Some Common Speech Disorders

When you were younger and first began talking, you may have lisped or stuttered; and if you did, your relatives probably considered it cute. If you're in your teens and still stuttering, though, you may not feel like it's so endearing.

You're not alone. More than 3 million Americans have the speech disorder known as stuttering (or stammering, as it's known in Britain). It's one of several conditions that can affect a person's ability to speak clearly.

Stuttering is a problem that interferes with fluent speech. A person who stutters may repeat the first part of a word (as in wa-wa-wa-water) or hold a single sound for a long time (as in caaaaaaake). Some people who stutter have trouble getting sounds out altogether. Stuttering is complex, and it can affect speech in many different ways.

Cluttering is another problem that makes a person's speech difficult to understand. Like stuttering, cluttering affects the fluency, or flow, of a person's speech. However, the difference is that cluttering is a language disorder, while stuttering is a speech disorder. A person who stutters has trouble getting out what they want to say, and a person who clutters says what they are thinking, but it becomes disorganized while actually speaking. Because of this disorganization, someone who clutters may speak in bursts or pause in unexpected places. The rhythm of cluttered speech may sound jerky, rather than smooth, and the speaker is often unaware of the problem.

Articulation disorders encompass a wide range of errors people can make when talking. Substituting a "w" for an "r" ("wabbit" for "rabbit"), omitting sounds ("cool" for "school"), or adding sounds to words ("pinanio" for "piano") are examples of articulation errors. Lisping refers to specific substitution involving the letters "s" and "z." A person who lisps replaces those sounds with "th."

Apraxia (dyspraxia), also known as oral-motor speech disorder, is a problem with motor coordination or motor planning. A person with this speech problem has difficulty moving the muscles and structures necessary to form speech sounds into words.

Normal speech might seem effortless, but it's actually a complex process that requires precise timing, nerve, and muscle control.

When we speak, we must coordinate many muscles from various body parts and systems, including the larynx, which contains the vocal cords; the teeth, lips, tongue, and mouth; and the respiratory system.

The ability to understand language and produce speech is coordinated by the brain. So a person with brain damage from an accident, stroke, or birth defect may have speech and language problems. Apraxia is thought to be due to a brain impairment that may or may not show up on brain magnetic resonance imaging (MRI) tests.

Some people with speech problems, particularly articulation disorders, may have hearing problems. Even mild hearing loss may have an impact on how a person reproduces the sounds they hear. Certain birth defects, such as a cleft palate, can interfere with someone's ability to produce speech. When a person has a cleft palate there is a hole in the roof of the mouth, which affects the movement of air through the oral and nasal passages. There also may be problems with other structures needed for speech, including the lips, teeth, and jaw.

Genetics may also play a role in some speech problems. For example, stuttering seems to run in some families. But in some cases, no one knows exactly what causes a person to have speech problems.

The good news is that treatments like speech therapy can help people of any age overcome some speech problems.

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

A speech-language pathologist is trained to observe people as they speak and to identify their speech problems. Speech-language pathologists look for the type of problem (such as a lack of fluency, articulation, or motor skills) someone has. For example, if you stutter, the pathologist will examine how and when you do so.

Speech-language pathologists may evaluate their clients' speech either by recording them on audio or videotape or by listening during conversation. A few clinics that specialize in fluency disorders may use computerized analysis. By gathering as much information as possible about the way someone speaks, the pathologist can develop a treatment plan that meets each individual's needs. The plan will depend on things like age and the type of speech disorder a person has.

If you're being treated for a speech disorder, part of your treatment plan may include seeing a speech therapist, a person who is trained to treat speech disorders.

How often you have to see the speech therapist will vary — you'll probably start out seeing him or her more frequently at first, then your visits may decrease over time. Most treatment plans include breathing techniques, relaxation strategies that are designed to help you relax your muscles when you speak, posture control, and a type of voice exercise called oral-motor exercises. You'll probably have to do these exercises each day on your own to help make your treatment plan as successful as possible.

Only people with speech problems know how frustrating it can be. People who stutter, for example, often complain that others try to finish their sentences or fill in words for them. Some feel like people treat them as if they're stupid, especially when a listener says things like "slow down" or "take it easy." (People who stutter are just as intelligent as people who don't.) People who stutter report that listeners often avoid eye contact and refuse to wait patiently for them to finish speaking. If you have a speech problem, don't hesitate to let others know how you like to be treated when speaking.

Some people look to their speech therapists for advice and resources on issues of stuttering. Speech therapists can often connect you with others in similar situations, such as support groups in your area for teens who stutter.

If you have a speech problem, achieving and maintaining control of your speech might be a lifelong process. Although speech therapy can help, you are sure to have ups and downs in your efforts to communicate. But the truth is that the way you speak is only a small part of who you are. Don't be embarrassed to make yourself heard!