideas. For example, this person may not have adequate or “age-appropriate” vocabulary and grammar skills. Again, there are several different language disorders that fall under this category that will be addressed in this blog.

Speech Blubs  is a language therapy app with a vast library of more than 1,500 activities, face filters, voice-activated activities, and educational bonus videos. 

The more you practice, the more it carries over! Try the Speech Blubs app for fun and engaging therapy sessions with your little one.

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3 Types of Speech Disorders

Apraxia of speech is a neurogenic (starts in the nervous system) communication disorder that involves the planning system for speech.

Individuals with Apraxia know what they want to say, but there is a disconnect in the part of the brain that tells a specific muscle to move. When someone is diagnosed with  apraxia of speech , they may have signs of groping, which is where the mouth searches for the position to create the sound.

When this occurs, it affects how long or short the sounds are, and could lead to odd pitch or volume issues and to sounds being distorted or substituted. A tell-tale sign of someone who has apraxia is that they lose the ability to produce sounds that they previously could say.

For instance, if you ask a child to say the word “dog,” which they do successfully and then ask them to say the same word again 10 minutes later, they will not be able to do it. 

Speech sound disorders may be of two varieties: articulation (the production of sounds) or phonological processes (sound patterns).

An articulation disorder  may take the form of substitution, omission, addition, or distortion of normal speech sounds.

Phonological process disorders  may involve more systematic difficulties with the production of particular types of sounds, such as those made in the back of the mouth, like “k” and “g” (ASHA 2018).

Educating a child on the appropriate ways to produce a speech sound and encouraging the child to practice this articulation over time may produce natural speech.

For additional reading on articulation and phonological disorders, check these blogs:

• What Are Phonological Processes
• Process of Articulation Therapy

Stuttering  is a disruption in the fluency of an individual’s speech, which begins in childhood and may persist over a lifetime.

Stuttering is a form of disfluency (an inability to produce fluent speech). Disfluency becomes a problem because it impedes successful communication between two parties. Disfluencies may be due to unwanted repetitions of sounds (e.g., “I-I-I want ice cream”), or the extension of speech sounds (e.g., “S——tart the wash”), syllables (e.g., “Na-na-na nasty”), or words (e.g., “go-go-go to the store”). Disfluencies also incorporate unintentional pauses in speech, in which the individual is unable to produce speech sounds (ASHA 2016).

Unfortunately, the cause of stuttering is unknown, which makes it more difficult to treat. Treatment can vary from person to person depending on the severity and type of stuttering that is occurring. 

Read more on  how to distinguish stuttering as a part of typical speech development from stuttering as a speech disorder!

3 Types of Language Disorders

Specific Learning Impairment (SLI) is diagnosed when a child’s language is not developing as rapidly or as typically as other children. In order for a child to be diagnosed with SLI, they cannot have Autism Spectrum Disorder, Apraxia, hearing loss, or an abnormality of the speech mechanisms. If those disorders are present, they do not have SLI and are exhibiting speech patterns typical of those diagnoses. Usually, the first indication of SLI is that the child is later than usual in starting to speak and subsequently is delayed in putting words together to form sentences.  Spoken language  may be immature. In many children with SLI, understanding of  language , or  receptive  language, is also impaired, though this may not be obvious unless the child is given a formal assessment. This diagnosis is reserved for children whose language difficulties persist into school age, not for children who are speech delayed and eventually catch up to their peers. 

Aphasia  is an inability to comprehend or formulate language because of damage to specific brain regions.

The major causes are a cerebral vascular accident (stroke), or head trauma, but aphasia can also be the result of brain tumors, brain infections, or neurodegenerative diseases such as dementia (ASHA 2017).

The difficulties of people with aphasia can range from occasional trouble finding words, to losing the ability to speak, read, or write; intelligence, however, is unaffected. Any person of any age can develop aphasia, given that it is often caused by a traumatic injury. However, people who are middle-aged and older are the most likely to experience the problem. 

Language-based learning disabilities occur in children who are falling behind their same-aged peers. These children will have difficulties with spelling, reading, and/or writing, but have normal intelligence levels. This is a common source of academic struggles in young children and can often be misdiagnosed or missed in typical assessments.

The key to supporting students with LBLD is knowing how to adjust curriculum and instruction to ensure they develop  proficient language and literacy skills . Most individuals with LBLD need instruction that is specialized, explicit, structured, and multisensory, as well as ongoing, guided practice aimed at remediating their specific areas of weakness.

There are a lot of speech and language impediments that can occur in children and adults. This blog only scratches the surface of these disorders, so please stay tuned and check out Speech Blubs regularly for more in-depth blogs regarding these subjects.

If there’s a topic you’d like to know more about, please reach out to us and we will get working on it! As always, if you feel like your child is exhibiting any signs or symptoms of these disorders, it’s important that you make an appointment with a speech-language pathologist as soon as possible to get a full evaluation.

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The author’s views are entirely his or her own and may not necessarily reflect the views of Blub Blub Inc. All content provided on this website is for informational purposes only and is not intended to be a substitute for independent professional medical judgement, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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• Childhood apraxia of speech

Childhood apraxia of speech (CAS) is a rare speech disorder. Children with this disorder have trouble controlling their lips, jaws and tongues when speaking.

In CAS , the brain has trouble planning for speech movement. The brain isn't able to properly direct the movements needed for speech. The speech muscles aren't weak, but the muscles don't form words the right way.

To speak correctly, the brain has to make plans that tell the speech muscles how to move the lips, jaw and tongue. The movements usually result in accurate sounds and words spoken at the proper speed and rhythm. CAS affects this process.

CAS is often treated with speech therapy. During speech therapy, a speech-language pathologist teaches the child to practice the correct way to say words, syllables and phrases.

Children with childhood apraxia of speech (CAS) may have a variety of speech symptoms. Symptoms vary depending on a child's age and the severity of the speech problems.

CAS can result in:

• Babbling less or making fewer vocal sounds than is typical between the ages of 7 to 12 months.
• Speaking first words late, typically after ages 12 to 18 months old.
• Using a limited number of consonants and vowels.
• Often leaving out sounds when speaking.
• Using speech that is hard to understand.

These symptoms are usually noticed between ages 18 months and 2 years. Symptoms at this age may indicate suspected CAS . Suspected CAS means a child may potentially have this speech disorder. The child's speech development should be watched to determine if therapy should begin.

Children usually produce more speech between ages 2 and 4. Signs that may indicate CAS include:

• Vowel and consonant distortions.
• Pauses between syllables or words.
• Voicing errors, such as "pie" sounding like "bye."

Many children with CAS have trouble getting their jaws, lips and tongues to the correct positions to make a sound. They also may have a hard time moving smoothly to the next sound.

Many children with CAS also have language problems, such as reduced vocabulary or trouble with word order.

Some symptoms may be unique to children with CAS , which helps to make a diagnosis. However, some symptoms of CAS are also symptoms of other types of speech or language disorders. It's hard to diagnose CAS if a child has only symptoms that are found both in CAS and in other disorders.

Some characteristics, sometimes called markers, help distinguish CAS from other types of speech disorders. Those associated with CAS include:

• Trouble moving smoothly from one sound, syllable or word to another.
• Groping movements with the jaw, lips or tongue to try to make the correct movement for speech sounds.
• Vowel distortions, such as trying to use the correct vowel but saying it incorrectly.
• Using the wrong stress in a word, such as pronouncing "banana" as "BUH-nan-uh" instead of "buh-NAN-uh."
• Using equal emphasis on all syllables, such as saying "BUH-NAN-UH."
• Separation of syllables, such as putting a pause or gap between syllables.
• Inconsistency, such as making different errors when trying to say the same word a second time.
• Having a hard time imitating simple words.
• Voicing errors, such as saying "down" instead of "town."

Other speech disorders sometimes confused with CAS

Some speech sound disorders often get confused with CAS because some of the symptoms may overlap. These speech sound disorders include articulation disorders, phonological disorders and dysarthria.

A child with an articulation or phonological disorder has trouble learning how to make and use specific sounds. Unlike in CAS , the child doesn't have trouble planning or coordinating the movements to speak. Articulation and phonological disorders are more common than CAS .

Articulation or phonological speech errors may include:

• Substituting sounds. The child might say "fum" instead of "thumb," "wabbit" instead of "rabbit" or "tup" instead of "cup."
• Leaving out final consonants. A child with CAS might say "duh" instead of "duck" or "uh" instead of "up."
• Stopping the airstream. The child might say "tun" instead of "sun" or "doo" instead of "zoo."
• Simplifying sound combinations. The child might say "ting" instead of "string" or "fog" instead of "frog."

Dysarthria is a speech disorder that occurs because the speech muscles are weak. Making speech sounds is hard because the speech muscles can't move as far, as quickly or as strongly as they do during typical speech. People with dysarthria may also have a hoarse, soft or even strained voice. Or they may have slurred or slow speech.

Dysarthria is often easier to identify than CAS . However, when dysarthria is caused by damage to areas of the brain that affect coordination, it can be hard to determine the differences between CAS and dysarthria.

Childhood apraxia of speech (CAS) has a number of possible causes. But often a cause can't be determined. There usually isn't an observable problem in the brain of a child with CAS .

However, CAS can be the result of brain conditions or injury. These may include a stroke, infections or traumatic brain injury.

CAS also may occur as a symptom of a genetic disorder, syndrome or metabolic condition.

CAS is sometimes referred to as developmental apraxia. But children with CAS don't make typical developmental sound errors and they don't grow out of CAS . This is unlike children with delayed speech or developmental disorders who typically follow patterns in speech and sounds development but at a slower pace than usual.

Risk factors

Changes in the FOXP2 gene appear to increase the risk of childhood apraxia of speech (CAS) and other speech and language disorders. The FOXP2 gene may be involved in how certain nerves and pathways in the brain develop. Researchers continue to study how changes in the FOXP2 gene may affect motor coordination and speech and language processing in the brain. Other genes also may impact motor speech development.

Complications

Many children with childhood apraxia of speech (CAS) have other problems that affect their ability to communicate. These problems aren't due to CAS , but they may be seen along with CAS .

Symptoms or problems that are often present along with CAS include:

• Delayed language. This may include trouble understanding speech, reduced vocabulary, or not using correct grammar when putting words together in a phrase or sentence.
• Delays in intellectual and motor development and problems with reading, spelling and writing.
• Trouble with gross and fine motor movement skills or coordination.
• Trouble using communication in social interactions.

Diagnosing and treating childhood apraxia of speech at an early stage may reduce the risk of long-term persistence of the problem. If your child experiences speech problems, have a speech-language pathologist evaluate your child as soon as you notice any speech problems.

Childhood apraxia of speech care at Mayo Clinic

• Jankovic J, et al., eds. Dysarthria and apraxia of speech. In: Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed April 6, 2023.
• Carter J, et al. Etiology of speech and language disorders in children. https://www.uptodate.com/contents/search. Accessed April 6, 2023.
• Childhood apraxia of speech. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/childhood-apraxia-of-speech/. Accessed April 6, 2023.
• Apraxia of speech. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/pages/apraxia.aspx. Accessed April 6, 2023.
• Ng WL, et al. Predicting treatment of outcomes in rapid syllable transition treatment: An individual participant data meta-analysis. Journal of Speech, Language and Hearing Research. 2022; doi:10.1044/2022_JSLHR-21-00617.
• Speech sound disorders. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/disorders/SpeechSoundDisorders/. Accessed April 6, 2023.
• Iuzzini-Seigel J. Prologue to the forum: Care of the whole child — Key considerations when working with children with childhood apraxia of speech. Language, Speech and Hearing Services in Schools. 2022; doi:10.1044/2022_LSHSS-22-00119.
• Namasivayam AK, et al. Speech sound disorders in children: An articulatory phonology perspective. 2020; doi:10.3389/fpsyg.2019.02998.
• Strand EA. Dynamic temporal and tactile cueing: A treatment strategy for childhood apraxia of speech. American Journal of Speech-Language Pathology. 2020; doi:10.1044/2019_AJSLP-19-0005.
• Ami TR. Allscripts EPSi. Mayo Clinic. March 13, 2023.
• Kliegman RM, et al. Language development and communication disorders. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed April 6, 2023.
• Adam MP, et al., eds. FOXP2-related speech and language disorder. In: GeneReviews. University of Washington, Seattle; 1993-2023. https://www.ncbi.nlm.nih.gov/books/NBK1116. Accessed April 6, 2023.
• How is CAS diagnosed? Childhood Apraxia of Speech Association of North America. https://www.apraxia-kids.org/apraxia_kids_library/how-is-cas-diagnosed/. Accessed April 13, 2023.
• Chenausky KV, et al. The importance of deep speech phenotyping for neurodevelopmental and genetic disorders: A conceptual review. Journal of Neurodevelopmental Disorders. 2022; doi:10.1186/s11689-022-09443-z.
• Strand EA. Dynamic temporal and tactile cueing: A treatment strategy for childhood apraxia of speech. American Journal of Speech Language Pathology. 2020; doi:10.1044/2019_AJSLP-19-0005.
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10 Most Common Speech-Language Disorders & Impediments

As you get to know more about the field of speech-language pathology you’ll increasingly realize why SLPs are required to earn at least a master’s degree . This stuff is serious – and there’s nothing easy about it.

In 2016 the National Institute on Deafness and Other Communication Disorders reported that 7.7% of American children have been diagnosed with a speech or swallowing disorder. That comes out to nearly one in 12 children, and gets even bigger if you factor in adults.

Whether rooted in psycho-speech behavioral issues, muscular disorders, or brain damage, nearly all the diagnoses SLPs make fall within just 10 common categories…

Types of Speech Disorders & Impediments

Apraxia of speech (aos).

Apraxia of Speech (AOS) happens when the neural pathway between the brain and a person’s speech function (speech muscles) is lost or obscured. The person knows what they want to say – they can even write what they want to say on paper – however the brain is unable to send the correct messages so that speech muscles can articulate what they want to say, even though the speech muscles themselves work just fine. Many SLPs specialize in the treatment of Apraxia .

There are different levels of severity of AOS, ranging from mostly functional, to speech that is incoherent. And right now we know for certain it can be caused by brain damage, such as in an adult who has a stroke. This is called Acquired AOS.

However the scientific and medical community has been unable to detect brain damage – or even differences – in children who are born with this disorder, making the causes of Childhood AOS somewhat of a mystery. There is often a correlation present, with close family members suffering from learning or communication disorders, suggesting there may be a genetic link.

Mild cases might be harder to diagnose, especially in children where multiple unknown speech disorders may be present. Symptoms of mild forms of AOS are shared by a range of different speech disorders, and include mispronunciation of words and irregularities in tone, rhythm, or emphasis (prosody).

Stuttering – Stammering

Stuttering, also referred to as stammering, is so common that everyone knows what it sounds like and can easily recognize it. Everyone has probably had moments of stuttering at least once in their life. The National Institute on Deafness and Other Communication Disorders estimates that three million Americans stutter, and reports that of the up-to-10-percent of children who do stutter, three-quarters of them will outgrow it. It should not be confused with cluttering.

Most people don’t know that stuttering can also include non-verbal involuntary or semi-voluntary actions like blinking or abdominal tensing (tics). Speech language pathologists are trained to look for all the symptoms of stuttering , especially the non-verbal ones, and that is why an SLP is qualified to make a stuttering diagnosis.

The earliest this fluency disorder can become apparent is when a child is learning to talk. It may also surface later during childhood. Rarely if ever has it developed in adults, although many adults have kept a stutter from childhood.

Stuttering only becomes a problem when it has an impact on daily activities, or when it causes concern to parents or the child suffering from it. In some people, a stutter is triggered by certain events like talking on the phone. When people start to avoid specific activities so as not to trigger their stutter, this is a sure sign that the stutter has reached the level of a speech disorder.

The causes of stuttering are mostly a mystery. There is a correlation with family history indicating a genetic link. Another theory is that a stutter is a form of involuntary or semi-voluntary tic. Most studies of stuttering agree there are many factors involved.

Dysarthria is a symptom of nerve or muscle damage. It manifests itself as slurred speech, slowed speech, limited tongue, jaw, or lip movement, abnormal rhythm and pitch when speaking, changes in voice quality, difficulty articulating, labored speech, and other related symptoms.

It is caused by muscle damage, or nerve damage to the muscles involved in the process of speaking such as the diaphragm, lips, tongue, and vocal chords.

Because it is a symptom of nerve and/or muscle damage it can be caused by a wide range of phenomena that affect people of all ages. This can start during development in the womb or shortly after birth as a result of conditions like muscular dystrophy and cerebral palsy. In adults some of the most common causes of dysarthria are stroke, tumors, and MS.

A lay term, lisping can be recognized by anyone and is very common.

Speech language pathologists provide an extra level of expertise when treating patients with lisping disorders . They can make sure that a lisp is not being confused with another type of disorder such as apraxia, aphasia, impaired development of expressive language, or a speech impediment caused by hearing loss.

SLPs are also important in distinguishing between the five different types of lisps. Most laypersons can usually pick out the most common type, the interdental/dentalised lisp. This is when a speaker makes a “th” sound when trying to make the “s” sound. It is caused by the tongue reaching past or touching the front teeth.

Because lisps are functional speech disorders, SLPs can play a huge role in correcting these with results often being a complete elimination of the lisp. Treatment is particularly effective when implemented early, although adults can also benefit.

Experts recommend professional SLP intervention if a child has reached the age of four and still has an interdental/dentalised lisp. SLP intervention is recommended as soon as possible for all other types of lisps. Treatment includes pronunciation and annunciation coaching, re-teaching how a sound or word is supposed to be pronounced, practice in front of a mirror, and speech-muscle strengthening that can be as simple as drinking out of a straw.

Spasmodic Dysphonia

Spasmodic Dysphonia (SD) is a chronic long-term disorder that affects the voice. It is characterized by a spasming of the vocal chords when a person attempts to speak and results in a voice that can be described as shaky, hoarse, groaning, tight, or jittery. It can cause the emphasis of speech to vary considerably. Many SLPs specialize in the treatment of Spasmodic Dysphonia .

SLPs will most often encounter this disorder in adults, with the first symptoms usually occurring between the ages of 30 and 50. It can be caused by a range of things mostly related to aging, such as nervous system changes and muscle tone disorders.

It’s difficult to isolate vocal chord spasms as being responsible for a shaky or trembly voice, so diagnosing SD is a team effort for SLPs that also involves an ear, nose, and throat doctor (otolaryngologist) and a neurologist.

Have you ever heard people talking about how they are smart but also nervous in large groups of people, and then self-diagnose themselves as having Asperger’s? You might have heard a similar lay diagnosis for cluttering. This is an indication of how common this disorder is as well as how crucial SLPs are in making a proper cluttering diagnosis .

A fluency disorder, cluttering is characterized by a person’s speech being too rapid, too jerky, or both. To qualify as cluttering, the person’s speech must also have excessive amounts of “well,” “um,” “like,” “hmm,” or “so,” (speech disfluencies), an excessive exclusion or collapsing of syllables, or abnormal syllable stresses or rhythms.

The first symptoms of this disorder appear in childhood. Like other fluency disorders, SLPs can have a huge impact on improving or eliminating cluttering. Intervention is most effective early on in life, however adults can also benefit from working with an SLP.

Muteness – Selective Mutism

There are different kinds of mutism, and here we are talking about selective mutism. This used to be called elective mutism to emphasize its difference from disorders that caused mutism through damage to, or irregularities in, the speech process.

Selective mutism is when a person does not speak in some or most situations, however that person is physically capable of speaking. It most often occurs in children, and is commonly exemplified by a child speaking at home but not at school.

Selective mutism is related to psychology. It appears in children who are very shy, who have an anxiety disorder, or who are going through a period of social withdrawal or isolation. These psychological factors have their own origins and should be dealt with through counseling or another type of psychological intervention.

Diagnosing selective mutism involves a team of professionals including SLPs, pediatricians, psychologists, and psychiatrists. SLPs play an important role in this process because there are speech language disorders that can have the same effect as selective muteness – stuttering, aphasia, apraxia of speech, or dysarthria – and it’s important to eliminate these as possibilities.

And just because selective mutism is primarily a psychological phenomenon, that doesn’t mean SLPs can’t do anything. Quite the contrary.

The National Institute on Neurological Disorders and Stroke estimates that one million Americans have some form of aphasia.

Aphasia is a communication disorder caused by damage to the brain’s language capabilities. Aphasia differs from apraxia of speech and dysarthria in that it solely pertains to the brain’s speech and language center.

As such anyone can suffer from aphasia because brain damage can be caused by a number of factors. However SLPs are most likely to encounter aphasia in adults, especially those who have had a stroke. Other common causes of aphasia are brain tumors, traumatic brain injuries, and degenerative brain diseases.

In addition to neurologists, speech language pathologists have an important role in diagnosing aphasia. As an SLP you’ll assess factors such as a person’s reading and writing, functional communication, auditory comprehension, and verbal expression.

Speech Delay – Alalia

A speech delay, known to professionals as alalia, refers to the phenomenon when a child is not making normal attempts to verbally communicate. There can be a number of factors causing this to happen, and that’s why it’s critical for a speech language pathologist to be involved.

The are many potential reasons why a child would not be using age-appropriate communication. These can range anywhere from the child being a “late bloomer” – the child just takes a bit longer than average to speak – to the child having brain damage. It is the role of an SLP to go through a process of elimination, evaluating each possibility that could cause a speech delay, until an explanation is found.

Approaching a child with a speech delay starts by distinguishing among the two main categories an SLP will evaluate: speech and language.

Speech has a lot to do with the organs of speech – the tongue, mouth, and vocal chords – as well as the muscles and nerves that connect them with the brain. Disorders like apraxia of speech and dysarthria are two examples that affect the nerve connections and organs of speech. Other examples in this category could include a cleft palette or even hearing loss.

The other major category SLPs will evaluate is language. This relates more to the brain and can be affected by brain damage or developmental disorders like autism. There are many different types of brain damage that each manifest themselves differently, as well as developmental disorders, and the SLP will make evaluations for everything.

Issues Related to Autism

While the autism spectrum itself isn’t a speech disorder, it makes this list because the two go hand-in-hand more often than not.

The Centers for Disease Control and Prevention (CDC) reports that one out of every 68 children in our country have an autism spectrum disorder. And by definition, all children who have autism also have social communication problems.

Speech-language pathologists are often a critical voice on a team of professionals – also including pediatricians, occupational therapists, neurologists, developmental specialists, and physical therapists – who make an autism spectrum diagnosis .

In fact, the American Speech-Language Hearing Association reports that problems with communication are the first detectable signs of autism. That is why language disorders – specifically disordered verbal and nonverbal communication – are one of the primary diagnostic criteria for autism.

So what kinds of SLP disorders are you likely to encounter with someone on the autism spectrum?

A big one is apraxia of speech. A study that came out of Penn State in 2015 found that 64 percent of children who were diagnosed with autism also had childhood apraxia of speech.

This basic primer on the most common speech disorders offers little more than an interesting glimpse into the kind of issues that SLPs work with patients to resolve. But even knowing everything there is to know about communication science and speech disorders doesn’t tell the whole story of what this profession is all about. With every client in every therapy session, the goal is always to have the folks that come to you for help leave with a little more confidence than when they walked in the door that day. As a trusted SLP, you will build on those gains with every session, helping clients experience the joy and freedom that comes with the ability to express themselves freely. At the end of the day, this is what being an SLP is all about.

Ready to make a difference in speech pathology? Learn how to become a Speech-Language Pathologist today

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• Emerson College - Master's in Speech-Language Pathology online - Prepare to become an SLP in as few as 20 months. No GRE required. Scholarships available.
• NYU Steinhardt - NYU Steinhardt's Master of Science in Communicative Sciences and Disorders online - ASHA-accredited. Bachelor's degree required. Graduate prepared to pursue licensure.
• Arizona State University - Online - Online Bachelor of Science in Speech and Hearing Science - Designed to prepare graduates to work in behavioral health settings or transition to graduate programs in speech-language pathology and audiology.

Biden’s stutter surges into the presidential campaign

Trump mocks and exaggerates the speech impediment. biden embraces it as reflecting compassion..

President Biden recently sent out a video of a meeting with a 9-year-old with a stutter, telling the young boy, “Don’t let anybody tell you that you can’t do anything.”

He wrote about having “struggled with a stutter all my life,” an unusual nod to the ongoing nature of his battle. And in interviews, he has spoken at length about the childhood trauma and embarrassment of struggling to speak.

Donald Trump has mocked Biden in recent weeks by falsely claiming that the president is stuttering during his speeches, and he has parodied the purported stammer on occasion, but Biden has been relying on a longtime centerpiece of his personal and political biography, embracing it to sell himself as the candidate of compassion for the 2024 presidential rematch.

The election may ultimately be decided by sweeping issues like the economy, immigration, abortion and democracy. But the early phase has also been marked by a discussion, in ways both crass and subtle, of a far more personal topic — Biden’s stutter. That back-and-forth reflects the candidates’ sharply differing views of disability and struggle, and their role in a divided political culture that can reward ridicule more than acceptance.

“We don’t even talk about what is ‘presidential’ anymore,” said Ted Kaufman, a longtime confidant and friend of Biden’s. “But if you look at Joe Biden’s reaction and you look at Trump’s reaction, one is presidential and one is not.”

He insisted that Trump’s attacks don’t get under Biden’s skin — “He’s been through worse things than that in his life” — and said the stutter highlights a core part of the president’s past and “an example of how he overcame things.”

Trump’s aides contend that he ridicules Biden’s competence, not his stutter. “President Trump has never mocked Joe Biden’s speech impediment,” said adviser Jason Miller. “He’s simply called out the fact Biden is a cognitively impaired, low-IQ individual.”

There is no evidence that Biden is cognitively impaired, and Miller declined to say how he squares his assertion with Trump, for example, telling a crowd after one Biden speech earlier this year: “Did you see him? He was stuttering through the whole thing.”

It was after the State of the Union on March 7, when Biden attacked Trump in fiery terms , that Trump most recently introduced Biden’s stutter into the campaign. At a rally in Georgia, Trump asked sarcastically if Biden would “bring the country t-t-t-together.” Biden never used that phrase in his speech, and in the seven instances he said the word “together,” he did not stutter.

Biden reacted by embracing the disability he battled to overcome as a child, one that he still works to subdue. In Wisconsin last week, Biden met with Harry Abramson, a 9-year-old boy who had written to Biden asking how he had defeated his stutter and adding that — if he could overcome his own — perhaps he, too, could one day become president.

“You can do whatever you want to do,” Biden told Harry, according to a video released by the campaign.

Afterward, Biden sent out a clip of the exchange from his personal X account, writing: “Harry, I’ve struggled with a stutter all of my life. Thank you for telling me about yours, and don’t let anyone tell you it will stop you from achieving your dreams.”

Biden’s use of the phrase “all of my life” reflects a new way of talking about his battle, said John Hendrickson, author of “Joe Biden’s Stutter, and Mine,” an in-depth article in the Atlantic. “This is a remarkable shift in language from Biden — by far the closest he’s ever come to saying ‘I still stutter,’” he tweeted.

Biden and his aides talk about the stutter in complex and even contradictory ways. Biden has often portrayed it as something he fully conquered as a child, a story of resilience and triumph. At other times, aides have highlighted the stammer to explain Biden’s verbal stumbles, framing them as a function of a disability rather than age.

In a December interview with Conan O’Brien, the comedian and podcast host observed that Biden’s struggle with stuttering must have helped “fuel” and “forge” him as a person. Biden responded, “Well, when I was a kid …,” prompting O’Brien to quickly add, “You’ve got this problem licked, by the way.”

Biden cast the childhood experience as central to his sympathy for those less fortunate.

“We were never allowed to make fun of anyone, no matter how mean they were to us, if they had something they couldn’t overcome. Swear to God,” Biden told O’Brien. “If you did, you’d get your rear end kicked when you went home. Not a joke. And so, it taught me that there’s a lot of people dealing with dilemmas that take away their pride, their dignity.”

Although Biden rarely focuses on his stutter as a current challenge, he often brings it up as a story of overcoming adversity.

He has spoken about it at fundraisers and campaign rallies. He brought it up when presenting the Presidential Medal of Freedom and when honoring the national teachers of the year. He mentioned it at an event in Virginia on health-care costs, at a eulogy in Delaware, at a commencement address at South Carolina State University. He cited it during a banquet in Dublin, a talk to U.S. military personnel in the United Kingdom, an event for the Toys for Tots drive.

“Probably the best thing that’s ever happened to me was one of the worst things,” Biden said on a podcast hosted by Anderson Cooper that explores grief. “When I was a kid, I stuttered badly — t-t-t-talk-talk like-like that — … and I used to hate the fact I stuttered.”

When he had a paper route, Biden has said, he would work out conversations in his head before he got to someone’s door to avoid tripping over his words. He would read poetry — the same Irish poets he would later quote as president — to sound out the words.

He recalled as a high school freshman being embarrassingly exempted from a public speaking assignment. “But I realized it was a great lesson I learned, because everybody has something they can’t fully control — everybody,” Biden told Cooper. “And so it turned out to be a great gift for me that I stuttered.”

To this day, he says that one of his favorite movies is “The King’s Speech,” which depicts the ascent to the throne of King George VI of Britain, who must overcome a speech impediment and address the country during World War II.

For Trump, however, the stutter has been one more way to go after Biden. The presumptive Republican nominee regularly embraces mockery and derision, whether the target is undocumented immigrants, GOP rivals or liberal Democrats.

Trump most often makes fun of Biden for purportedly struggling to find his way offstage after a speech, depicting the president as confused and aimless. But the stutter has also become a target.

Following a Biden speech in Pennsylvania in January, Trump spoke to a crowd in Sioux Center, Iowa. “Did you see him? He was stuttering through the whole thing,” Trump said to a chuckling crowd. “He’s saying I’m a threat to democracy.”

“'He’s a threat to d-d-democracy,’” he continued, pretending himself to stutter. “Couldn’t read the word.”

The remark was untrue. Biden said the word “democracy” 29 times in his speech, never stumbling over it.

Miller, the Trump adviser, downplayed the distinction between mocking Biden’s stutter and attacking his general competence.

“Joe Biden can’t put two sentences together,” Miller said. “It’s not President Trump’s responsibility to diagnose what’s wrong with Biden. He’s simply observing what every other American sees, that Joe Biden is a shell of his former self and unable to lead our country. This weakness has emboldened our adversaries and led to death and destruction at home and abroad.”

Experts say that someone who has conquered a stutter in his youth can see it reemerge as he ages. Biden himself can shift his emphasis, sometimes framing the stutter as a distant memory and other times as an ongoing battle.

For the most part, he places it far in his past. “I used to stutter when I was a little boy, until I was in high school,” Biden said in December 2022. On another occasion that same year, he said he largely vanquished his stutter when he took a speech and debate class in college, even if it still appears from time to time.

But occasionally, as during a CNN town hall in February 2020 , Biden talks of a never-ending struggle. “It’s a debilitating situation,” Biden said at that event. “And I still occasionally, when I find myself really tired, ca-ca-catch myself saying something like that.”

David Frank, a professor of rhetoric at the University of Oregon who has studied Biden’s speeches, said the president clearly uses techniques to work around his stutter, like staying away from certain words or phrases. “There are words that he avoids or substitutes for, and he avoids syllables that he knows will stumble over,” Frank said.

Frank said Biden should acknowledge his stutter more fully, saying it would help him connect to audiences. “He’s like a lot of us confronting our own demons,” Frank said. “If he admits he hasn’t conquered it, he is perceived to be weak. If he says he’s totally overcome it, he’s not being true to himself.”

Biden allies have often pointed to his willingness to speak openly about his struggle, even if it’s usually in the past tense, as a way to uplift the estimated 3 million Americans who stutter.

At an event in 2022, for example, he noticed someone in the crowd holding a sign that read, “Thank you for having a stutter.” In 2020, he encountered 13-year-old Brayden Harrington at a campaign stop, giving him advice for handling his speech impediment and later inviting him to speak at the Democratic National Convention . And last week, he met Harry Abramson, the 9-year-old in Wisconsin.

“If you think about it, the only handicap everybody thinks they can still laugh at is stuttering,” Biden said at a fundraiser in October.

As for Trump, Biden is not the first person whose disability he has made fun of. In 2015, as a presidential candidate , he derisively imitated New York Times reporter Serge Kovaleski, who has a congenital condition affecting joints known as arthrogryposis. Trump has denied knowing about Kovaleski’s condition.

As president, Trump resisted appearing alongside wounded veterans, as reported by Peter Baker and Susan Glasser in their book “The Divider,” and later confirmed by former White House chief of staff John F. Kelly. “I don’t want them,” Trump said. “It doesn’t look good for me.”

Trump has disputed Kelly’s account.

In a 2015 television interview, Trump responded to criticism from columnist Charles Krauthammer, who used a wheelchair, by calling him “a guy that can’t buy a pair of pants.”

“Trump thinks mocking people and taking away their rights makes him look strong,” said Biden campaign spokesman TJ Ducklo. “But it just reveals how weak, insecure and vulnerable he is having to face voters who want real leadership.”

Some of those close to Biden say it is significant that he not only overcame his stutter, but also entered a profession that demands endless public speaking.

“It’s like, how does a guy go from being a stutterer to a guy who makes a career out of speaking?” he added. “Who in history has given more speeches than Joe Biden?”

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Kyle Rittenhouse speech at University of Memphis sparks outrage

The 21-year-old gun rights activist, who was acquitted after fatally shooting two in Kenosha unrest, was met with student protests

Kyle Rittenhouse, a 21-year-old gun rights activist who was acquitted after shooting dead two people and injuring another during racial justice protests in 2020, sparked fierce outrage during a speech at the University of Memphis.

On Wednesday, Rittenhouse was met with widespread student protests as he spoke at a campus event organized by the university’s chapter of Turning Point USA, a conservative student organization.

Rittenhouse’s speech topics included the importance of the second amendment and “the lies of Black Lives Matter”, according to event details.

Pictures posted online showed students protesting Rittenhouse’s appearance with signs that said “Murderers don’t belong here!” and “Where’s the tears now, lil boy?” – an apparent reference to Rittenhouse’s emotional sobs during his murder trial in 2021.

In August 2020, Rittenhouse, who was 17 years old at the time, traveled from his home in Antioch, Illinois, armed with an AR-15-style rifle to aid a Kenosha-based militia that was calling for protection for businesses against protesters supporting the Black Lives Matter movement.

At the protests , Rittenhouse shot and killed 36-year-old Joseph Rosenbaum before shooting and killing 26-year-old Anthony Huber. Rittenhouse also wounded Gaige Grosskreutz, a 26-year-old protester and volunteer medic at the time who carried his own gun.

Following a widely watched and controversial trial in which he repeatedly claimed self-defense, Rittenhouse was acquitted in November 2021. His acquittal was largely regarded by critics as a revelation of the favorable treatment from law enforcement towards white self-styled militant vigilantes, in contrast to the treatment meted out to racial justice protestors.

The University of Memphis said it was legally obligated to allow Rittenhouse to speak despite the widespread protests.

“The upcoming event at the University of Memphis featuring Kyle Rittenhouse is not sponsored by the university. A registered student organization, University of Memphis TPUSA, is hosting the event. Under the first amendment and Tennessee’s Campus Free Speech Act, the University of Memphis cannot legally prohibit such events from being hosted by a registered student organization,” it said , the Commercial Appeal reported.

Speaking to WREG, one student said : “They’re portraying him like this icon for the gun people … We already have enough gun violence in Memphis itself, so having this guy come here and spread racist views and also talking about how we need more guns on the street … I think it’s awful, just baffling, that they allow this. Because this is borderline free speech, but this is more toward hate speech.”

Another student told WMC-TV: “We’re also a city that is predominately Black and we’re also a city that is grappling with gun violence … We are actively giving a platform to a white nationalist.”

One video posted online showed students booing and walking out of the auditorium as Rittenhouse spoke. Another video showed a student yelling to Rittenhouse: “What lie? What lie? Tell me the lies of Black Lives Matter? Tell me the lies you’re [going to] talk about?”

In a separate video , a student was seen confronting Rittenhouse, who was on stage with a dog, about comments made by Turning Point USA’s founder Charlie Kirk.

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“The CEO of Turning Point USA, Charlie Kirk, has said a lot of racist things,” the student said from his seat.

“What racist things has Charlie Kirk said?” Rittenhouse replied before repeating his question.

“He says that we shouldn’t celebrate Juneteenth, we shouldn’t celebrate Martin Luther King Day – we should be working those days – he called [supreme court justice] Ketanji Brown Jackson an affirmative action hire, he said all this nonsense about George Floyd and he said he’d be scared if a Black pilot was on a plane. Does that not seem racist?” the student said.

In response, Rittenhouse said: “I don’t know anything about that.”

“Well, after all the things I just told you, would you consider that hate speech?” the student asked.

“I’m not going to comment on that,” Rittenhouse said, prompting cries from the audience.

Following the event, Rittenhouse posted a video on X, saying : “Great event! I think it’s funny that a lot of the media is saying that we got booed off stage. In reality we did a hard cut off time and just happened to leave at that.”

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This week in science: whale menopause, bird rest stops and a speech-generating patch

Margaret Cirino

Emily Kwong

NPR's Ari Shapiro talks with Emily Kwong and Margaret Cirino about whale menopause, songbird rest stops along migratory routes, and a device that allows people with voice disorders to speak.

ARI SHAPIRO, HOST:

It's time for our regular science news roundup with our friends at NPR's Short Wave podcast, Emily Kwong and Margaret Cirino. Hi, there.

EMILY KWONG AND MARGARET CIRINO: Hey, Ari.

SHAPIRO: OK. So how this works is you bring us three science stories that have caught your eye this week.

EMILY KWONG, BYLINE: Yep.

SHAPIRO: What have you got for us today?

KWONG: Well, we have an innovative patch to help people with vocal disorders speak.

MARGARET CIRINO, BYLINE: And we've got new research on menopause in whales.

KWONG: And songbird migration and their secret rest stops.

SHAPIRO: Emily, let's start with this patch that might help people with voice disorders speak?

KWONG: Yeah. So a little backstory - the person who actually inspired me to become a journalist was this fantastic newspaper reporter up in Maine. His name was Doug Harlow, and he used a special device to speak. I interviewed him about it 10 years ago.

(SOUNDBITE OF ARCHIVED RECORDING)

DOUG HARLOW: (Through electrolarynx) Good afternoon. Doug Harlow calling.

KWONG: The reason is because, when Doug was in his mid 50s, Ari, doctors found throat cancer. So he had his vocal cords removed to save his life. And in their place, he was given a hand-held, battery powered device called an electrolarynx.

HARLOW: (Through electrolarynx) I remember it being, like, a - more an advantage.

SHAPIRO: Wow.

KWONG: The device basically vibrates, and Doug would hold it up against his throat. And with time, he learned how to turn those vibrations into the sound of words like you just heard. But now, a team at UCLA has figured out a new way to help people with voice disorders speak, no hands required.

SHAPIRO: Huh.

CIRINO: Yeah. This is a type of patch that sticks directly to the skin on the throat. They published their research in the journal Nature Communications last week.

SHAPIRO: So this patch sticks onto the throat. And how does it work?

CIRINO: So the patch is about 1 square inch. It's made of this soft, stretchy material. Ari, I'm going to ask you to put your hand to your throat as you speak - and just say a few words for me.

SHAPIRO: OK. My hand is on my throat like a hand scarf.

KWONG: (Singing) La, la, la, la.

SHAPIRO: Yeah, I'm feeling vibrations here.

KWONG: Yeah. So that muscle movement that you feel - the patch can turn it into an electrical signal, which is then converted into audible speech that anyone can hear - sounds a little like this.

UNIDENTIFIED PERSON: (Through voice-changer patch) Merry Christmas.

SHAPIRO: Wow. The difference between the earlier version of the voice device and that is night and day.

CIRINO: Yeah.

SHAPIRO: Well, everybody has a different voice. Is this patch able to kind of decode all the different range of voices that there are in an accurate way?

CIRINO: Yeah. So the researchers developed a machine learning algorithm to correlate the electrical signal to certain words. And the machine learns over time since everyone's voice is different.

KWONG: Yeah. The device's inventor, Jun Chen, said his team has measured an accuracy rate of about 95%.

SHAPIRO: Is this device going to be commercially available anytime soon?

KWONG: So Jun's team has to do a lot more tests to increase the vocabulary and translation accuracy of the patch. But if that pans out, he hopes something like this can be commercially available in three to five years.

SHAPIRO: Wild.

OK, next, Marge, can we go to your story about menopause in whales?

CIRINO: Yes, we can. But first, did you know most animals don't go through menopause? Humans are kind of special that way.

SHAPIRO: Not to brag, but I did know that.

CIRINO: Well, I didn't. And so I had Sam Ellis, an animal behavior researcher involved in the study, explain why it's so rare.

SAM ELLIS: The best way to propagate your genes is to get as many offspring as possible into the next generation. The best way to do that is almost always going to be to reproduce for your whole life. So I think, really, it's not a surprise that it's so rare because it's such a strange strategy.

KWONG: Sam is at the University of Exeter in the U.K., and he studies menopause in one of the only types of mammals that experience it other than humans, and that is toothed whales, like killer whales.

SHAPIRO: So why would these toothed whales experience menopause and not like - I don't know - baleen whales?

CIRINO: Researchers aren't sure why exactly, but they do know menopause has evolved several times in whales, so they think it must have some benefit.

KWONG: OK. This is the study. It was in the journal Nature. Sam and his team compared the five known species of toothed whales that go through menopause to the ones that don't. And they found that the female whales undergoing menopause lived, on average, 40 years longer than females of other species.

KWONG: And on top of that, they also lived longer than the males of their own species.

SHAPIRO: And could they say why menopause appears to have this link with longevity?

CIRINO: Well, Sam told me this has to do with something called reproductive competition. Like, if a mother and her daughter are both reproducing - you know, still living in the same group at the same time, they're gunning for the same resources, like food. Menopause fixes that. Instead of grandmother whales competing with their daughters for resources, this allows older female toothed whales to provide intergenerational help.

KWONG: Yeah. These grandma whales - they can share food with relatives, share their knowledge of the ecosystem and even babysit their grand-offspring.

KWONG: Older whales have been documented babysitting their grand-calves.

SHAPIRO: I don't want to anthropomorphize whales, but does this study tell us anything about why menopause may have evolved in humans?

KWONG: That's a good question, yeah.

CIRINO: Yeah. I mean, we can't say for sure that this is why menopause evolved in humans, but Sam says that's likely the case. And either way, this research reveals some of the social utility of going through menopause and being a grandma.

SHAPIRO: We all love grandmas.

KWONG: Shout-out to the grandmas.

SHAPIRO: OK, third science story for today is about the secret places songbirds rest during their migration. What a seasonally appropriate choice.

KWONG: Indeed. Yes, happy spring to you, Ari - to everyone. The spring bird migration is underway. That means billions of birds will be migrating north to and through the U.S.

CIRINO: And some of these birds are traveling thousands of miles to breeding grounds in search of food. So scientists generally know where birds are traveling to and from, but what's been less clear is where they stop to rest and recuperate along the way.

SHAPIRO: Secret bird rest stops.

CIRINO: Exactly.

KWONG: Not knowing the rest stops is a problem. It's been kind of the missing link for people who want to protect migrating birds. And bird populations in North America have been plummeting in recent years. Ornithologists estimate roughly 3 billion birds, which is nearly 30% of their population, have been lost in the last 50 years.

SHAPIRO: Oh, so if you want to protect these bird populations, knowing where they rest can help you protect those spaces and protect the populations.

CIRINO: That's right. So a recent study published in Current Biology has finally given us an idea of where this happens along the eastern U.S. by using weather radar. Our colleague, Nathan Rott, talked to the lead researcher on the paper, a Princeton Ph.D. student, Fengyi Guo.

FENGYI GUO: The cool thing about this is that most of them are nocturnal migrants, meaning that they migrate at night, and they usually take off in a very synchronized way near sunset, which can be well captured by weather radars.

CIRINO: So birds show up differently on weather radar than rain, for example. And it's those distinctions that help them map out where the birds are resting.

SHAPIRO: I'm dying to know - what were these secret places that the scientists uncovered?

KWONG: So for spring migration, the researchers identified hotspots throughout the Midwest and the East. They're mainly in deciduous forest fragments - so, like, blocks of forest. And when you add up both spring and fall hotspots, the researchers found that only one-third of those spots are in protected areas, like a state forest or national park.

CIRINO: Fengyi says part of the reason for that is that a lot of this land is privately owned, so she hopes this kind of data can create opportunities to partner up with private landowners on bird conservation efforts.

SHAPIRO: Fascinating.

SHAPIRO: That is Emily Kwong and Margaret Cirino from NPR's science podcast, Short Wave, where you can learn about new discoveries, everyday mysteries and the science behind the headlines. Good to have you both with us. Thanks again.

CIRINO: Thanks, Ari.

KWONG: Always a pleasure.

(SOUNDBITE OF SLVR SONG, "BACK N FORTH")

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Elon Musk's X bans revealing the names of anonymous users after scrutiny of an antisemitic cartoonist

Elon Musk’s X changed its privacy policy this week to ban users from publishing the real names of people behind anonymous accounts after some users appeared to unmask a pseudonymous cartoonist who drew antisemitic images. 

The social media platform updated its privacy policy to say people “cannot share … the identity of an anonymous user, such as their name or media depicting them,” without that person’s permission. The company said it was doing so to maintain a safe and secure platform. 

X users expressed mixed feelings about the change, because the catalyst appeared to be someone involved in antisemitism, but, depending on how it is applied, it could benefit other people, such as anonymous dissidents in repressive countries. 

The policy change added to what some X users and critics have said is a growing list of examples of Musk going out of his way to defend neo-Nazis, antisemites and white supremacists. Musk has embraced an antisemitic conspiracy theory, and, since he bought the app then known as Twitter in 2022, he has welcomed back antisemitic accounts that Twitter’s previous management had suspended for breaking its rules. Musk has also second-guessed law enforcement officials after they said a mass shooter was a suspected neo-Nazi sympathizer. 

The policy also clashes with Musk’s ongoing claims that X is dedicated to free speech, because journalists have a long history of unmasking powerful people who avoid public scrutiny. Since he bought the platform, Musk has suspended journalists and filed lawsuits targeting his critics while continuing to state that X is a bulwark against censorship. 

“Twitter’s policies have officially been changed to aid a neo nazi,” Alejandra Caraballo, a clinical instructor at the Harvard Law Cyberlaw Clinic and a vocal Musk critic, wrote on the rival platform Threads. 

In a phone interview, Caraballo said that the new policy was poorly thought-out and that she doubted that X would apply it evenly. 

“If this had been a long-term policy that would be consistently enforced, I don’t think it would necessarily be a bad thing,” she said. 

Other X users also expressed doubt that Musk would apply the new policy in an even-handed manner, given his own extreme views.

X did not immediately respond to a request for comment or further information. In a post on X, it described the change as a clarification of its existing rules against posting other people’s private information. 

“We’re further clarifying our external policy to explicitly include provisions for user anonymity reinforcing X’s commitment to maintaining a safe and secure platform,” the post said . 

The change came a day after Wired magazine reported that X was already following the policy in at least one case without having put it in writing. The magazine reported that X was suspending the accounts of some journalists and researchers who posted the possible identity of an antisemitic cartoonist going by the pseudonym Stonetoss. 

The person behind the Stonetoss online comics was the subject of a report March 12 by the Anonymous Comrades Collective, an antifascist research group. It said Stonetoss is the creation of a Texas man who works in information technology, and it named him and his employer, as well as documenting comments he had made on podcasts and social media. 

The cartoons by Stonetoss are extreme. One shows a Jewish man drinking the blood of an infant, which is a common antisemitic trope. Others use the deaths by suicide of transgender people as punchlines. Stonetoss posts the cartoons on X, where they often attract millions of views. 

NBC News has not confirmed the identity of the person behind Stonetoss, and the Stonetoss account did not immediately respond to a request for comment Thursday. Stonetoss’ X account posted this week that they had been wrongly labeled a “Nazi” and they said they were making money off the dispute by selling plushie dolls online. 

Despite the new policy, hundreds of X users were posting the alleged name of Stonetoss this week. 

The platform previously known as Twitter has had a long history with anonymous and pseudonymous accounts. While Facebook has in general required people to use their real names since it opened to the public in 2006, Twitter has never had such a requirement. At times, Twitter went to court to prevent attempts by governments to unmask critics, moves that human rights advocates welcomed as evidence of a commitment to protect dissidents. 

Anonymous accounts played pivotal roles in some of Twitter’s key moments in history, including the Occupy Wall Street protests, which began in 2011. Saudi Arabia hired a Twitter employee as a spy to try to unmask dissidents, with a jury in California later convicting the man of acting as an unregistered agent. 

In 2021, Twitter’s then-safety team published an essay in defense of anonymity, although Twitter at that time was different in other ways, including its enforcement of a policy against hateful or dehumanizing imagery. Now, some antisemitic posts on X get hundreds of thousands of views and are not taken down after people flag them, according to a review by The Washington Post . 

Corynne McSherry, legal director of the online rights group Electronic Frontier Foundation, said platforms are free to make their own decisions about moderation policies and what speech they will host. But she expressed concern about inconsistency at X. 

“Policies protecting users’ anonymity (which can be critical to free expression) are important, but should be carefully and consistently enforced, especially when there are competing speech interests. If Wired’s reporting is correct, that’s not happening here,” she said in a statement to NBC News. 

McSherry added that X has unmasked users at the behest of governments under Musk. She cited a report last year from the website Rest of World finding that, during the first six months of Musk’s ownership, Twitter said it fully complied with 808 of 971 requests from governments and courts, including orders to remove posts and demands for private data. It said it partially complied in 154 other cases.

Broadly speaking, the privacy policies of X and other sites are designed to prevent what is known as doxxing: the release of a person’s identifying information with malicious intent. 

The situation around the cartoonist Stonetoss is further complicated because X is under investigation in the European Union over the spread of illegal content such as hate speech. New rules against hate speech took effect there in August. 

David Ingram covers tech for NBC News.

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The State of the First Amendment: Free Speech

The Keller Center  has organized an upcoming presentation and discussion of potential interest to PSCI students, faculty and staff. Mike McDevitt  (from CU Journalism) and Scott Skinner-Thompson  (CU Law) will present the first of a planned semesterly series of "State of the First Amendment"  events on the five 1A freedoms, starting with free speech . Expect discussion not only of current cases and controversies in First Amendment law and jurisprudence but also of broader free speech issues in their social and political dimensions, including campus issues involving limits on or threats to political speech and academic freedom.

The event will be held in UMC 382-84-86  on Wednesday, April 3 , with doors opening at 3 pm  and the presentation starting at 3:15  (ending at 4:45, reserving the last 30 minutes for Q&A and discussion). Refreshments will be available. The event is open to all within the CU community (including alums) with no requirement for prior registration. Please share this announcement with your students - I've attached a .jpg of our promotional poster to facilitate sharing through lecture slides.

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David Seidler, Oscar-Winning Writer of ‘The King’s Speech,’ Dies at 86

He drew on his own painful experiences with a stutter in depicting King George VI’s struggles to overcome his impediment and rally Britain in World War II.

By Trip Gabriel

David Seidler, a screenwriter whose Oscar-winning script for “The King’s Speech” — about King George VI conquering a stutter to rally Britain at the outset of World War II — drew on his own painful experience with a childhood stammer, died on Saturday on a fly-fishing trip in New Zealand. He was 86 and lived in Santa Fe, N.M.

His manager, Jeff Aghassi, disclosed the death in a statement but did not cite a cause. “David was in the place he loved most in the world — New Zealand — doing what gave him the greatest peace, which was fly-fishing,” Mr. Aghassi said. “If given the chance, it is exactly as he would have scripted it.”

On winning the Academy Award for best original screenplay for “The King’s Speech” (2010), Mr. Seidler said from the Hollywood stage that he was accepting on behalf of all stutterers. “We have a voice; we have been heard,” he said.

The movie, a historical drama in the form of a buddy picture about an afflicted future monarch (Colin Firth) and his talented but unlicensed speech therapist (Geoffrey Rush), was a commercial and critical success. It also won Oscars for best picture, best director (Tom Hooper) and best actor (Mr. Firth).

Mr. Seidler, who was born in England but emigrated with his family to the United States as a child during World War II, spent much of his career writing little-noticed television projects, including soap operas, a biopic of the Partridge Family singers and the TV movie “Onassis: The Richest Man in the World” (1988), written with a longtime co-writer, Jacqueline Feather. That same year, he broke onto the big screen as a co-writer (with Arnold Schulman) of “Tucker: The Man and His Dream,” about the automobile inventor Preston Tucker, directed by Francis Ford Coppola.

But Hollywood’s doors did not swing open widely for him before “The King’s Speech,” or in the years that followed. A stage version of the film that he wrote toured England in 2012. After transferring to London’s West End, it closed earlier than expected because of poor ticket sales.

Mr. Seidler’s stammer, he told Patrick Healy in an interview for The New York Times in 2011, developed when he was a toddler, shortly after his family had moved to the United States — it might have been set off by the trauma of wartime relocation — and persisted through his high school years on Long Island.

He tried to conquer the impediment using some of the same therapies that Lionel Logue, played by Mr. Rush, imposes on the future George VI in the movie: placing marbles in his mouth as he speaks and taking up smoking. None of them worked.

Mr. Seidler told the site filmcritic.com that his parents, aiming to inspire him, tuned the family radio to George VI’s speeches during the war as object lessons of mastering a stutter.

“They would say to me, ‘David, he was a much worse stutterer than you, and listen to him now. He’s not perfect. But he can give these magnificent, stirring addresses that rallied the free world,’” Mr. Seidler said.

At 16, he recalled, he had a “profanity-laden, F-bomb-filled emotional catharsis” like one that King George, who was known as “Bertie,” his childhood nickname, experiences in the film. “I thought that if I’m stuck with stuttering, you’re all stuck with listening with me,” he told The Times, inserting an expletive.

Soon after, his stutter faded away in conversations.

David Seidler was born on Aug. 4, 1937, in London, to Doris (Falkoff) Seidler, a painter and printmaker, and Bernard Seidler, a fur broker. He graduated from Cornell University in 1959. He is survived by two adult children, Marc and Maya Seidler.

The screenplay of “The King’s Speech” gestated with Mr. Seidler for decades. In interviews , he said he had set the project aside for years until after the death in 2002 of Queen Elizabeth the Queen Mother, widow of George VI, who had asked him not to pursue it in her lifetime.

In a 2011 interview with The Times, he compared the process of drawing on his experiences as a stutterer to remembering from afar a bad toothache.

“While you’ve got the toothache it’s all you think about, but as soon as you go to the dentist, and he or she takes away the pain, the last thing you want to think about was how that tooth ached,” he said. “You put it away from your mind and forget about it. The same with stuttering. So it was only by waiting until I had reached the stage of … let me use the euphemism maturity … when by nature you start to look back on your life anyway, that it allowed me to revisit that pain, that sense of isolation and loneliness, which I think helped the script immensely.”

Trip Gabriel is a national correspondent. He covered the past two presidential campaigns and has served as the Mid-Atlantic bureau chief and a national education reporter. He formerly edited the Styles sections. He joined The Times in 1994. More about Trip Gabriel