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What Is a Speech Sound Disorder?

Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

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Speech sound disorders are a blanket description for a child’s difficulty in learning, articulating, or using the sounds/sound patterns of their language. These difficulties are usually clear when compared to the communication abilities of children within the same age group.

Speech developmental disorders may indicate challenges with motor speech. Here, a child experiences difficulty moving the muscles necessary for speech production. This child may also face reduced coordination when attempting to speak.

Speech sound disorders are recognized where speech patterns do not correspond with the movements/gestures made when speaking.  

Speech impairments are a common early childhood occurrence—an estimated 2% to 13% of children live with these difficulties. Children with these disorders may struggle with reading and writing. This can interfere with their expected academic performance. Speech sound disorders are often confused with language conditions such as specific language impairment (SLI).

This article will examine the distinguishing features of this disorder. It will also review factors responsible for speech challenges, and the different ways they can manifest. Lastly, we’ll cover different treatment methods that make managing this disorder possible.

Symptoms of Speech Sound Disorder

A speech sound disorder may manifest in different ways. This usually depends on the factors responsible for the challenge, or how extreme it is.

There are different patterns of error that may signal a speech sound disorder. These include:

• Removing a sound from a word
• Including a sound in a word
• Replacing hard to pronounce sounds with an unsuitable alternative
• Difficulty pronouncing the same sound in different words (e.g., "pig" and "kit")
• Repeating sounds or words
• Lengthening words
• Pauses while speaking
• Tension when producing sounds
• Head jerks during speech
• Blinking while speaking
• Shame while speaking
• Changes in voice pitch
• Running out of breath while speaking

It’s important to note that children develop at different rates. This can reflect in the ease and ability to produce sounds. But where children repeatedly make sounds or statements that are difficult to understand, this could indicate a speech disorder.

Diagnosis of Speech Sound Disorders

For a correct diagnosis, a speech-language pathologist can determine whether or not a child has a speech-sound disorder.

This determination may be made in line with the requirements of the DSM-5 diagnostic criteria . These guidelines require that:

• The child experience persistent difficulty with sound production (this affects communication and speech comprehension)
• Symptoms of the disorder appear early during the child’s development stages
• This disorder limits communication. It affects social interactions, academic achievements, and job performance.
• The disorder is not caused by other conditions like a congenital disorder or an acquired condition like hearing loss . Hereditary disorders are, however, exempted. 

Causes of Speech Sound Disorders

There is no known cause of speech sound disorders. However, several risk factors may increase the odds of developing a speech challenge. These include:

• Gender : Male children are more likely to develop a speech sound disorder
• Family history : Children with family members living with speech disorders may acquire a similar challenge.
• Socioeconomics : Being raised in a low socioeconomic environment may contribute to the development of speech and literacy challenges.
• Pre- and post-natal challenges : Difficulties faced during pregnancy such as maternal infections and stressors may worsen the chances of speech disorders in a child. Likewise, delivery complications, premature birth, and low-birth-weight could lead to speech disorders.
• Disabilities : Down syndrome, autism , and other disabilities may be linked to speech-sound disorders.
• Physical challenges : Children with a cleft lip may experience speech sound difficulties.
• Brain damage : These disorders may also be caused by an infection or trauma to a child’s brain . This is seen in conditions like cerebral palsy where the muscles affecting speech are injured.

Types of Speech Sound Disorders

By the time a child turns three, at least half of what they say should be properly understood. By ages four and five, most sounds should be pronounced correctly—although, exceptions may arise when pronouncing “l”, “s”,”r”,”v”, and other similar sounds. By seven or eight, harder sounds should be properly pronounced. 

A child with a speech sound disorder will continue to struggle to pronounce words, even past the expected age. Difficulty with speech patterns may signal one of the following speech sound disorders:

This refers to interruptions while speaking. Stuttering is the most common form of disfluency. It is recognized for recurring breaks in the free flow of speech. After the age of four, a child with disfluency will still repeat words or phrases while speaking. This child may include extra words or sounds when communicating—they may also make words longer by stressing syllables.

This disorder may cause tension while speaking. Other times, head jerking or blinking may be observed with disfluency. 

Children with this disorder often feel frustrated when speaking, it may also cause embarrassment during interactions. 

Articulation Disorder

When a child is unable to properly produce sounds, this may be caused by inexact placement, speed, pressure, or movement from the lips, tongue, or throat.  

This usually signals an articulation disorder, where sounds like “r”, “l”, or “s” may be changed. In these cases, a child’s communication may be understood by only close family members.

Phonological Disorder

A phonological disorder is present where a child is unable to make the speech sounds expected of their age. Here, mistakes may be made when producing sounds. Other times, sounds like consonants may be omitted when speaking.  

Voice Disorder

Where a child is observed to have a raspy voice, this may be an early sign of a voice disorder. Other indicators include voice breaks, a change in pitch, or an excessively loud or soft voice.  

Children that run out of breath while speaking may also live with this disorder. Likewise, children may sound very nasally, or can appear to have inadequate air coming out of their nose if they have a voice disorder.

Childhood apraxia of speech occurs when a child lacks the proper motor skills for sound production. Children with this condition will find it difficult to plan and produce movements in the tongue, lips, jaw, and palate required for speech.  

Treatment of Speech Sound Disorder

Parents of children with speech sound disorders may feel at a loss for the next steps to take. To avoid further strain to the child, it’s important to avoid showing excessive concern.

Instead, listening patiently to their needs, letting them speak without completing their sentences, and showing usual love and care can go a long way.

For professional assistance, a speech-language pathologist can assist with improving a child’s communication. These pathologists will typically use oral motor exercises to enhance speech.

These oral exercises may also include nonspeech oral exercises such as blowing, oral massages and brushing, cheek puffing, whistleblowing, etc.

Nonspeech oral exercises help to strengthen weak mouth muscles, and can help with learning the common ways of communicating.

Parents and children with speech sound disorders may also join support groups for information and assistance with the condition.

A Word From Verywell

It can be frustrating to witness the challenges in communication. But while it's understandable to long for typical communication from a child—the differences caused by speech disorders can be managed with the right care and supervision. Speaking to a speech therapist, and showing love o children with speech disorders can be important first steps in overcoming these conditions.

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McLeod S, Harrison LJ, McAllister L, McCormack J. Speech sound disorders in a community study of preschool children . Am J Speech Lang Pathol . 2013;22(3):503-522. doi:10.1044/1058-0360(2012/11-0123)

Murphy CF, Pagan-Neves LO, Wertzner HF, Schochat E. Children with speech sound disorder: comparing a non-linguistic auditory approach with a phonological intervention approach to improve phonological skills . Front Psychol . 2015;6:64. Published 2015 Feb 4. doi:10.3389/fpsyg.2015.00064

Penn Medicine. Speech and Language Disorders-Symptoms and Causes .

PsychDB. Speech Sound Disorder (Phonological Disorder) .

Sices L, Taylor HG, Freebairn L, Hansen A, Lewis B. Relationship between speech-sound disorders and early literacy skills in preschool-age children: impact of comorbid language impairment . J Dev Behav Pediatr . 2007;28(6):438-447. doi:10.1097/DBP.0b013e31811ff8ca

American Speech-Language-Hearing Association. Speech Sound Disorders: Articulation and Phonology .

American Speech-Language-Hearing Association. Speech Sound Disorders .

MedlinePlus. Phonological Disorder .

National Institute on Deafness and Other Communication Disorders. Articulation Disorder .

National Institute of Health. Phonological Disorder.

Lee AS, Gibbon FE. Non-speech oral motor treatment for children with developmental speech sound disorders . Cochrane Database Syst Rev . 2015;2015(3):CD009383. Published 2015 Mar 25. doi:10.1002/14651858.CD009383.pub2

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Overcoming Speech Impediment: Symptoms to Treatment

There are many causes and solutions for impaired speech

• Types and Symptoms
• Speech Therapy
• Building Confidence

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

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

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

FG Trade / Getty Images

Types and Symptoms of Speech Impediment

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

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

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

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

Can Symptoms Worsen?

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

Symptoms of dysarthria can include:

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

Symptoms of aphasia may involve:

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

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

Causes of Speech Impediment

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

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

Speech Impairment in Children

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

Common causes of childhood speech impediments include:

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

Do Childhood Speech Disorders Persist?

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

Speech Impairment in Adulthood

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

Common causes of adult speech impairment include:

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

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

Do Speech Disorders Resolve on Their Own?

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

Steps to Treating Speech Impediment 

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

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

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

Diagnostic testing may include:

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

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

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

Therapy to Address Speech Impediment

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

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

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

Exercises during speech therapy may include:

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

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

Building Confidence With Speech Problems 

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

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

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

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

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

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

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

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

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

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

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

By Heidi Moawad, MD Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.

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

• Calvin University - Calvin University's Online Speech and Hearing Foundations Certificate - Helps You Gain a Strong Foundation for Your Speech-Language Pathology Career.
• 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.

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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Home / Resources

What are the Most Common Speech Disorders?

July 24, 2020 

Speech disorders impact millions of people and their ability to communicate. The National Institute of Deafness and Other Communication Disorders estimates that  5% of children in the U.S. ages 3 to 17 have had a speech disorder  in the past 12 months. Some speech disorders can be overcome, while others are lifelong conditions. In either case, therapy with a  speech pathologist  can help a person make the most of their speech capabilities and develop alternative methods of communication. 

Speech pathologists or speech therapists complete  a master’s program  to be able to evaluate a person’s speech and communication, create a treatment plan and provide treatment to improve a person’s speech and other communication methods. Some  speech pathologists’ careers  deal with research and development treatment guidelines for various speech and language disorders.

What Is a Speech Disorder?

Speech is how people make sounds and words , according to the American Speech-Language-Hearing Association (ASHA). Speech problems can include the inability to make sounds clearly, having a raspy voice or stuttering (repeating sounds or pauses when speaking). 

Language is not the same thing as speech; it is the words we use to share ideas. Problems with language can include difficulty understanding, talking, reading or writing. 

According to ASHA, a speech disorder is an impairment of the articulation of sounds, fluency or voice. It is one of many types of communication disorders, which also include language and hearing disorders. 

Types of Speech Disorders

There are  three categories of speech disorders : 

• Articulation disorders : An unusual production of speech sounds involving substitutions, omissions, additions or distortions that might interfere with whether the sounds are intelligible to others.
• Fluency disorders : Interruptions in the flow of a person’s speech, such as an uncommon rate, rhythm, or repetition of sounds, syllables, words or phrases.
• Voice disorders : An abnormal production or absence of vocal quality, pitch, volume, resonance or duration that’s inappropriate for the person’s age and sex. 

Speech Disorder Causes

The medical community doesn’t know the cause of all speech disorders and, for many, the cause can vary. Potential causes for speech disorders include: 

• Brain damage : Some speech and other communication disorders are due to a congenital condition. A child or adult who suffers a traumatic brain injury might sustain damage to a portion of the brain that impacts speech. Also, diseases and conditions such as stroke, dementia, Parkinson’s disease, ALS, Huntington’s disease, MS, cerebral palsy, muscular dystrophy, cancer and benign brain tumors can impact speech.
• Nervous system condition : A disorder that affects a person’s nervous system can affect the muscles in their mouth, jaw, lips, or tongue or their vocal folds (voice box).
• Nerve damage : Nerve damage in the voice box can impact the vocal folds and cause voice disorders, which are a type of speech disorder.
• Stress : In some cases, it’s believed that stress can trigger certain speech disorders. 

10 Common Speech Disorders 

1. childhood apraxia of speech.

To talk, messages from the brain tell the muscles around the mouth and throat to move. In childhood apraxia, the messages don’t get through to the muscles correctly, according to ASHA. The child’s muscles aren’t weak, but they can’t move their mouth or tongue the right way to make the necessary sounds. The severity of this condition can vary. In more severe cases, a child might not be able to talk much. 

Childhood apraxia is not a developmental issue that a child can grow out of. With the help of a speech therapist, a child’s speech can improve. But ultimately, the way the child learns to make speech sounds won’t be typical of other children. 

2. Adult Apraxia

Apraxia of speech in adults is also called acquired apraxia of speech, verbal apraxia and dyspraxia. Adults suffer from verbal apraxia because of brain damage, such as a stroke, oxygen deprivation or a traumatic brain injury. 

Acquired apraxia in adults can affect their speech in various ways. A person might make a new sound, leave out sounds or say something the wrong way. They might not be able to make a sound the right way consistently. A person might have a hard time controlling their mouth, lips and tongue to make the right sounds. They might have to talk slowly. In severe cases, an adult might not be able to talk at all. 

3. Dysarthria

Dysarthria is the result of muscle weakness due to brain damage. The severity of the condition can vary, and it can be accompanied by other conditions, like speech apraxia. People with dysarthria might slur their words, speak slowly or too fast, talk softly, sound robotic and not be able to move their mouth or tongue well. Some people’s voices sound different than before their injury. 

4. Orofacial Myofunctional Disorders

People of any age can have an orofacial myofunctional disorder (OMD). An OMD might interfere with the development of the bones and muscles in a person’s face and mouth. This can impact a person’s ability to breathe, swallow, eat and talk. Various issues can cause an OMD, including anything that causes a person to rest their tongue in the right place or keep their lips together when at rest. 

One type of OMC is called tongue thrusting, which involves children pushing their tongue out when they try to talk, drink or eat. 

5. Speech Sound Disorders

A child who can’t correctly make speech sounds by 4 years old might have a speech sound disorder, also known as a phonological disorder or articulation disorder. Speech sound disorders are not only in children, though. Adults might have suffered from a disorder since childhood or acquired this disorder after sustaining brain damage. 

With a speech sound disorder, a person might make one sound in place of another, add sounds, change a sound or leave a sound out. The changes can be severe enough to make it hard for others to understand them. It’s important to note that people with accents will do some of these things, like replace one sound with another. An accent or dialect is not a speech sound disorder. 

6. Stuttering

A person who stutters might repeat whole words or sounds, stretch out sounds or have a hard time saying certain words. These are known as repetitions, prolongations and blocks, respectively. While everyone might stutter once in a while, stuttering becomes a speech disorder when it gets in the way of a person’s ability to communicate with others and is accompanied by negative feelings about talking. 

There’s no specific cause for stuttering. It might be the result of differences in children’s brains. In many cases, there’s a family history of stuttering. Most children start to stutter between the ages of 2 and 6 years. If the stuttering lasts for more than 6 months, then treatment with a speech pathologist might be necessary. 

7. Voice Disorders

Several conditions impact a person’s voice, and therefore, their ability to talk. These include:

Chronic cough : A cough that lasts more than four weeks in children and eight weeks in adults is considered chronic. It can alter the sound of a person’s voice or their ability to talk.

Paradoxical vocal fold movement : PVFM is when a person’s vocal folds (inside the voice box) close partly or all the way when they should open. This can cause breathing difficulties, change a person’s voice, or cause someone to lose their voice. PVFM can be triggered by acid reflux, stress, smoke, pollen, other allergens, exercise or breathing cold air, though no one knows the underlying cause.

Spasmodic dysphonia : With this long-term condition, a person’s vocal folds don’t move properly. A person with this disorder might not be able to speak all the time, though, at other times, their voice might sound normal. Their vocal folds might spasm or tighten when they talk, which can make them sound jerky or hoarse. A brain or nervous system disorder can cause this condition.

Vocal fold nodules and polyps : Growths on a person’s vocal folds can change their voice and cause discomfort and pain. This condition is usually caused by vocal abuse — typically long-term overuse or abuse.

Vocal fold paralysis : Vocal fold paralysis happens when one or both of your vocal folds can’t move. If they can’t come together, separate and vibrate, then a person doesn’t have a voice. It also causes issues with breathing and swallowing. When one fold is paralyzed, a person’s voice might be quiet. They might be limited in their pitch and tone and sound breathy. When two folds are paralyzed, the person might need a tracheotomy. 

Aphasia is technically a language disorder caused by brain damage to the left side of the brain. People with aphasia might have a hard time understanding other people, speaking, reading or writing. For example, a person with aphasia might hear another person and understand them, but then have a difficult time responding with the correct speech sounds. Aphasia can cause people to not remember the right word, say the wrong word, make up words, have a hard time speaking in full sentences or have a hard time speaking coherent sentences. 

9. Selective Mutism

Selective mutism is a childhood language disorder, often associated with a child being extremely shy, afraid of embarrassment, traumatized, wanting to be alone or having an anxiety disorder. A child might refuse to talk in certain situations, say in public or at school. 

10. Childhood Speech Delays

A child who is significantly delayed in developing their language and speech skills might have a language disorder. These are called preschool language disorders. Delayed speech is also called alalia. Some children have a hard time with receptive language, which helps them follow directions, understand gestures and answer questions. Others have difficulties with expressive language, like asking questions, naming objects or putting words together for a sentence. Some children have trouble with both. 

Speech Disorder Treatments

Many speech disorders cannot be cured, but by receiving speech and language therapy with a licensed speech pathologist, many children and adults can improve their speech or adapt to alternative communication methods. 

Speech therapists can help individuals learn the correct way to make a sound, including when and how to move their mouth and tongue, practice saying certain sounds, learn to tell when a sound is correct or wrong and practice using sounds in longer sentences. Speech pathologists can give children and adults exercises to improve their speech. Additionally, depending on the type of speech disorder, other medical or mental health care might be necessary. 

Speech disorders impact children and adults from all walks of life. But these disorders don’t have to stand in the way of their communication, education and careers. Licensed speech pathologists can help individuals improve their speaking, and when helpful, learn to use augmentative and alternative communication methods. 

Information last updated June 2020

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Aphasia vs. Dysarthria and More: A Look at Different Disorders and How They Affect Areas of the Brain

A lthough aging is a natural aspect of life, getting older can often accompany some scary diagnoses . When celebrity media personality Wendy Williams was first diagnosed with aphasia, many of her fans and followers were concerned about what that meant for the future of her health.

As it turns out, aphasia is only one of many speech-related disorders that affect the brain, typically as a symptom of a larger problem like stroke or brain injury. Keep reading to find out the differences between aphasia and dysarthria, plus other disorders that are similar and can affect the brain.

Aphasia is a type of frontotemporal dementia.

Frontotemporal dementia, according to the National Institute on Aging, is an umbrella term for a series of disorders (also known as frontotemporal disorder, or FTD) that is "the result of damage to neurons in the frontal and temporal lobes of the brain."

If you are diagnosed with FTD, you could also develop many different types of symptoms, including trouble walking, trouble communicating, difficulty regulating emotions, and unusual behaviors. Tragically, there is currently no cure for FTD, and it does worsen as it progresses.

According to the Cleveland Clinic, aphasia is specifically "a disorder where you have problems speaking or understanding what other people say." There are eight main kinds of aphasia, but the three most common types are Broca's aphasia, Global aphasia, and Wernicke's aphasia.

Aphasia affects two parts of the brain's communication centers. Symptoms can include struggling to form words, repeating phrases, or understanding what someone else is saying to them.

What is the difference between aphasia vs. dysarthria?

Per Connected Speech Pathology, aphasia and dysarthria have a lot in common, including that both are often caused by factors such as stroke and brain injuries.

The main difference between them is that aphasia is about damage to the areas of the brain that control language and dysarthria is about difficulty controlling the muscles used for speech.

Because dysarthria affects speech, it can also cause difficulty with breath control and articulation. There are six main types of dysarthria, which vary based on how the nervous system is affected. Symptoms can include things like slowed speech, slurred speech, jerky speech, sounding robotic or monotone, and speaking louder or more quietly than intended.

What are aphagia and dysphagia?

Similar to aphasia and dysarthria, aphagia concerns the mouth and nose, but instead of difficulty with speech, it causes the inability to swallow , according to the University of South Florida Health Sciences Center. Aphagia is similar to dysphagia, which, per the Cleveland Clinic, means "difficulty swallowing. "

There are three main types of dysphagia: oral (where the issue is with your mouth), oropharyngeal (where the issue is with your throat), or esophageal (where the problem is with your esophagus).

Like the other disorders on this list, dysphagia is a brain disorder. It can be caused by many issues, including dementia, ALS, brain tumors, Parkinson's disease, or multiple sclerosis. It has also been linked to muscle disorders and blockage issues.

What is apraxia?

According to the University of Washington, apraxia, sometimes known as apraxia of speech, is a speech disorder t hat impairs the ability to speak. Essentially, someone might know the word they want to say, but apraxia makes it difficult for them to communicate all the sounds.

Symptoms of apraxia might include slower speech, speech errors, difficulty imitating speech or sounds, or trying to use fingers to force the mouth and lips to move.