There are many different types of speech impediments, including:
DisfluencyArticulation errorsAnkyloglossiaDysarthriaApraxia
This article explores the causes, symptoms, and treatment of the different types of speech disorders.
Disfluency
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 strainHead jerkingEye blinkingLip 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 Errors
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
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 Jaw pain
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
Symptoms and Characteristics of Dysarthria
Dysarthria is characterized by:
Slurred, choppy, or robotic speechRapid, slow, or soft speechBreathy, 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
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.
Treating Speech Disorders
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.
