When you were younger and first began talking, you may

have lisped, stuttered, or had a hard time pronouncing

words. Maybe you were told that it was "cute," or not to
worry because you would soon grow out of it. But if
you're in your teens and still stuttering, you may not feel
like it's so endearing.
You're not alone. More than 3 million Americans have the
speech disorder known as stuttering (or stammering, as
it's known in Britain). It's one of several conditions that
can affect a person's ability to speak clearly.
Some Common Speech and Language Disorders
Stuttering is a problem that interferes with fluent
(flowing and easy) speech. A person who stutters may
repeat the first part of a word (as in wa-wa-wa-water) or
hold a single sound for a long time (as in caaaaaaake).
Some people who stutter have trouble getting sounds out
altogether. Stuttering is complex, and it can affect
speech in many different ways.
Articulation disorders involve a wide range of errors
people can make when talking. Substituting a "w" for an
"r" ("wabbit" for "rabbit"), omitting sounds ("cool" for
"school"), or adding sounds to words ("pinanio" for

"piano") are examples of articulation

errors. Lisping refers to specific substitution involving
the letters "s" and "z." A person who lisps replaces those
sounds with "th" ("simple" sounds like "thimple").
Cluttering is another problem that makes a person's
speech difficult to understand. Like stuttering, cluttering
affects the fluency, or flow, of a person's speech. The
difference is that stuttering is a speech disorder,
while cluttering is a language disorder. People who
stutter have trouble getting out what they want to say;
those who clutter say what they're thinking, but it
becomes disorganized as they're speaking. So, someone
who clutters may speak in bursts or pause in unexpected
places. The rhythm of cluttered speech may sound jerky,
rather than smooth, and the speaker is often unaware of
the problem.
Apraxia (also known as verbal apraxia or dyspraxia) is an
oral-motor speech disorder. People with this problem
have difficulty moving the muscles and structures needed
to form speech sounds into words.
What Causes Speech Problems?
Normal speech might seem effortless, but it's actually a
complex process that needs precise timing, and nerve
and muscle control.
When we speak, we must coordinate many muscles from
various body parts and systems, including the larynx,
which contains the vocal cords; the teeth, lips, tongue,
and mouth; and the respiratory system.

The ability to understand language and produce speech is

coordinated by the brain. So a person with brain damage
from an accident, stroke, or birth defect may have
speech and language problems.
Some people with speech problems, particularly
articulation disorders, may also have hearing problems.
Even mildhearing loss can affect how people reproduce
the sounds they hear. Certain birth defects, such as
a cleft palate, can interfere with someone's ability to
produce speech. People with a cleft palate have a hole in
the roof of the mouth (which affects the movement of air
through the oral and nasal passages), and also might have
problems with other structures needed for speech,
including the lips, teeth, and jaw.
Some speech problems, like stuttering, can run in
families. But in some cases, no one knows exactly what
causes a person to have speech problems.
How Are Speech Problems Treated?

The good news is that treatments like speech therapy

can help people of any age overcome some speech
problems.
If you are concerned about your speech, it's important to
let your parents and doctor know. If hearing tests and
physical exams don't reveal any problems, some doctors
arrange a consultation with a speech-language
pathologist(pronounced: puh-THOL-uh-jist).

A speech-language pathologist is trained to observe

people as they speak and to identify their speech
problems. Speech-language pathologists look for the type
of problem (such as a lack of fluency, articulation, or
motor skills) someone has. For example, if you stutter,
the pathologist will examine how and when you do so.
Speech-language pathologists may evaluate their clients'
speech either by recording them on audio or videotape or
by listening during conversation. A few clinics that
specialize in fluency disorders may use computerized
analysis. By gathering as much information as possible
about the way someone speaks, the pathologist can
develop a treatment plan that meets each individual's
needs. The plan will depend on things like a person's age
and the type of speech disorder.
If you're being treated for a speech disorder, part of your
treatment plan may include seeing a speech therapist, a
person who is trained to treat speech disorders.
How often you have to see the speech therapist will vary
you'll probably start out seeing him or her fairly often
at first, then your visits may decrease over time. Most
treatment plans include breathing techniques, relaxation
strategies that are designed to help you relax your
muscles when you speak, posture control, and a type of
voice exercise called oral-motor exercises. You'll
probably have to do these exercises each day on your
own to help make your treatment plan as successful as
possible.
Dealing With a Speech Problem

People with speech problems know how frustrating they

can be. People who stutter, for example, often complain
that others try to finish their sentences or fill in words
for them. Some feel like people treat them as if they're
stupid, especially when a listener says things like "slow
down" or "take it easy." (People who stutter are just as
intelligent as people who don't.) People who stutter
report that listeners often avoid eye contact and refuse
to wait patiently for them to finish speaking. If you have
a speech problem, it's fine to let others know how you
like to be treated when speaking.
Some people look to their speech therapists for advice
and resources on issues of stuttering. Your speech
therapist might be able to connect you with others in
similar situations, such as support groups in your area for
teens who stutter.
If you have a speech problem, achieving and keeping
control of your speech might be a lifelong process.
Although speech therapy can help, you are sure to have
ups and downs in your efforts to communicate. But the
truth is that the way you speak is only a small part of
who you are. Don't be embarrassed to make yourself
heard!
Reviewed by: Rhonda S. Walter, MD
Date reviewed: September 2016
Reference : http://m.kidshealth.org/en/teens/speech-disorders.html

What Are Speech

Disorders?
Speech disorders can affect the way a person creates sounds
to form words. Certain voice disorders may also be
considered speech disorders.
One of the most commonly experienced speech disorders
is stuttering. Other speech disorders include:

apraxia: a motor speech disorder caused by damage to

the parts of the brain related to speaking

dysarthria: a motor speech disorder in which the

muscles of the mouth, face, or respiratory system may
become weak or have difficulty moving
Some people with speech disorders are aware of what they
would like to say, but are unable to articulate their thoughts.
This may lead to self-esteem issues and the development of
depression.
Speech disorders can affect adults and children. Early
treatment can correct these conditions.

What Causes Speech

Disorders?

Speech disorders affect the vocal cords, muscles, nerves, and

other structures within the throat.
Causes may include:

vocal cord damage

brain damage
muscle weakness
respiratory weakness
strokes
polyps or nodules on the vocal cords
vocal cord paralysis
People who have certain medical or developmental conditions
may also have speech disorders. Common conditions that can
lead to speech disorders are:

autism

attention deficit hyperactivity disorder (ADHD)

strokes
oral cancer
laryngeal cancer
Huntingtons disease
dementia
amyotrophic lateral sclerosis (ALS or Lou Gehrigs
disease)
Speech disorders may be hereditary, and they can develop
over time.

Part 3 of 7

What Are the

Symptoms of a
Speech Disorder?

Depending on the cause of the speech disorder, several

symptoms may be present. Common symptoms experienced
by people with speech disorders are:

repeating sounds (most often seen in people who

stutter)
adding extra sounds and words
elongating words
making jerky movements while talking (usually involving
the head)
blinking several times while talking
visible frustration when trying to communicate
taking frequent pauses when talking
distorting sounds when talking
hoarseness (raspy or gravely sounding voice)

Part 4 of 7

How Are Speech

Disorders
Diagnosed?

Denver Articulation Screening Exam

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

Early Language Milestones Scale 2

This test determines a childs language development. This
test can quickly identify delayed speech or language
disorders.

Peabody Picture Vocabulary Test Revised

This test measures a persons vocabulary and ability to

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

Part 5 of 7

How Are Speech

Disorders Treated?

Mild speech disorders may not require any treatment. Some

speech disorders may simply go away. Others can improve
with speech therapy.
Treatment varies and depends on the type of disorder. In
speech therapy, a professional therapist will guide you
through exercises that work to strengthen the muscles in the
face and throat. Youll learn to control your breathing while

speaking. Muscle-strengthening exercises and controlled

breathing help improve the way your words sound. Youll also
learn ways to practice smoother, more fluent speech.
Some people with speech disorders experience nervousness,
embarrassment, or depression. Talk therapy may be helpful in
these situations. A therapist will discuss ways to cope with
the condition and ways to improve the outlook of your
condition. If your depression is severe, antidepressant
medications can help.

What Are the

Potential
Complications of
Speech Disorders?

Untreated speech disorders may cause a person to

experience a great deal of anxiety. Over time, this anxiety
can trigger anxiety disorders or a phobia of speaking in
public. Early treatment for anxiety can help prevent the
development of anxiety disorders or phobias. Treatment
options include talk therapy and anti-anxiety medications.

Part 7 of 7

What Is the LongTerm Outlook?

The outlook improves for people who seek early treatment.

Early treatment helps prevent a speech disorder from
worsening. The outlook for those with permanent disabilities
depends upon the severity of the disability.
Ref:http://www.healthline.com/health/speechdisorders#Diagnosis4

Speech disorders - children

A speech disorder is a condition in which a person has problems creating or forming the
speech sounds needed to communicate with others.
Three common speech disorders are:

Articulation disorders

Disfluency

Voice disorders
Speech disorders are different from language disorders in children, such as:

Getting their meaning or message across to others

Understanding the message coming from others

Causes
Speech is one of the main ways in which we communicate with those around
us. It develops naturally, along with other signs of normal growth and
development.
Disfluencies are disorders in which a person repeats a sound, word, or
phrase. Stuttering may be the most serious disfluency.
Articulation disorders may have no clear cause. They may also occur in other
family members. Other causes include:

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

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

Acid from the stomach moving upward (GERD)

Cancer of the throat
Cleft palate or other problems with the palate

Conditions that damage the nerves that supply the muscles of the vocal

cords

Laryngeal webs or clefts (a birth defect in which a thin layer of tissue is

between the vocal cords)

Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or

ulcers) on the vocal cords

Overuse of the vocal cords from screaming, constantly clearing the throat, or
singing

Symptoms
DISFLUENCY
Stuttering is the most common type of disfluency.
Symptoms of disfluency can include:

Repetition of sounds, words, or parts of words or phrases after age 4 (I

want...I want my doll. I...I see you.)

Putting in (interjecting) extra sounds or words (We went to the...uh...store.)

Making words longer (I am Boooobbby Jones.)

Pausing during a sentence or words, often with the lips together

Tension in the voice or sounds

Frustration with attempts to communicate

Head jerking while talking

Eye blinking while talking

Embarrassment with speech

ARTICULATION DISORDER

Sounds may be distorted (changed)

Sounds (most often consonants) will be substituted, left off, added, or
changed

Errors may make it hard for people to understand the person (only family
members may be able to understand a child)

VOICE DISORDERS

Hoarseness or raspiness to the voice

Voice may break in or out

Pitch of the voice may change suddenly

Voice may be too loud or too soft

Person may run out of air during a sentence

Speech may sound odd because too much air is escaping through the hose
(hypernasality) or too little air is coming out through the nose (hyponasality)

Exams and Tests

The following tests can help diagnose speech disorders:

Denver Articulation Screening Examination

Early Language Milestone Scale

Denver II test

Peabody Picture Test Revised

A hearing test may also be done.

Treatment
Milder forms of speech disorders may disappear on their own.
Speech therapy may help with more severe symptoms or speech problems
that do not improve.
In therapy, the child will learn how to create certain sounds.

Outlook (Prognosis)
Outlook depends on the cause of the disorder. Speech can often be improved
with speech therapy. Early treatment is likely to have better results.

Possible Complications
Speech disorders may lead to psychosocial problems associated with
ineffective communication.

When to Contact a Medical Professional

Call your health care provider if:

Your child's speech is not developing according to normal milestones

You think your child is in a high-risk group

Your child is showing signs of a speech disorder

Prevention
Intellectual disability and hearing loss make children more likely to develop
speech disorders. At-risk infants should be referred to an audiologist for a
hearing test. Hearing and speech therapy can then be started, if necessary.
As young children begin to speak, some disfluency is common. Children lack
a large vocabulary and have difficulty expressing themselves. This results in
broken speech. If you place excessive attention on the disfluency, a
stuttering pattern may develop. The best way to prevent stuttering,
therefore, is to avoid paying too much attention to the disfluency.

Alternative Names
Articulation deficiency; Voice disorders; Vocal disorders; Disfluency;
Communication disorder - speech disorder; Speech disorder - stuttering

References
American Speech-Language-Hearing Association. Child speech and language:
speech disorders. www.asha.org/public/speech/disorders/childsandl.htm.
Accessed March 10, 2016.
Choi SS, Zalzal GH. Voice disorders. In: Flint PW, Haughey BH, Lund VJ, et al,
eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia,
PA: Elsevier Saunders; 2015:chap 203.

Simms MD, Schum RL. Language development and communication disorders,

In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of
Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 35.