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Overcoming Speech Impediment: Symptoms to Treatment

There are many causes and solutions for impaired speech

  • Types and Symptoms
  • Speech Therapy
  • Building Confidence

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

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

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

FG Trade / Getty Images

Types and Symptoms of Speech Impediment

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

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

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

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

Can Symptoms Worsen?

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

Symptoms of dysarthria can include:

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

Symptoms of aphasia may involve:

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

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

Causes of Speech Impediment

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

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

Speech Impairment in Children

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

Common causes of childhood speech impediments include:

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

Do Childhood Speech Disorders Persist?

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

Speech Impairment in Adulthood

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

Common causes of adult speech impairment include:

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

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

Do Speech Disorders Resolve on Their Own?

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

Steps to Treating Speech Impediment 

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

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

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

Diagnostic testing may include:

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

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

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

Therapy to Address Speech Impediment

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

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

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

Exercises during speech therapy may include:

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

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

Building Confidence With Speech Problems 

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

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

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

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

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

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

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

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

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

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

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

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

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Types of Speech Impediments

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.

National Library of Medicine. Speech disorders . Medline Plus.

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

Cincinnati Children's Hospital. Stuttering .

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

Cleveland Clinic. Speech impediment .

Lee H, Sim H, Lee E, Choi D. Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms . J Commun Disord . 2017;65:54-64. doi:10.1016/j.jcomdis.2016.12.001

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.

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Home / Blog

Speech Impediment Guide: Definition, Causes, and Resources

December 8, 2020 

can a speech impediment come back

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.

A woman struggles to communicate due to a speech disorder.

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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Signs of speech disorders include unintelligible speech and sound omissions, substitutions, and additions.

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.  

About 5% of children in the U.S. have a speech disorder such as stuttering, apraxia, dysarthria, and lisping.

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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Speech Sound Disorders in Children

What are speech sound disorders in children?

It’s normal for young children learning language skills to have some trouble saying words the right way. That’s part of the learning process. Their speech skills develop over time. They master certain sounds and words at each age. By age 8, most children have learned how to master all word sounds.

But some children have speech sound disorders. This means they have trouble saying certain sounds and words past the expected age. This can make it hard to understand what a child is trying to say.  

Speech sound problems include articulation disorder and phonological process disorder.

Articulation disorder is a problem with making certain sounds, such as “sh.”

Phonological process disorder is a pattern of sound mistakes. This includes not pronouncing certain letters.

What causes speech sound disorders in a child?

Often, a speech sound disorder has no known cause. But some speech sound errors may be caused by:

Injury to the brain

Thinking or development disability

Problems with hearing or hearing loss, such as past ear infections

Physical problems that affect speech, such cleft palate or cleft lip

Disorders affecting the nerves involved in speech

Which children are at risk for speech sound disorders?

The cause often is not known, but children at risk for a speech sound disorder include those with:

Developmental disorders such as autism

Genetic disorders such as Down syndrome

Hearing loss

Nervous system disorders such as cerebral palsy

Illnesses such as frequent ear infections

Physical problems such as a cleft lip or palate

Too much thumb-sucking or pacifier use

Low education level of the parent

Lack of support for learning in the home

What are the symptoms of speech sound disorders in a child?

Your child’s symptoms depend on what type of speech sound disorder your child has. He or she may have trouble forming some word sounds correctly past a certain age. This is called articulation disorder. Your child may drop, add, distort, or swap word sounds. Keep in mind that some sound changes may be part of an accent. They are not speech errors. Signs of this problem can include:

Leaving off sounds from words (example: saying “coo” instead of “school”)

Adding sounds to words (example: saying “puhlay” instead of “play”)

Distorting sounds in words (example: saying “thith” instead of “this”)

Swapping sounds in words (example: saying “wadio” instead of “radio”)

If your child often makes certain word speech mistakes, he or she may have phonological process disorder. The mistakes may be common in young children learning speech skills. But when they last past a certain age, it may be a disorder. Signs of this problem are:

Saying only 1 syllable in a word (example: “bay” instead of “baby”)

Simplifying a word by repeating 2 syllables (example: “baba” instead of “bottle”)

Leaving out a consonant sound (example: “at” or “ba” instead of “bat”)

Changing certain consonant sounds (example: “tat” instead of “cat”)

How are speech sound disorders diagnosed in a child?

First, your child’s healthcare provider will check his or her hearing. This is to make sure that your child isn’t simply hearing words and sounds incorrectly.

If your child’s healthcare provider rules out hearing loss, you may want to talk with a speech-language pathologist. This is a speech expert who evaluates and treats children who are having problems with speech-language and communication.                       

By watching and listening to your child speak, a speech-language pathologist can determine whether your child has a speech sound disorder. The pathologist will evaluate your child’s speech and language skills. He or she will keep in mind accents and dialect. He or she can also find out if a physical problem in the mouth is affecting your child’s ability to speak. Finding the problem and getting help early are important to treat speech sound disorders.

How are speech sound disorders treated in a child?

The speech-language pathologist can put together a therapy plan to help your child with his or her disorder. These healthcare providers work with children to help them:

Notice and fix sounds that they are making wrong

Learn how to correctly form their problem sound

Practice saying certain words and making certain sounds

The pathologist can also give you activities and strategies to help your child practice at home. If your child has a physical problem in the mouth, the pathologist can refer your child to an ear, nose, throat healthcare provider or orthodontist if needed.

Spotting a speech sound disorder early can help your child overcome any speech problems. He or she can learn how to speak well and comfortably.

How can I help my child live with a speech sound disorder?

You can do things to take care of your child with a speech sound disorder:

Keep all appointments with your child’s healthcare provider.

Talk with your healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include experts such as speech-language pathologists and counselors. Your child’s care team will depend on your child’s needs and the severity of the speech sound disorder.

Tell others of your child’s disorder. Work with your child’s healthcare provider and schools to develop a treatment plan.

Reach out for support from local community services. Being in touch with other parents who have a child with a speech sound disorder may be helpful.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child has:

Symptoms that don’t get better, or get worse

New symptoms

Key points about speech sound disorders in children

A speech sound disorder means a child has trouble saying certain sounds and words past the expected age.

A child with an articulation disorder has problems making certain sounds the right way.

A child with phonological process disorder regularly makes certain word speech mistakes.

The cause of this problem is often unknown.

A speech-language pathologist can help diagnose and treat a speech sound disorder.

Tips to help you get the most from a visit to your child’s healthcare provider:

Know the reason for the visit and what you want to happen.

Before your visit, write down questions you want answered.

At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

Ask if your child’s condition can be treated in other ways.

Know why a test or procedure is recommended and what the results could mean.

Know what to expect if your child does not take the medicine or have the test or procedure.

If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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What Is a Lisp?

can a speech impediment come back

A lisp is a speech impediment that specifically relates to making the sounds associated with the letters S and Z. Lisps usually develop during childhood and often go away on their own. But some persist and require treatment.

What Causes a Lisp?

There are no known causes of lisps. Some people think that using a pacifier after a certain age may contribute to lisps. They believe prolonged pacifier use can strengthen the muscles of the tongue and lips, making lisps more likely. However, pacifier usage is not a factor in every child with a lisp. Additionally, each child who uses a pacifier doesn't get a lisp.

Other possible causes of lisps include:

  • Tongue-tie — a condition where the tongue is tethered to the bottom of the mouth. This restricts its movement. Another name for a tongue-tie is ankyloglossia.
  • Problems with jaw alignment.
  • Simply having learned to say the sound incorrectly.

When Is Lisping a Concern?

Many young children have some kind of lisp as they learn to talk. It is one of the most common speech impediments. About 23% of speech-language pathologist clients have lisps. 

However, you may want to look into professional help if your child is still lisping after the age of 4 1/2. However, children as young as three years old can work on lisping with a speech-language pathologist.

Types of Lisps

There are four types of lisps:

  • Frontal lisp. This lisp occurs when you push your tongue too far forward, making a "th" sound when trying to words with S or Z in them.
  • Lateral lisp. Extra air slides over your tongue when making S and Z sounds, making it sound like there is excess saliva.
  • Palatal lisp. You touch your tongue to the roof of your mouth when making S and Z sounds.
  • Dental lisp. This lisp sounds like a frontal lisp. The difference is that instead of pushing the tongue through the teeth, it is pressing against the teeth.

Treatment for Lisps

Speech-language pathologists are specialists who can help children with lisps. They will evaluate what type of lisp your child has and then help them with it over a period of time. It can take anywhere from a few months to a few years to get rid of a lisp. If a child is older when they start working with a speech-language pathologist, it may take a longer time. 

Speech pathologists work with people who have lisps to help them recognize what their lisp sounds like and how to position their tongue in the correct place to make the sound. They do this by giving them exercises to do, like saying specific words or phrases with the sounds in them. Once your child has been working on their lisp for a while, your speech pathologist will engage them in conversation to challenge them to remember proper tongue placement.

If your child's lisp is from a tongue-tie, a doctor may recommend a simple in-office procedure called a frenotomy to reduce the tethering. They take a pair of scissors and snip the excess tissue holding the tongue down. If the tongue-tie is more severe, a surgery called a frenuloplasty may be required.

How to Find a Speech-Language Pathologist

Make sure that any speech-language pathologist you take your child to is licensed. In the US, each state has a different licensure process for speech-language therapists. They may also opt to get an additional certification from ASHA — the American Speech-Language-Hearing Association. Those who have this certification show they meet certain qualifications and follow ASHA's code of ethics. 

You should also make sure the speech-language therapist is child-friendly. You may be able to find this information on their website or by reading reviews online. In the session, you can also observe the interaction to make sure you are comfortable with how the therapist is treating your child.

After evaluation, the speech-language pathologist should be able to tell which type of lisp your child has. They should also be able to recommend exercises specific to that type of lisp to help your child. 

Other Types of Speech Impediments

Lisps are just one type of speech impediment. Other common speech impediments include:

  • Lambdacism. Trouble saying the letter L. People with lambdacism often use the R sound as a substitute.
  • Rhotacism. Difficulty with saying the letter R correctly.

The three most common speech impediments are sigmatism (lisping), lambdacism, and rhotacism. However, other people can also have trouble pronouncing the sounds associated with the letters K, G, T, D, and E. 

Home Remedies to Help Lisps

Whether or not your child sees a speech-language pathologist, there are things you can do at home to help your child's lisp, including:

  • Treat allergies and sinus problems that may lead to lisping.
  • Curb thumb sucking .
  • Have your child drink through a straw to build strength.
  • Encourage playtime with things like bubbles or horns.

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Exploring The Impact Speech Disorders Can Have On One's Mental Health

Speech disorders are a wide-ranging set of conditions that impact a person's ability to communicate. These conditions, ranging from stuttering to apraxia of speech, are increasingly common in the population.   Speech disorders, while primarily affecting communication abilities, also exert significant influence on an individual's mental health, often leading to psychological distress and social isolation. Implementing robust mental health support alongside speech therapy can help to address these intertwined challenges and enable individuals with speech disorders to lead healthier, fulfilling lives.

Understanding speech disorders

Speech disorders are a broad category of conditions that impact an individual's communication ability. Examples of these disorders can include stuttering, apraxia of speech, and dysarthria. These conditions interfere with developing and utilizing language skills, usually leading to speech deficits. The challenges posed by these disorders affect daily life, from straightforward communication tasks to more complex social interactions. 

For instance, an individual with a stutter may struggle with verbal expressions, while someone with a language disorder might find the nuances of social discourse challenging to grasp. Some individuals may seek out speech therapy to address these concerns. A professional speech and language pathologist can help those struggling with speech disorders to develop useful skills and coping mechanisms.

However, the ramifications of these disorders extend beyond communication and language. There's an underlying connection between speech disorders and the onset of mental disorders, including serious mental illness. The strain of coping with communication challenges can lead to psychological distress, and the potential stigma associated with these disorders can compound these mental health issues. This intricate connection can require a comprehensive approach that includes both speech therapy and mental health support.

Psychological impact of speech disorders

Language disorders can create a web of psychological complications, significantly affecting an individual's mental well-being. The difficulties in mastering communication skills and expressing oneself clearly can lead to heightened anxiety and feelings of low self-esteem. In more severe cases, these language difficulties can even precede conditions such as depression.

Additionally, language problems often foster a sense of isolation. Individuals struggling with these disorders may find it taxing to participate in significant interactions with others, feeling marginalized and alone. This sense of isolation can exacerbate existing psychological distress, creating a cycle of mental strain. This strain is magnified in societies that place a high value on eloquent speech and effective communication, turning the challenge of coping with a speech disorder into a cognitive resource issue. The persistent need to navigate a world designed for seamless communication while wrestling with a speech disorder can intensify the psychological burden, reinforcing the need for adequate mental health support alongside speech therapy.

Social implications of speech disorders

Generally speaking, the societal reactions and expectations surrounding speech disorders can significantly intensify the mental health struggles those dealing with these conditions face. A society prioritizing fluent speech can inadvertently create an environment where individuals with speech disorders face stigma, resulting in a heightened sense of isolation. Bullying or ostracization often emphasize this isolation, especially in settings that lack understanding or acceptance of these disorders. Such negative social experiences can lead to increased feelings of loneliness and can even trigger depressive symptoms. These societal implications extend beyond the individual, affecting their relationships, career prospects, and overall quality of life. The combination of societal pressures and personal struggles related to speech disorders can, in turn, significantly impact the mental well-being of those affected. Raising societal awareness, fostering a more inclusive and accepting environment for individuals coping with speech disorders, and providing them with robust mental health support can help them lead healthy and fulfilling lives

The importance of mental health support for people with speech disorders

As mentioned before, speech disorders can significantly impact an individual's mental health. This realization underscores the importance of comprehensive mental health support for those grappling with such conditions. Forbes provides a list of Quick Statistics About Voice, Speech, and Language from the NIDCD . Some of the findings include:

  • Five percent of U.S. children ages 3-17 have a speech disorder that lasted for a week or longer during the past 12 months.
  • Boys aged 3-17 are more likely than girls to have a voice, speech, language, or swallowing disorder (9.6 percent compared to 5.7 percent).
  • The prevalence of voice, speech, language, or swallowing disorders is highest among children ages 3-6 (11.0 percent), compared to children ages 7-10 (9.3 percent) and children ages 11-17 (4.9 percent).

Individuals affected by speech disorders can benefit from access to various mental health interventions, including therapy and counseling. These interventions can provide coping strategies and mental resilience to manage the psychological stressors associated with speech disorders.

Effective mental health therapy also helps to alleviate associated conditions such as anxiety, depression, and self-esteem issues, which are often found alongside these disorders. In addition to individual therapy, societal support can be pivotal in creating an environment conducive to the well-being of those with speech disorders. Raising awareness, promoting understanding, and fostering inclusivity can help reduce these disorders' mental health impact.

Seeking professional support online

Online therapy services like BetterHelp can be a beneficial option when considering mental health support for those grappling with speech disorders. Online therapy offers a comfortable and safe environment which can be particularly advantageous for individuals who may feel self-conscious about their speech in a traditional face-to-face setting. In the context of mental health implications of speech disorders, the availability of online therapy can be a valuable tool in a comprehensive support plan, fostering a space for coping, resilience, and understanding.

Online therapy is also effective. A systematic review revealed that telepractice, including online therapy, has demonstrated feasibility, efficacy, diagnostic accuracy, and non-inferiority across various speech-language pathology services . This review shows the potential of online therapy as a service model in speech-language pathology for adults.

Though primarily affecting an individual's ability to communicate effectively, speech disorders can also significantly influence psychological well-being and social interactions. Mental health support, including interventions like online therapy, can address these intertwined challenges. With the right support and understanding, individuals with speech disorders can effectively navigate their unique challenges, bolster their resilience, and improve their quality of life.

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  • Nov 1, 2023

Common Types Of Speech Impediments Explained

Updated: Dec 1, 2023

can a speech impediment come back

Speech impediments—a phrase is often thrown but hardly understood. They aren't character flaws or something to brush off lightly. Communication issues can make life tough for people who deal with them daily. Understanding speech impediment issues helps us show empathy and support for those with them.

Remember, living with a speech impediment isn't a choice—cope or conquer it is. As we learn more, we understand they are more than stutters or lisps. They're silent battles fought every day. This is an opportunity for us to lend support through enhanced understanding and shared respect.

In our daily interactions, we can make a significant impact. We can do this by listening, respecting their struggles, and appreciating their courage. Remember, understanding is the cradle of support. We learn, we grow, and together, we conquer.

Understanding Speech Impediments

Speech impediments involve troubles with voice or actual speech sounds—consonants, vowels, or both. They interfere with one's ability to communicate or articulate thoughts effectively. Some pose a significant hurdle socially, academically, or occupationally. To better support and relate to those with speech impediments, it helps to understand the different types and levels of challenges they face.

Navigating Stutters

Stutters usually stir up visual imagery of duplicated words or parts of words. However, stuttering is more complicated. It also includes longer sounds and pauses that disrupt speech fluency. You'll witness people begging for that elusive word to go off the tip of the tongue.

But what's the culprit? The answer is neurological. The brain and muscles working together for speech are not synchronized. People who stutter know what they want to say but need help to speak fluently.

Decoding Lisps

A lisp is another everyday speech impediment. The infliction is primarily with the letters S and Z. People with a lisp pronounce these sounds as "th." Witness someone say "thun" instead of Sun? That's a lisp playing its mischief.

Lisps originate from incorrect tongue placements in the mouth. If your tongue hits the front teeth when saying S and Z, that's called a lisp.

Apraxia of speech is another form of speech impediment and is quite nasty in its play. Apraxia of speech is different from stutters or lisps. Instead, it's an issue with the motor skill programming involved in speech.

People with apraxia struggle to coordinate the speech muscles in their brains. They understand the language perfectly and know what they wish to say. But the necessary complex motor movements evade them, disrupting smooth speech.

Another impediment to consider is dysarthria, resulting from nerve or muscle damage. It hinders speaking when these parts don't work well. Controlling the tongue and managing breath becomes difficult.

Dysarthria is different from stuttering. It needs help struggling to form words correctly. Dysarthria patients know what to say but struggle to say the words physically.

Phonological Disorders

This speech problem depends on knowing and using speech sound rules. Typically, younger children grapple with such issues while learning language rules. But when these problems persist and impact intelligibility, it's labeled a phonological disorder.

Individuals struggling with phonological disorders encounter set sound patterns they seemingly can't break. To outsiders, pronunciation errors may come across as child-like talk. But in reality, it's a complex issue requiring professional attention.

Selective Mutism

Selective mutism is when someone struggles to speak in specific social situations while being acceptable to others. It's often linked to shyness or social anxiety. Selective mutism usually begins in childhood and is often connected to extreme shyness or social anxiety.

Selective mutism can disrupt learning in school due to its impact on communication. In certain situations, someone with selective mutism can't speak due to anxiety, even if they know how to use language.

Vocal Cord Paralysis

Vocal cord paralysis is a speech problem caused by nerve damage from surgery, accidents, strokes, or tumors. The result? Difficulty in swallowing and even breathing. Speech production is severely affected when the vocal cords do not open and close smoothly.

People with vocal cord paralysis often have a hoarse or whispered speech. The pitch could be too high or low, making it easier to transition between pitches. But safety is also a concern due to difficulty swallowing, leading to recurring pneumonia and lung problems.

Articulation and Phonological Troubles

Finally, we touch on speech sound disorders, comprising articulation and phonological disorders. People with articulation disorders struggle to produce certain sounds, which makes their words hard to understand. Sounds are often switched or left out, making it harder to understand each other.

Phonological disorders, as we've discussed, relate to predictable, regular patterns of sound errors. Children with phonological disorders often substitute sounds made at the back of the mouth, such as "k" and "g," with front-mouth sounds like "t" and "d." In such cases, 'cat' might become 'tat,' and 'game' turns into 'dame.'

They learn sound patterns while learning language rules but don't stop using them as they age. This pattern then molds into a phonological disorder, impacting clear communication.

Woman helping teach child who has speech language disorder

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

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

On this page

When to see a doctor, complications.

Aphasia is a disorder that affects how you communicate. It can impact your speech, as well as the way you write and understand both spoken and written language.

Aphasia usually happens suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). The severity of aphasia depends on a number of things, including the cause and the extent of the brain damage.

The main treatment for aphasia involves treating the condition that causes it, as well as speech and language therapy. The person with aphasia relearns and practices language skills and learns to use other ways to communicate. Family members often participate in the process, helping the person communicate.

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Aphasia is a symptom of some other condition, such as a stroke or a brain tumor.

A person with aphasia may:

  • Speak in short or incomplete sentences
  • Speak in sentences that don't make sense
  • Substitute one word for another or one sound for another
  • Speak unrecognizable words
  • Have difficulty finding words
  • Not understand other people's conversation
  • Not understand what they read
  • Write sentences that don't make sense

Patterns of aphasia

People with aphasia may have different strengths and weaknesses in their speech patterns. Sometimes these patterns are labeled as different types of aphasia, including:

  • Broca's aphasia
  • Wernicke aphasia
  • Transcortical aphasia
  • Conduction aphasia
  • Mixed aphasia
  • Global aphasia

These patterns describe how well the person can understand what others say. They also describe how easy it is for the person to speak or to correctly repeat what someone else says.

Aphasia may develop slowly over time. When that happens, the aphasia may be labeled with one of these names:

  • Logopenic aphasia
  • Semantic aphasia
  • Agrammatism

Many people with aphasia have patterns of speech difficulty that don't match these types. It may help to consider that each person with aphasia has unique symptoms, strengths and weaknesses rather than trying to label a particular type of aphasia.

Because aphasia is often a sign of a serious problem, such as a stroke, seek emergency medical care if you or a loved one suddenly develop:

  • Difficulty speaking
  • Trouble understanding speech
  • Difficulty with word recall
  • Problems with reading or writing

From Mayo Clinic to your inbox

The most common cause of aphasia is brain damage resulting from a stroke — the blockage or rupture of a blood vessel in the brain. Loss of blood to the brain leads to brain cell death or damage in areas that control language.

Brain damage caused by a severe head injury, a tumor, an infection or a degenerative process also can cause aphasia. In these cases, the aphasia usually occurs with other types of cognitive problems, such as memory problems or confusion.

Primary progressive aphasia is the term used for language difficulty that develops gradually. This is due to the gradual degeneration of brain cells located in the language networks. Sometimes this type of aphasia will progress to a more generalized dementia.

Sometimes temporary episodes of aphasia can occur. These can be due to migraines, seizures or a transient ischemic attack (TIA). A transient ischemic attack (TIA) occurs when blood flow is temporarily blocked to an area of the brain. People who've had a are at an increased risk of having a stroke in the near future.

Aphasia can create numerous quality-of-life problems because communication is so much a part of your life. Communication difficulty may affect your:

  • Relationships
  • Day-to-day function

Difficulty expressing wants and needs can result in embarrassment, frustration, isolation and depression. Other problems may occur together, such as more difficulty moving around and problems with memory and thinking.

Jun 11, 2022

  • Clark DG. Approach to the patient with aphasia. https://www.uptodate.com/contents/search. Accessed May 24, 2022.
  • Aphasia. Merck Manual Professional Edition. http://www.merckmanuals.com/professional/neurologic_disorders/function_and_dysfunction_of_the_cerebral_lobes/aphasia.html#v1034169. Accessed May 24, 2022.
  • Clark DG. Aphasia: Prognosis and treatment. https://www.uptodate.com/contents/search. Accessed May 24, 2022.
  • Aphasia. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/aphasia/. Accessed May 24, 2022.
  • Aphasia. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/Pages/aphasia.aspx. Accessed May 24, 2022.
  • Crosson B, et al. Neuroplasticity and aphasia treatments: New approaches for an old problem. Journal of Neurology, Neurosurgery and Psychiatry. 2019; doi:10.1136/jnnp-2018-319649.
  • Elsner B, et al. Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. Cochrane Database of Systematic Reviews. 2019; doi:10.1002/14651858.CD009760.pub4.
  • Botha H, et al. Classification and clinicoradiologic features of primary progressive aphasia (PPA) and apraxia of speech. Cortex. 2015. doi:10.1016/j.cortex.2015.05.013.
  • Kasselimis DS, et al. The unbridged gap between clinical diagnosis and contemporary research on aphasia: A short discussion on the validity and clinical utility of taxonomic categories. Brain and Language. 2017; doi:10.1016/j.bandl.2016.10.005.
  • Clark H (expert opinion). Mayo Clinic. May 30, 2022.
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Here comes the Sun (Belt): With Harris running, the presidential map has shifted back

Headshot of Stephen Fowler.

Stephen Fowler

SHIFTING ELECTORAL BATTLEGROUND MAP

Vice President Harris waves during a packed campaign rally Tuesday in Atlanta.

Vice President Harris waves during a packed campaign rally Tuesday in Atlanta. John Bazemore/AP hide caption

For more on the 2024 race, head to the NPR Network's live updates page.

ATLANTA — President Biden’s decision to drop out of the presidential race may have reset the states considered up for grabs in November, as both major-party campaigns shift their attention to the Sun Belt once again.

The seven states decided by narrow margins in 2020 — Arizona, Georgia, Michigan, Nevada, North Carolina, Pennsylvania and Wisconsin — are the primary focus of Vice President Harris and former President Donald Trump with fewer than 100 days until Election Day — and with early voting set to begin in many places weeks before that.

Four years ago, Biden narrowly won all of those states except North Carolina by stitching together a diverse coalition of voters that also gave the campaign multiple pathways to win.

But following his disastrous debate performance a month ago, polling averages showed him losing to Trump nationwide, and trailing outside the margin of error in every battleground state except the so-called “Blue Wall” states of Michigan, Pennsylvania and Wisconsin.

Vice President Harris speaks during a campaign rally in Atlanta on July 30, 2024.

Harris tries to flip the script on Trump on the border during raucous Georgia speech

Now, with Harris replacing Biden as the likely Democratic nominee, early surveys of the new presidential race show a changing contest that is close, driven by a surge in Democratic enthusiasm and Harris winning back younger, nonwhite voters that had soured on Biden.

Those shifting coalitions point to improved chances for Democrats in the more diverse Sun Belt swing states of Arizona, Georgia, North Carolina and Nevada — and put the original battleground map back into place.

The latest NPR/PBS News/Marist national poll shows a statistical tie between Harris and Trump, both head to head and in a larger contest that includes minor party and independent candidates. Several state-level polls in swing states since Harris announced her candidacy show a tighter race as well.

The candidates themselves have both implicitly and explicitly acknowledged the altered political map. On the airwaves, both campaigns are launching multimillion-dollar ad buys in the key battleground states. Harris’ campaign is running a spot that highlights her background as a prosecutor and Trump’s video attacks Harris as weak on immigration issues.

Republican vice presidential candidate Sen. JD Vance, R-Ohio, speaks at the 2024 Republican National Convention on July 17 in Milwaukee.

JD Vance and the Republican vets who think America should do less, not more, abroad

Harris held a rally in Atlanta Tuesday night, the largest of the campaign so far, in front of thousands of supporters at Georgia State University’s Convocation Center.

"Georgia, it is so good to be back, and I am very clear: The path to the White House runs right through this state," Harris said to a filled 10,000-person arena. "And you all helped us win in 2020 — and we're gonna do it again in 2024!"

Trump and his vice presidential nominee, Ohio U.S. Sen. JD Vance, will hold a rally at the same location on Saturday.

Georgia in particular is seen as an opportunity for the Harris campaign to improve before Election Day.

Left: President Lyndon B. Johnson announcing he will not seek or accept the nomination for re-election and orders a halt to the bombing of North Vietnam, March 31, 1968. Image is a screen grab. Right: US President Joe Biden delivers a prime-time address to the nation in the Oval Office of the White House in Washington, DC, US, on Wednesday, July 24, 2024.

Biden's withdrawal from the race has echoes of LBJ

Nearly a third of the electorate is Black, Atlanta’s suburbs are home to a sizable share of moderate voters who have voted for Republicans and Democrats in past elections, and the Harris campaign says it is making record staffing investments.

“In Georgia, we're running the largest in-state operation of any Democratic presidential campaign cycle ever,” Harris campaign communications director Michael Tyler said to reporters. “Since the vice president began her candidacy, we've seen tremendous energy on the ground.”

The Trump campaign is not ceding focus on the Sun Belt, though.

Vance is campaigning in Nevada and Arizona this week, with a planned appearance at the U.S. southern border on Thursday.

Arizona and Georgia are also two primary states where Republicans' "Trump Force 47" campaign strategy to use volunteers to lead targeted get-out-the-vote efforts is in full swing.

As both Trump and Harris continue to make their case to voters in these swing states over the next three months, there are still several key events that could continue to shape the contour of the race, like Harris naming her vice presidential pick, the Democratic National Convention next month in Chicago and any potential debates between Trump and Harris before voting begins.

Harris is set to announce her running mate within days, and the campaign says they will do a series of rallies, a tour that will begin on Tuesday and take them to Philadelphia, western Wisconsin, Detroit, Raleigh, N.C., Savannah, Ga., Phoenix and Las Vegas.

NPR's Deepa Shivaram contributed reporting.

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Asking the right questions to grow our regional allied health workforce

by Flinders University

Asking the right questions to grow our regional allied health workforce

As regional Australia continues to struggle with workforce shortages in allied health professions, Flinders University researchers are looking to uncover what support and programs are needed to keep people living and working in rural and remote positions.

Led by Dr. Alison Dymmott from Flinders University's Caring Futures Institute, the team will survey regional physios, occupational therapists , speech pathologists and other allied health professionals about how to attract them to the regions, then support them to stay.

The first study is published in the journal BMC Health Services Research . The second study is published in the journal Rural and Remote Health .

"There is a pressing need for more allied health professionals in rural and remote Australia and this will only worsen with our aging population and an expanding NDIS that allied health professionals pay a key role in," says Dr. Dymmott, Academic Lead of Rural Allied Health in the College of Nursing and Health Sciences.

"It costs a lot of money to keep recruiting people to these positions and even once attracted, many people only stay for one to two years and leave.

"What is needed is support programs for career progression, alongside professional and personal support that may prevent people from feeling isolated while living and working in rural communities . Our survey is looking to determine what these programs should look like so they can be as effective as possible."

The online questionnaire is available now and the team is inviting all allied health professionals, supervisors and managers across Australia to take part, from both rural and remote settings, as well as those in metropolitan areas .

It takes around 15 minutes to complete and participants will have the opportunity to enter a draw to win a $250 voucher.

"We're hoping to hear from as many people as people, from those who have worked in remote settings to those who may have never ever considered it, all feedback will help us understand how best to assist our regional allied health workforce," says Dr. Dymmott.

The project builds upon Flinders University's years-long evaluation of the South Australian government's Allied Health Rural Generalist Pathway; a post-graduate work integrated education program designed to enhance early career allied health professionals' clinical capabilities and improve service delivery in rural settings.

A recent study by Dr. Dymmott and colleagues found the program had a positive impact on participants and consumers, while another study found the program was economically viable, with a positive return on investment when supporting trainees.

"Our research demonstrates that with the right support and training, allied health professionals can significantly impact the quality of care in regional and rural communities," says Dr. Dymmott.

"With a relatively small investment, the program can achieve substantial returns in terms of workforce stability and service quality in rural areas as it not only supports individual career development but also strengthens the entire health service network.

"However, our analysis also identified areas in need of improvement, including participants' work life balance and in some cases a lack of managerial support to complete the training.

"This highlights the program must continue to adapt to ensure the regions can attract and retain an allied health workforce and the best way to do that is to listen to the participants themselves."

Dymmott et al, The allied health rural generalist pathway: a cost consequence analysis, Rural and Remote Health (2024). DOI: 10.22605/RRH8557

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Warning of ‘Extreme’ Agenda, Biden Calls for Supreme Court Overhaul

In a speech in Austin, Texas, the president outlined a proposal that included term limits and an enforceable ethics code for the justices but that faces long odds in a divided Congress.

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Biden Calls for Supreme Court Reforms

The president outlined his proposals for major changes to the supreme court, including imposing term limits and creating an enforceable code of ethics on the justices..

We need a mandatory code of ethics for the Supreme Court, and we need it now. We’ve had term limits for presidents of the United States for nearly 75 years, after the Truman administration. And I believe we should have term limits for Supreme Court justices in the United States as well. I’m calling for a constitutional amendment. Called No One Is Above the Law Amendment. I mean this sincerely. It holds no immunity for crimes former president committed while in office. My fellow Americans, based on all my experience, I’m certain we need these reforms. We need these reforms to restore trust in the courts, preserve the system of checks and balances that are vital to our democracy. We’re also common sense reforms that a vast majority of the American people support, as well as leading constitutional law scholars, progressives and conservatives.

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By Katie Rogers

Katie Rogers covers the White House and reported from Austin, Texas.

  • July 29, 2024

President Biden, warning that the country’s courts were being weaponized as part of an “extreme and unchecked” conservative agenda, said on Monday that he would push for legislation that would bring major changes to the Supreme Court, including term limits and an enforceable code of ethics on the justices.

Mr. Biden detailed his plans in a speech at the Lyndon B. Johnson Presidential Library and Museum in Austin, Texas, his first public engagement since announcing his decision to end his presidential campaign last week.

His visit was initially scheduled to commemorate the 60th anniversary of the Civil Rights Act. But it quickly became a venue for Mr. Biden to begin buttoning up a 51-year legislative legacy while outlining an election-year intention to try to stop what many in his party feel is the Supreme Court’s ideological drift into conservatism.

The proposal would require congressional approval and has little hope of gaining traction in a Republican-controlled House and a divided Senate. In a social media post, Speaker Mike Johnson called the plan “dead on arrival” in the House. (Mr. Biden later said onstage that Mr. Johnson’s “thinking is dead on arrival.”)

Earlier this month, the court issued a 6-to-3 ruling that grants broad immunity to presidents from prosecution for actions they take while in office. Mr. Biden called for a constitutional amendment that would limit such immunity .

“For all practical purposes, the court’s decision almost certainly means that the president can violate the oath, flout our laws and face no consequences,” Mr. Biden said. “Folks, just imagine what a president could do trampling civil rights and liberties, given such immunity.”

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IMAGES

  1. How To Help Your Homeschooler with a Speech Impediment

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  2. 6 Types of Speech Impediments

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  3. 6 Types of Speech Impediments

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  4. Speech Impediment: What are Speech Impediments in Children

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  5. Types of Speech Impediment

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  6. Speech Impediment and Speech Impediment Types

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VIDEO

  1. What if Fridge can speech 😂🤣 #funny #telugu # #comedy

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  4. The Reason Why Speech Delayed Child Can’t Focus On Learning

  5. Speech Failure

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COMMENTS

  1. Speech Impediment: Types in Children and Adults

    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.

  2. Types of Speech Impediments

    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: Disfluency. Articulation errors. Ankyloglossia. Dysarthria. Apraxia. This article explores the causes, symptoms, and treatment of the different ...

  3. Speech Impairment: Types and Health Effects

    There are three general categories of speech impairment: Fluency disorder. This type can be described as continuity, smoothness, rate, and effort in speech production. Voice disorder. A voice ...

  4. Speech Impediment Guide: Definition, Causes, and Resources

    Back To Top. 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 ...

  5. Help for speech, language disorders

    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.

  6. Speech Sound Disorders in Children

    Key points about speech sound disorders in children. A speech sound disorder means a child has trouble saying certain sounds and words past the expected age. A child with an articulation disorder has problems making certain sounds the right way. A child with phonological process disorder regularly makes certain word speech mistakes.

  7. Speech disorder

    Speech disorders, impairments, or impediments, are a type of communication disorder in which normal speech is disrupted. This can mean fluency disorders like stuttering, cluttering or lisps.Someone who is unable to speak due to a speech disorder is considered mute. Speech skills are vital to social relationships and learning, and delays or disorders that relate to developing these skills can ...

  8. Lisps: What They Are and How to Deal With Them

    It is one of the most common speech impediments. About 23% of speech-language pathologist clients have lisps. However, you may want to look into professional help if your child is still lisping ...

  9. Can You Get Disability Benefits for a Speech Impairment

    Causes of Speech Impediments. Speech impairments frequently appear in adults as a result of a brain injury, tumor, or stroke. Adults who've undergone a laryngectomy (removal of the larynx, or voicebox) or glossectomy (removal of the tongue) to treat throat cancer will likely also have difficulty speaking clearly.

  10. Stuttering

    Symptoms. Stuttering symptoms may include: Having a hard time starting a word, phrase or sentence. Stretching out a word or sounds within a word. Repeating a sound, syllable or word. Brief silence for certain syllables or words, or pausing before or within a word.

  11. Common Speech Impediments: Causes, Symptoms, Treatment ...

    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.

  12. Learning to Speak Again After Brain Injury: How to Recover

    3) Use Speech Therapy Apps. The key to learning how to speak again after brain injury is to practice as much as possible. While participating in speech therapy is effective, individuals also need to practice speech exercises at home to optimize their recovery. An excellent way to do this is to download speech therapy apps onto your phone or tablet.

  13. Exploring The Impact Speech Disorders Can Have On One's ...

    Five percent of U.S. children ages 3-17 have a speech disorder that lasted for a week or longer during the past 12 months. Boys aged 3-17 are more likely than girls to have a voice, speech, language, or swallowing disorder (9.6 percent compared to 5.7 percent).

  14. Common Types Of Speech Impediments Explained

    Speech impediments—a phrase is often thrown but hardly understood. They aren't character flaws or something to brush off lightly. Communication issues can make life tough for people who deal with them daily. Understanding speech impediment issues helps us show empathy and support for those with them.Remember, living with a speech impediment isn't a choice—cope or conquer it is.

  15. Is a Lisp a Speech Impediment?

    A lisp is a functional speech disorder commonly called a speech impediment. A lisp is characterized by difficulty making specific speech sounds, such as /s/ and /z/. Incorrect tongue placement is the primary reason behind a lisp, resulting in difficulty articulating the /s/ and /z/ sounds. The exact causes of lisping are not universally agreed ...

  16. Stroke Affecting Speech: Diagnosis, Treatment, and Timeline

    Similar to dysarthria, apraxia of speech is a motor speech disorder. While researchers are still determining the exact areas of the brain involved, damage to Broca's area, a specific portion of the left insula, and/or the premotor cortex may lead to apraxia of speech. Apraxia of speech and aphasia often occur together, which may make ...

  17. 10 Most Common Speech Impediments & Language Disorders

    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.

  18. Aphasia

    Aphasia is a disorder that affects how you communicate. It can impact your speech, as well as the way you write and understand both spoken and written language. ... Aphasia usually happens suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent ...

  19. Britain shuts up shop as 100 far-Right rallies planned

    Speaking in Rotherham at a hotel housing migrants that was damaged during riots on Sunday, Angela Rayner, the Deputy Prime Minister, said people should "stay away" from any unrest.

  20. Riots Break Out Across UK: What to Know

    The country was bracing for more unrest, with fresh protests planned after a weekend of demonstrations turned into anti-immigrant riots.

  21. As Stock Markets Tumble, Experts Doubt a Fed Emergency Rate Cut is

    "There are no mulligans in monetary policy, unfortunately, but we'll probably look back and say, yes, they waited too long," Mr. Feroli said. "In real time, it didn't seem obvious."

  22. Violent, racist attacks have gripped several British cities. What ...

    The UK is facing the worst disorder it has seen in more than a decade, after outbreaks of far-right, anti-immigrant violence swept the country. Protests first broke out late last month, after an ...

  23. Who Are the Far-Right Groups Behind the U.K. Riots?

    After a deadly stabbing at a children's event in northwestern England, an array of online influencers, anti-Muslim extremists and fascist groups have stoked unrest, experts say.

  24. How Kamala Harris' candidacy changes the 2024 electoral map : NPR

    "Georgia, it is so good to be back, and I am very clear: The path to the White House runs right through this state," Harris said to a filled 10,000-person arena. "And you all helped us win in 2020 ...

  25. UK riots latest: MPs advised to work from home ahead of 100 far-Right

    MPs have been told to consider working from home as police brace for more than 100 far-Right demonstrations and 30 counter-protests tonight.

  26. Trump Declines to Back Away From 'You Don't Have to Vote Again' Line

    The exchange began when Ms. Ingraham told the former president: "They're saying that you said to a crowd of Christians that they won't have to vote in the future."

  27. Asking the right questions to grow our regional allied health workforce

    Use this form if you have come across a typo, inaccuracy or would like to send an edit request for the content on this page. For general inquiries, please use our contact form .

  28. Disinformation Fed Far-Right Riot in England After Deadly Stabbing

    The group chanted, "We want our country back" and "England 'til I die." The Metropolitan Police of London said more than 100 people had been arrested on offenses including violent ...

  29. Warning of 'Extreme' Agenda, Biden Calls for Supreme Court Overhaul

    In a speech in Austin, Texas, the president outlined a proposal that included term limits and an enforceable ethics code for the justices but that faces long odds in a divided Congress.