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Visual perceptual/visual motor deficit (Kathryn)

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Visual perceptual/visual motor deficit (Kathryn)

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Individuals with visual perceptual/visual motor deficit (VMD) exhibit poor hand-eye coordination, often lose their places when reading, and have difficulty with pencils, crayons, glue, scissors, and other fine motor activities. They may also confuse similar-looking letters, have trouble navigating their surroundings, or demonstrate unusual eye activity when reading or completing assignments. VMD affects the ability to understand information gathered through visual means. Sensory data obtained through seeing may be compromised due to defects in the way a person’s eyes move. These kinds of ocular defects can impair reading comprehension skills, lead to a short attention span, and negatively impact one’s ability to draw or copy information.

There are various visual perceptual skills:

Visual Memory

Visual Closure

Form Constancy

Visual Spatial Relationships

Visual discrimination

Visual Attention

Visual Sequential Memory

Visual Figure-ground

Strategies to support students with VMD

Use of large print books

Employ books on tape

Experiment with different paper styles

Use bold lines on paper so that students can attend to the spacing of letters and writing space

Using colour-coded lines on writing paper and indicating starting and stopping point

Allow the child to dictate creative stories

Suggest the use of pencil grips

Allow use of a computer/word processor

Provide tracking tools such as rulers and compasses

Play visual and memory-based games

Use reading guide highlight strips to help the child isolate text

Employ handwriting accommodation strategies

Beck, C. (2017, November 28). Strategies to Address Visual Perception Needs and Handwriting - The OT Toolbox. The OT Toolbox. https://www.theottoolbox.com/strategies-to-address-visual-perception/

seven-learning-disabilities-every-psychology-professional-should-study. (2020). Walden University. https://www.waldenu.edu/online-masters-programs/ms-in-psychology/resource/seven-learning-disabilities-every-psychology-professional-should-study

Visual Perceptual Motor Deficit - Integrated Learning Academy Boulder CO. (2015, October 2). Integrated Learning Academy. https://integratedlearningacademy.com/visual-perceptual-motor-deficit/

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 Nonverbal learning disabilities (Kathryn)

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 Nonverbal learning disabilities (Kathryn)

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While it may sound like nonverbal learning disabilities (NVLD) relate to an individual’s inability to speak, it actually refers to difficulties in decoding nonverbal behaviours or social cues. NVLD sufferers struggle with understanding body language, facial expressions and tone of voice, or the nonverbal aspects of communication. Successful interventions can be developed using a child’s strengths to compensate for weaknesses. For example, students who struggle with organization, flexibility, mathematical reasoning, and social skills can be helped by using their remarkable rote memory, attention to detail, auditory retention, and innate sense of fairness and integrity.

Practical Strategies:
- Share a teacher-parent journal that goes back and forth between school and home several times a week to monitor progress and problems.
- Adapt and adjust homework and classwork to the child's specific abilities.
- Share new content and work at least a week ahead of time. NLD children function well when they can slowly immerse themselves in the material and become more comfortable with it.
- Pair the child up with a class buddy that can help with missing notes, pacing and long-term assignments.
- NLD students can be targets for bullying. Ensure that there is adequate supervision and a buddy system where they have friends to eat with
- Respect the child when they tell you they 'can't'. They are reaching out for help
- consider classroom seating for sensory needs and ensure that tests are untimed and allow student to be relaxed.
- Give clear instructions for long-term projects and one on one meetings to explain and support.
- Consider assistive technology
- Praise often and never discipline in public or punitively

14 Ways to Help a Child with NLD Succeed - Smart Kids. (2014, August 31). Smart Kids -. https://www.smartkidswithld.org/getting-help/nld/14-ways-to-help-a-child-with-nld-succeed/

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Auditory processing disorder - strategies to support students (Kathryn)

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Auditory processing disorder - strategies to support students (Kathryn)

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In auditory processing disorder (APD), patients have difficulty processing sounds. The child may confuse the order of sounds or be unable to filter different sounds, like a teacher’s voice versus background noise. In APD, the brain misinterprets the information received and processed from the ear.

Practical strategies in the classroom

Provide a quiet area for independent work.

Let the student sit near the teacher and away from auditory distractions, like doors and windows.

Check-in frequently with the student to make sure they understand the work.

Provide an assistive listening device to make it easier to distinguish the teacher’s voice.

Give extra time for testing.

Give step-by-step instructions, and have the student repeat them.

Use attention-getting phrases like “This is important to know because….”

Decide with the student on a nonverbal signal to show that a key point is being made.

Say directions, assignments, and schedules out loud, and rephrase as needed.

Repeat key information throughout the lesson, and rephrase as needed.

Use visual tools, images, and gestures to enhance and support spoken lessons.

Break down test or classwork instructions into short, written steps.

Highlight keywords and ideas on worksheets.

Give written homework instructions.

Provide a list of homework assignments for the week (or day) so they can know what to expect.

Speak clearly and slowly when presenting new information.

Give material on a new concept to the student before it’s taught to the whole class (so the student can get familiar with it ahead of time).

Give a list of or highlight key vocabulary and concepts for upcoming lessons.

Give a short review or connection to a previous lesson before teaching something new.

Give the student an outline of the lesson.

Grade based on the student’s completion of the lesson goal. (For instance, don’t grade spelling errors if that’s not what the student was supposed to learn.)

Team, U. (2019, August 5). Classroom accommodations for auditory processing disorder. Understood.org. https://www.understood.org/en/articles/classroom-accommodations-for-auditory-processing-disorder

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Dyscalculia - Strategies to support students (Kathryn)

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Dyscalculia - Strategies to support students (Kathryn)

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Dyscalculia is a mathematics-related disability resulting from neurological dysfunction. Students who are diagnosed with Dyscalculia have average to above-average intellectual functioning and a significant discrepancy between their math skills and their chronological-age-peer norms.

Strategies used to support students:

Building math competence

- Keep step-by-step sample problems nearby. - can refer to and help student review the steps.

- Highlight operation signs, directions, and other important details in problems.
- Use acronyms to support operations like DMSBR (long division family - daddy, mommy, sister, brother, rover - divide, multiply, subtract, bring down and remainder) and other practical tools to help students refer to the steps and processes

- Check for accuracy at each step of the problem, instead of at the end, to stem frustration.
- Talk or write out the problem - Talking through a problem or writing it down in sentence form can help with seeing relationships between the elements. Even restating word problems in a new way can help with organizing information and seeing solutions.
- Draw math problems to help them visualise the question
- Use the CUBES or CHASE strategy to help with breaking down a word problem into manageable parts. Separating a problem into its component parts and working through them one at a time can help students focus, see connections and avoid overload.
- Using manipulatives and real life tools such as calculators to make the concepts less abstract and more practical.
- Short, frequent review sessions — every day, if necessary — help keep information fresh and applicable to the next new task. Creating written or drawn references such as cue cards, anchor charts or diagrams can help with quick reviews.
- Pre-teach component skills of algorithms and strategies to reduce processing demands
- Use graph paper for problem solving to help them structure and organise their work into parts and steps.
- Use games and motivational material to reinforce concepts

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Approximately 60% of students with dyslexia have at least one other diagnosis, most commonly: ADHD, another SLD, a developmental language disorder or speech language impairment, anxiety, oppositional defiant disorder, autism, or another disability. This website offers a really great chart highlighting some ways to differentiate between dyslexia and other common conditions!

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Identifying dyslexia can be more complicated when other health or developmental conditions are also present. As an educator or clinician, you're asked to find out if a reading difficulty is the result of dyslexia or some other condition that changes how the brain works. For example, is a student feeling anxiety because reading is so hard, or is anxiety keeping a student from reading with ease?

This article may help you map the shared territory, differentiating factors, and key questions to ask as you make your way through a comprehensive dyslexia evaluation.

Roughly 60% of those with dyslexia have at least one other diagnosis (Darweesh et al., 2020). Researchers have found that conditions co-occur because of the specific way biological, environmental, and protective factors interact in people's bodies and in their lives (Moll et al., 2020).

Here are some ideas to bear in mind:

A single risk factor, such as family income level or genetic differences, may lead to deficits in different areas.

Symptoms from multiple conditions can overlap. For example, problems with working memory are linked to both ADHD and dyslexia.

Conditions can develop independently of each other or one condition may develop as a result of another.

When people have more than one condition at the same time, the effects of each condition tend to be more severe (Willcutt et al., 2020).

Here's a brief overview of the conditions most commonly associated with reading disorders like dyslexia.

Attention-deficit/hyperactivity disorder (ADHD)

ADHD is the most common neurodevelopmental condition to occur alongside dyslexia. Between 25% and 40% of those with one condition also have the other (McGrath & Stoodley, 2019).

Other specific learning disorders (SLDs)

In studies, between 30% and 47% of those with dyslexia also have dysgraphia symptoms (Chung et al., 2020). Around 26% of those with dyslexia have symptoms of dyscalculia. Dysgraphia and dyscalculia can also occur together-around 36% of the time (Ashraf & Najam, 2020).

Developmental language disorder (DLD) or specific language impairment (SLI)

A 2019 study published in Child Development found that 43% of 8-year-old children with DLD also had dyslexia and 58% of children with dyslexia had DLD. With DLD/SLI, phonological difficulties may improve over time, but comprehension problems might continue.

Learn more about how sex and gender can influence diagnosis of DLD.

Anxiety

Studies show that around 21% of students with SLDs also have anxiety disorder (Visser et al., 2020). Researchers think there is a two-way relationship between anxiety and dyslexia.

When students are anxious, brain functions such as processing speed, visual attention, and task-switching abilities don't work as well. That's why a person with an anxiety disorder may develop reading difficulties. It's also true that students who are having reading difficulties become anxious when they're asked to read.

Oppositional defiant disorder (ODD) or conduct disorder (CD)

For some people, behavior disorders make it harder to learn to read. For others, reading difficulties can eventually lead to behavior problems. An accurate picture can be hard to piece together, especially if symptoms of ADHD are also present (Hendren et al., 2018).

Autism

Researchers estimate that autism and reading disorders overlap 6%-30% of the time. It's important to note that when autistic students have difficulty with reading comprehension, it is not usually related to decoding problems (Hendren et al., 2018).

Explore the WPS Guide to Autism Assessments and Resources.

Disabilities

When someone has a disability, its characteristics may affect the ability to read. For example, in one recent study, researchers found similar difficulties with word reading, non-word reading, and spelling among deaf students and students with dyslexia (Herman et al., 2019). Similarly, studies have shown that schizophrenia affects phonological processing, reading rate, vocabulary, working memory, and word reading (Vanova et al., 2020).

It's important to understand as much as possible about someone's background and their daily functioning so you can separate the effects of a disability from the construct you're measuring.
Are Your Assessments Equitable for People with Disabilities? Learn more here.
Here are a few ways to differentiate between dyslexia and other common conditions.

Difficulties with fluency, accuracy, and comprehension

Avoidance of reading

Difficulties with comprehension

For some, language impairment

Is there an underlying language impairment?

Does the student have difficulty decoding words and nonsense words?

Does the student work extra hard to read accurately ? (Hendren et al., 2018)

Attention difficulties, anxiety, task avoidance, reading difficulties in grades 3 and up-especially accuracy (Castro et al., 2020)

Do behavior difficulties occur primarily when academic or reading tasks are happening?

Did behavior difficulties begin before school age?

Dyslexia & dyscalculia:

Difficulties with visual working memory and task shifting, anxiety, lower self-esteem, distraction, or attention difficulties

Dyslexia & dysgraphia:

Difficulties with spelling, orthographic awareness, and rapid automatized naming (Chung et al., 2020)

Has the student received evidence-based instruction in the specific area of deficit?

Which specific skills present difficulties for the student?

Does the student have mild motor differences, which may link dysgraphia and dyslexia?

Students with DLD/SLI tend to do better on measures of orthographic processing, reading, semantics, and phonological memory than students with reading disorders alone (Spanoudis et al., 2019).

Can the student recognize orthographic patterns? This skill is not impaired in DLD/SLI alone.

Are auditory perception, verbal working memory, or processing speed impaired? Deficits could indicate DLD/SLI.

Are executive or motor issues also involved in preschool students? Deficits could point to DLD/SLI (Spanoudis et al., 2019).

Are fatigue or loss of sleep affecting a student's functioning?

Do anxiety interventions improve any reading skills?

Does the student experience anxiety only when asked to read?

Other key questions:

When did reading difficulties begin?

Do symptoms stay the same across different settings and contexts?

Do dyslexia symptoms change when the other condition is treated?

If a student has a psychological or physical disability, does it affect skills related to reading or taking assessments?

It can take time, experience, and a keen eye to discern between dyslexia and commonly co-occurring conditions. When you're clear about dyslexia comorbidity, you'll be better able to work with the student, their family, and your team to focus and prioritize interventions.
Download the WPS Dyslexia Assessment Tool Kit.
DYSLEXIA RESOURCES

Further Reading on Dyslexia

Check Out our Dyslexia Webinars

Check out our Dyslexia Assessment Toolkit
https://www.wpspublish.com/dyslexia-assessment-tool-kit
Do you have questions? Check out our Dyslexia FAQs

Research and Resources:

Darweesh, A. M., Elserogy, Y. M., Khalifa, H., Gabra, R. H. & El-Ghafour, M. A. (2020). Psychiatric comorbidity among children and adolescents with dyslexia.  Middle East Current Psychiatry   , 28. https://doi.org/10.1186/s43045-020-00035-y

Moll, K., Snowling, M. J., & Hulme, C., (2020). Introduction to the Special Issue "Comorbidities between reading disorders and other developmental disorders." Scientific Studies of Reading , , 1-6, DOI: 10.1080/10888438.2019.1702045

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The Most Common Comorbidities with Dyslexia

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A dyslexia comorbidity is the crossing of two or more conditions including ADHD, anxiety, autism, and more. Read our overview and assessment guide.

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Research suggests that those experiencing comorbidity between ADHD and dyslexia are predominantly found to to have the inattentive type of ADHD rather than the hyperactive-impulsive type. Phonics-based instruction that is systematic and explicit has the greatest evidence in the treatment of dyslexia. Such reading interventions for students with both dyslexia and ADHD have been shown to be effective regardless of medical intervention for the treatment of ADHD. While medical treatment for ADHD symptoms is effective in the reduction of these symptoms, research does not show that treatment for ADHD alone led to greater improvements in reading.

Additional common comorbid conditions with dyslexia are frequently reported and tend to be other specific learning disorders such as dysgraphia and dyscalculia. Reading disorders and dyscalculia have approximately a 40% comorbidity, whereas reading disorders and dysgraphia have a comorbidity of approximately 70%.

The other most commonly reported comorbidities with dyslexia are mental health disorders, both internalizing mental health conditions and externalizing mental health conditions. Internalizing conditions are inward-facing difficulties that occur in an individual and tend to not be overtly obvious to others, while externalizing problems involve more-apparent acting out within the environment and are outward facing.

Students with dyslexia are reported to have internalizing mental health conditions such as depression and anxiety two to five times more often than their non-dyslexic peers. Students with dyslexia also can exhibit externalizing mental health issues such as behaviors associated with impulse control, conduct disorders, and oppositional defiant disorders. It is not clear, however, how much of the higher incidence of externalizing behaviors among students with reading disorders precedes the reading problem or is the emotional result of it. Current trends in research suggest the possible explanation of the co-occurrence of dyslexia and behavioral disorders is each condition’s comorbidity with ADHD. ADHD commonly occurs with dyslexia, conduct disorders, and oppositional defiant disorder.

When a student receives a diagnosis of dyslexia or ADHD, it is very important to complete further assessment to determine the existence or nonexistence of other commonly occurring/comorbid conditions. When students are found to have comorbid conditions that can affect learning, a multimodal treatment plan is considered optimal. Unrecognized comorbidities can result in interventions that are not adequately specific to the student’s profile of learning challenges and needs.

7.4 The Role of Co-Morbidity in the Identification and Treatment of Dyslexia. Colorado Department of Education. (n.d.). Retrieved December 19, 2022, from https://www.cde.state.co.us/node/43723

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ADHD and Dyslexia: Why Do They So Often Co-Occur? (Madison)

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ADHD and Dyslexia: Why Do They So Often Co-Occur? (Madison)

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ADHD and Dyslexia: Why Do They So Often Co-Occur?

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ADHD is a problem with executive functions, like organization, attention, and planning. This may create other challenges. For example, kids with ADHD can struggle with working memory, which they need for reading. It’s common for kids with ADHD to also have other conditions. Research shows that learning disabilities and mental health issues impact kids with ADHD at higher rates than kids who don’t have ADHD.
According to a large study of kids with ADHD and learning disabilities:

65 percent struggled with written expression.

32 percent struggled with reading.

30 percent struggled with math.

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What is comorbidity? - YouTube

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Definition of speech and Language Impairments - Bianca

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Definition of speech and Language Impairments - Bianca

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According to the (U.S.) Department of Education for Individuals with Disabilities speech and language impairments can be defined as "Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.”

It is imperative to remember that there is a distinct difference between a speech disorder and language impairment. As they are different disorders, that means they are different and accommodated treating differently.

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Individuals with Disabilities Education Act

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Sec. 300.8 (c) (11) - Individuals with Disabilities Education Act

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(11) Speech or language impairment means a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance. Severe Discrepancyidea_regulations-template-default single single-idea_regulations pos…

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Orofacial Myofunctional Disorder (OMD)- Bianca

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Orofacial Myofunctional Disorder (OMD)- Bianca

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An orofacial myofunctional disorder (OMD) happens when the tongue moves forward abnormally during speech, swallowing, and rest postures. Many children who lack the ability to make the 'j',  's' or 'sh' sounds, they may make the 'th' instead. This disorder can be out grown with the correct redevelopment and training of the tongue.

The signs or symptoms of OMD are:

speech distortion, particularly a frontal lisp

chronic open mouth positioning

dental abnormalities, such as overjet and open bite

tongue thrust, or when the tongue pushes against teeth during speech or swallowing

difficulty with specific sounds, especially “s,” “sh,” and “j”

drooling, especially in children older than two

struggling to close lips when swallowing

The causes of OMD stream from multiple avenues, such as heredity, allergies, enlarge tonsils and adenoids, thumb sucking, and other  oral physiological problems.

The treatment given to children when diagnosed with OMD are but not limited to speech therapy, mouth exercises, practicing oral movements, etc... These treatments can go well into adulthood depending on the severity of OMD.

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Definition: Dysarthria is a motor speech disorder in which the muscles that are used to produce speech are damaged, paralyzed, or weakened. The person with dysarthria cannot control their tongue or voice box and may slur words.
Identification/Referral: Some symptoms of dysarthria are that a person may:

Speak more quickly, slowly or softly than intended.

Have speech that becomes slurred, mumbled, robotic or choppy.

Have difficulty moving his/her lips, jaw or tongue.

Sound hoarse, breathy or nasal.

These symptoms make it difficult for others to understand his/her speech.

A medical healthcare provider or speech-language pathologist will do tests and examine medical history to make a diagnosis.

This condition is caused by damage to certain areas of the brain from illness or injury.

Treatment is speech therapy.

Strategies and Accommodations for Students:

Students may be allowed to submit written instead of oral work.

The teacher should minimize noises and distractions in the classroom so the student can be understood and not have to repeat him/herself multiple times.

Non-verbal communication (such as writing or pointing) should be allowed and encouraged.

The teacher should encourage other students to listen attentively to the student with dysarthria and make an effort to understand.

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What is dysarthria?

Dysarthria (pronounced "dis-AR-three-uh") is a motor speech disorder that makes it difficult to form and pronounce words. Motor speech disorders occur when damage to your nervous system prevents you from fully controlling parts of your body that control speech, like your tongue, voice box (larynx) and jaw. Dysarthria makes it challenging to speak so that others can understand you.

Dysarthria can be developmental or acquired:

Developmental dysarthria happens due to brain damage during fetal development or at birth. For example, cerebral palsy can cause dysarthria. Children tend to have developmental dysarthria.

Acquired dysarthria happens as a result of brain damage later in life. For example, a stroke, a brain tumor or Parkinson's disease can lead to dysarthria. Adults tend to have acquired dysarthria.

People with dysarthria understand language. They know what they want to say and how to say it. It's just that muscle weakness makes speaking difficult.

What are the types of dysarthria?

There are six categories of dysarthria. They're grouped based on the specific part of your nervous system affected. Dysarthria may result from damage to various parts of your nervous system, including your brain and spinal cord (central nervous system) and the network of nerves that carry signals throughout your body ( peripheral nervous system).

Flaccid dysarthria results from damage to the lower motor neurons. The lower motor neurons are part of your peripheral nervous system. With flaccid dysarthria, your speaking may sound breathy and nasal.

Spastic dysarthria results from damage to the upper neurons on one or both sides of your brain. The upper neurons are part of your central nervous system. Your speaking may sound strained or harsh.

Ataxic dysarthria results from damage to the part of your brain called the cerebellum. Your cerebellum helps coordinate muscle movement. You may have trouble pronouncing vowels and consonants, and you may have difficulty placing emphasis on the right parts of a word when you're speaking.

Hypokinetic dysarthria results from damage to the part of your brain called the basal ganglia. The basal ganglia is a structure inside your brain that helps your muscles move. Hypokinetic dysarthria is associated with slow ("hypo"), monotone, rigid-sounding speech.

Hyperkinetic dysarthria also results from damage to your basal ganglia. It's associated with fast ("hyper") sounding and often unpredictable speech.

Mixed dysarthria includes a mix of two or more of the other five types. It's the most common type of dysarthria.

How common is dysarthria?

Dysarthria is more common in people with certain neurological conditions, such as:

Amyotrophic lateral sclerosis (ALS): Up to 30% of people with ALS (Lou Gehrig's disease) have dysarthria.

Multiple sclerosis (MS): Around 25% to 50% of people with MS get dysarthria at some point.

Parkinson's disease: Dysarthria affects 70% to 100% of people with Parkinson's disease.

Stroke: About 8% to 60% of people with stroke have dysarthria.

Traumatic brain injury: Some 10% to 65% of people with traumatic brain injury have dysarthria.

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Dysarthria (Slurred Speech): Symptoms, Causes & Treatment

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Dysarthria makes it difficult to control and coordinate your speaking muscles. Learn more about causes and common treatments, like speech therapy.

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Definition: Childhood apraxia of speech (CAS) is a motor-speech neurological disorder that affects some young children. Children with CAS know what they want to say, but are unable to form the words.
Identification/Referral: Some signs of CAS include:

Making inconsistent errors in speech.

Difficulty coordinating the movement from one syllable of a word to the next syllable.

Distorting sounds.

Attempting to say a word several times before saying it correctly.

Making errors in the tone, stress or rhythm of speech.

However, a speech-language pathologist must do tests and make a diagnosis of this disorder.

Treatment includes speech therapy.

Strategies and Accommodations for Students:

Students may be allowed to use electronic communication devices or sign language.

Students may need extra time on assignments.

Students may be allowed to submit non-verbal assignments.

Students may need extra help with speech and vocabulary.

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Overview

What is childhood apraxia of speech?

Childhood apraxia of speech (CAS) is a motor speech neurological (brain) condition that affects some young children as they learn to speak. Children with CAS know what they want to say, but are unable to form the words.

What is the difference between childhood apraxia of speech, developmental verbal dyspraxia and developmental apraxia of speech?

Childhood apraxia of speech, developmental verbal dyspraxia and developmental apraxia of speech refer to the same condition.

Apraxia means that you completely lose the ability to do something. Dyspraxia means that you partially lose the ability to do something with accuracy. The difference between the two terms is severity, with apraxia being the most severe.

You will see all three terms interchangeably used by different healthcare providers.

Who does childhood apraxia of speech affect?

Childhood apraxia of speech can affect any child. The cause of the condition is unknown.

Children may be more likely to have this condition if:

A child's language skills are stronger than their expressive communication and speech skills or if a child has limited to no speech.

A child has difficulties chewing foods, using a straw or drinking from a cup and processing what they feel in their mouth.

A child has difficulties with the development of reading, writing and spelling when they are school-aged.

A child has trouble with fine motor skills. For example, the child may have difficulty drawing or picking up small things.

How common is childhood apraxia of speech?

Childhood apraxia of speech is a rare condition that affects an estimated 1-2 out of every 1,000 children in the U.S.

How will childhood apraxia of speech affect my child?

Childhood apraxia of speech affects how your child communicates verbally. Children with CAS have trouble carrying out the movements of their mouth to produce speech accurately even though the child knows what they want to say.

Although your child's inability to speak is the reason for their diagnosis, they may also have trouble coordinating the movement of their mouth, lips and tongue. Some children with CAS may have trouble eating, but for many children with CAS, only their speech is affected.

Treatment should address the movement patterns required to produce speech appropriately and help to improve communication. Treatment may also include using supportive techniques such as augmentative communication (the use of voice output devices) or gesture communication, depending on the severity of their diagnosis.

Symptoms and Causes

What causes childhood apraxia of speech?

Childhood apraxia of speech occurs because of difficulty programming the movements needed for articulation (speech) to occur. The exact cause is unknown.

Children who have CAS may have interruptions in certain nerve pathways in their brains. These nerve pathways are responsible for planning the movements that are necessary for speech. In children who have CAS, the messages from their brain to the parts of their mouth used for speech are not being sent correctly.

Weakness or paralysis of the muscles involved in speech, including those of the lips, jaw and tongue, are not a cause of CAS.

In some cases, CAS is the result of an acquired brain injury, like a stroke, which causes nerve pathway interruptions in a person's brain.

There is also evidence that genetic conditions can lead to a CAS diagnosis. Studies show that a mutation of the FOXP2 gene leads to a severe form of CAS, along with other neurodevelopmental conditions like autism, attention-deficit/hyperactivity disorder and epilepsy. Research is ongoing to pinpoint the direct cause of CAS.

What are the red flags to know if my child has childhood apraxia of speech?

There are several red flags or signs that your child has apraxia of speech during early development. Red flags include:

Limited inventory of consonants and vowels (how many sounds your child makes with specific letters) and gaps in types of sounds like saying "pie" instead of "bye."

Limited rise and fall of voice (pitch) when speaking (intonation).

Only pronouncing words that have simple syllable shapes (part of a word that has one vowel sound), which are a combination of consonants "C" and vowels "V." A simple syllable shape consists of words with one C and one V, like the words "me" or "up."

Words appear then disappear quickly.

Your child leaves out sounds of words like saying "coo" instead of "school."

Signs that your child has apraxia of speech between birth and two years include:

Saying their first consonant after 12 months. Consonant sounds are not vowels (A, E, I, O, U).

Saying fewer than three consonants by 16 months.

Saying fewer than five consonants between 17 and 24 months.

Focusing on bilabial sounds of speech where the lips nearly close (P, B, M, W), alveolar sounds where the tongue connects with the upper part of the jaw (T, D, N, L, S) and nasal sounds where air passes through the nose for a sound that forms in the back of their mouth (M, N).

No velar or posterior sounds where the tongue touches the roof of their mouth (K and D) by 24 months.

What are the symptoms of childhood apraxia of speech?

The symptoms of CAS vary from child to child. In general, children affected by CAS usually understand the language but have difficulty with speaking and communicating. Symptoms for children with CAS include:

Making inconsistent errors in speech.

Difficulty coordinating the movement from one syllable of a word to the next syllable.

Distorting sounds.

Attempting to say a word several times before saying it correctly.

Making errors in the tone, stress or rhythm of speech.

Symptoms before 3 years of age

Signs and symptoms of CAS may appear at different stages of a child's life. Children younger than 3 years may:

Not make babbling or cooing sounds.

Use only a few different sounds.

Have trouble putting sounds together.

Take long pauses between sounds.

Say words differently each time.

Say their first words later than expected.

Have problems eating.

Symptoms after 3 years of age

Children diagnosed with childhood apraxia of speech who are older than 3 years may:

Have difficulty saying longer words clearly.

Have trouble imitating what other people say.

Be hard to understand, especially for people who don't know the child.

Have a flat or choppy speech pattern.

Grope, or search, for words by moving their mouth a few times before speaking.

Have more trouble speaking when nervous.

Diagnosis and Tests

How is childhood apraxia of speech diagnosed?

Childhood apraxia of speech is usually diagnosed by a speech-language pathologist (SLP). SLPs have extensive training and skill in treating speech disorders.

To diagnose CAS, an SLP will learn about your child's history, including any known medical problems. The SLP will also test your child's hearing, oral-motor skills and intonation (pitch) and the way they say sounds.

The SLP will also test your child's ability to speak by:

Checking for signs of mouth muscle weakness.

Checking how well your child makes consonant and vowel sounds.

Looking at nonspeech oral motor skills such as blowing, smiling, rounding lips and how quickly your child can move their mouth.

Observing how your child pauses or changes the pitch of their voice.

Observing how well others can understand what your child is saying.

Genetic testing can also determine if there is a genetic mutation that is responsible for causing symptoms of the condition. Your healthcare provider will examine a sample of your child's blood to identify any abnormalities of their genes.

Management and Treatment

How is childhood apraxia of speech treated?

Treatment for CAS may require more intense treatment than other speech sound conditions. Some children will visit their speech-language pathologist three to five times per week so they can develop their speaking ability.

Children with severe CAS symptoms may need treatment for several years, especially if they miss language development milestones throughout early childhood.

Treatment for CAS includes:

Enrolling in speech therapy to address syllables, words and phrases at a pace unique to fit the needs of your child.

Learning alternative means of communication like sign language or using electronic communication devices.

Practicing repetitive language exercises at home and outside of speech therapy.

Prevention

How can I prevent childhood apraxia of speech?

There is no way to prevent childhood apraxia of speech. It's a neurological condition tied to brain development.

Since some cases of CAS link to genetic mutations, if you plan on becoming pregnant, ask your healthcare provider about genetic testing to assess your risk of having a child with a genetic condition.

Outlook / Prognosis

What can I expect if I have a child with childhood apraxia of speech?

As your child grows, they may miss language development milestones, like saying their first words and using short sentences to express themselves. Developmental delays could prevent your child from learning in the classroom at the same level as their peers.

Children who have CAS do not outgrow the condition and there is no cure. Early treatment alleviates frustration that your child may show if they want to say something but are unable to communicate that message.

Your healthcare provider can make recommendations for treatment after a diagnosis and refer your child to a speech-language pathologist who will address your child's unique symptoms to improve their speech.

Living With

How do I take care of my child with childhood apraxia of speech?

Offering your child support as they grow is the best way you can take care of your child diagnosed with apraxia of speech. Your child will likely participate in one-on-one sessions with a speech-language pathologist (SLP). Your child's SLP may offer homework for your child to practice in between visits. Just like homework from a math class, it is important to help your child complete their speech assignments at the same rate as their educational assignments.

Follow up with your child's SLP to keep track of how much your child is improving and offer encouragement along their journey.

When should I see my healthcare provider?

If you notice symptoms or signs of CAS in your child, or if your child is missing language development milestones, like saying their first words or naming common objects, contact your healthcare provider for a referral to a speech-language pathologist.

If your child has trouble eating and coordinating movement with their mouth apart from speech, visit your healthcare provider immediately.

What questions should I ask my doctor?

Does my child need to see a speech-language pathologist?

What should I do if my child misses language development milestones?

Does my child need any language communication devices to speak?

A note from Cleveland Clinic
You might feel frustrated if you can't remember the name of a person you've met several times. If your child has CAS, they may experience a similar frustration when they know a person's name but are unable to formulate the correct sounds to express it. Your child's speech therapy treatment will be long-term to help them communicate, and treatment significantly improves their symptoms. Offer support and encouragement as your child reaches new milestones for communication each day.

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Childhood Apraxia of Speech (CAS) / Developmental Verbal Dyspraxia (DVD) / Developmental Apraxia of Speech (DAS)

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Childhood apraxia of speech (CAS) is a motor speech neurological (brain) condition that affects some young children as they learn to speak. Children with CAS know what they want to say, but are unable to form the words. Childhood apraxia of speech, developmental verbal dyspraxia and developmental apraxia of speech refer to the same condition.

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Definition: Articulation disorder is a common condition when your child can’t make specific sounds. For example, they may always replace “r” with “w” or “th” with “s.” The disorder isn’t related to any issues with their brain, mouth or hearing.
Identification/Referral: There are four main types of articulation errors:

Addition: Adding sounds or syllables to words that don’t belong there (for example, “puh-lay” instead of “play”).

Distortion: Changing a sound, which might seem like a lisp (when “s” sounds like “th”).

Omission: Leaving certain sounds out of their speech altogether (for example, never using “sc” in “school or “scratch”).

Substitution: Always substituting one sound for another (for example, using “s” instead of “th” or “w” in place of “r”).

However, a speech-language pathologist will need to perform tests and consider the child's medical history to make a diagnosis.

The treatment is speech therapy.

Strategies and Accommodations for Students:

Students may be allowed to read silently instead of out loud in front of the class to reduce anxiety.

Grading may be modified to accommodate articulation errors.

The teacher should be patient, kind, and model correct articulation.

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Overview

What is articulation disorder?

Most children learn to make all speech sounds by age 4 or 5. Children who have trouble speaking clearly after that age may have a speech sound disorder. One type of speech sound disorder is articulation disorder, which involves problems producing specific speech sounds.

Articulation is the process humans go through to produce sounds, syllables and words. A child with articulation disorder may be unable to produce certain sounds or form particular sounds incorrectly. It can make the child's speech hard to understand and affect socialization and learning.

The condition is sometimes called functional speech disorder or articulation delay.

What is the difference between articulation vs. phonological disorder?

Articulation disorder and phonological disorder are similar and often confused. But it's important to differentiate between the two because treatments vary.

Children with articulation disorder have trouble with the motor functions required to make certain speech sounds. They can't coordinate their lips, tongue, teeth, palate (roof of their mouth) and lungs to produce certain sounds. They may form distorted speech sounds or swap out sounds they can't make. Articulation disorder examples include not forming the sound "th" and always using "f" instead.

With phonological disorder, children can produce sounds correctly but have trouble putting sounds together correctly. For example, your child may be able to make the sound "d" on its own. But when your child tries to say a word that starts with "d," they swap it out with a "g."

Your child can have both types of disorders at the same time.

Who might get articulation disorder?

Articulation disorder occurs in children. If it's not treated, the disorder may last into adulthood. If an adult develops a speech sound disorder, it's due to another reason ( traumatic brain injury or stroke).

Articulation disorders are more common in boys than girls for unknown reasons. A child is more likely to have a speech sound disorder if the mother had complications during pregnancy or delivery. A speech sound disorder is also more likely in a child whose family has a history of the condition.

How common are speech sound disorders?

Speech sound disorders are common, affecting 8% to 9% of children.

Symptoms and Causes

What causes articulation disorder?

Articulation disorder has no known cause. It doesn't mean something is wrong with your child's brain, nerves, lips, tongue, teeth, jaw, lungs or hearing.

There are other types of speech disorders, including organic, developmental or acquired. These are due to other conditions, such as structural abnormalities or hearing impairment.

What are some signs and symptoms of articulation disorder?

A child with articulation disorder may be difficult to understand. They exhibit one or more of four types of articulation errors:

Addition: Adding sounds or syllables to words that don't belong there (for example, "puh-lay" instead of "play").

Distortion: Changing a sound, which might seem like a lisp (when "s" sounds like "th").

Omission: Leaving certain sounds out of their speech altogether (for example, never using "sc" in "school or "scratch").

Substitution: Always substituting one sound for another (for example, using "s" instead of "th" or "w" in place of "r").

If your child becomes self-conscious of articulation disorder, they may display certain behaviors:

Avoid reading aloud or speaking to other people.

Become quiet or seem excessively shy.

Get frustrated when speaking.

Stop saying certain words altogether.

Struggle with confidence and self-esteem.

Diagnosis and Tests

How is articulation disorder diagnosed?

If your child has a speech disorder, your healthcare provider will conduct a physical exam and hearing test. These steps help rule out other conditions.

If a medical issue isn't causing the speech disorder, your healthcare provider will refer you to a speech-language pathologist (SLP). An SLP is an expert in speech, language and communication problems.

An SLP will evaluate your child in several ways:

Ask your child to make certain sounds and form specific words.

Chat with your child to assess connected speech during conversation.

Perform standardized diagnostic testing.

Consider your child's medical history, such as premature birth, previous ear infections and more.

Discuss any family history of speech disorders.

Look at the mouth's structure for any issues that may be contributing (for example, with their teeth and palate).

Take your child's accent and dialect into consideration.

Watch the movement of your child's mouth during speech.

Their SLP will use the observations and diagnostic testing to diagnose articulation disorder or another type of speech disorder.

They also may rate the severity of the articulation disorder from mild to severe. There are several ways to rate severity:

How much of your child's speech the SLP can understand.

Numbered scale, such as 1 to 10.

Percentage of consonants correct.

Management and Treatment

How do you fix articulation disorder?

To treat articulation disorder, your child's SLP will recommend speech therapy. Your child will work on speech during regular appointments and have assigned exercises and activities to do at home.

During speech therapy, your child's SLP uses a variety of activities and exercises to help them:

Identify the sounds they can't make.

Correct the way they create sounds.

Re-learn ways to control the motor parts of speech (for example, moving their tongue, shaping their lips).

Strengthen the muscles involved in speech.

Practice sound formation at home.

Prevention

How can I prevent articulation disorder?

There aren't any strategies to prevent articulation disorders. But you can prevent a speech disorder from becoming worse by seeking early treatment.

Outlook / Prognosis

What's the outlook for a child with articulation disorder?

Early diagnosis and therapy can help prevent speech problems from worsening or affecting learning and socialization.

A child with articulation disorder can learn to communicate clearly. More severe cases often require longer courses of speech therapy.

Living With

When should I talk to my pediatrician about speech disorders?

If you have any concerns about your child's speech or ability to communicate, talk to your pediatrician. This is particularly important if your child:

Has any behavioral issues related to talking.

Isn't forming certain sounds correctly by age 4 or 5.

Stops making particular sounds or words.

A note from Cleveland Clinic
A child with articulation disorder has trouble producing certain sounds involved in speech. If your child reaches age 4 or 5 and still can't form certain sounds, talk to your pediatrician. They'll determine whether there are any medical issues involved or recommend speech therapy.

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Articulation Disorder: What It Is, Types & Treatment

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Most children learn to make all speech sounds by age 4 or 5. Children who have trouble speaking clearly after that age may have a speech sound disorder. One type of speech sound disorder is articulation disorder, which involves problems producing specific speech sounds.

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Definition: Stuttering is a condition that happens when muscles you use for speaking twitch or move uncontrollably while you talk. This disrupts the flow of your speech and causes pauses, unintended sounds and sticking on words.
Signs and Symptoms for Identification/Referral: A person must have at least one of the following symptoms:

Repeating sounds or syllables. This usually happens on the first syllable of a word. You’ll repeat the sound or syllable until you can say the whole word and then resume speaking.

Holding and drawing out certain syllables or sounds. This is when you get stuck on a sound or syllable and draw out the sound longer than intended.

Mid-word pauses. This is when you pause for a noticeably long time at a point in a word where it’s unnecessary.

Blocking. This is frequent pausing — either silently or with a sound (like “um” or “ah”) — while you’re talking. Its name refers to feeling like something’s blocking your flow of words.

Word switching. This is when you stutter on a word or phrase and switch to a different word or phrase to get around it.

Overstressing. This means you put too much stress or tension on part or all of a word.

Repeating single-syllable words. This is repeating a word that consists of a single sound, such as “I” or “the.”

Strategies and Accommodations for Students:

Students may be allowed extra time on oral presentations or work.

Students may be allowed to do presentations in front of the teacher alone (instead of in front of the class), or submit a written assignment instead.

Teachers should always strive to make students feel comfortable, relaxed, and not punish them (including lowering their grade) for stuttering.

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Overview

What is stuttering?

Stuttering is a speech disorder that affects the rhythm and flow of how you talk. This disorder disrupts how you speak, causing unintended sounds, pauses or other problems with talking smoothly.

There are a few different subtypes of stuttering:

Developmental stuttering (child-onset fluency disorder). This is a neurodevelopmental disorder, meaning it happens because your brain develops differently than expected. This form starts when you're a child.

Persistent stuttering. This is developmental stuttering that continues into adulthood.

Acquired stuttering. This is stuttering you develop because of an illness or injury that affects your brain.

Stuttering is a specific type of fluency disorder. These fall under the overall category of speech impediments.

Who does stuttering affect?

Stuttering can happen to anyone, but men or people assigned male at birth (AMAB) are four times more likely to develop it. Age can affect the type of stuttering you have:

Developmental stuttering is always a childhood condition. It can start as early as age 2 or as late as age 7. The average age for it to start is around 3 years old, and 95% of children start before age 4.

Persistent stuttering is always an adult condition that begins during childhood.

Acquired stuttering can affect people of any age. It's more likely to happen with injuries or conditions that damage areas of your brain.

How common is this condition?

Childhood stuttering affects between 1% and 2.4% of children. Persistent stuttering affects about 0.3% to 1% of adults. There's limited research on how commonly acquired stuttering happens.

Symptoms and Causes

What are the symptoms of stuttering?

Talking takes coordination between muscles in your face, mouth, throat, chest and belly. Stuttering causes uncontrolled movements or spasms in the muscles you use for speaking.

Seven key symptoms make up the official criteria for stuttering, and you have to have at least one of them for a healthcare provider to diagnose it:

Repeating sounds or syllables. This usually happens on the first syllable of a word. You'll repeat the sound or syllable until you can say the whole word and then resume speaking.

Holding and drawing out certain syllables or sounds. This is when you get stuck on a sound or syllable and draw out the sound longer than intended.

Mid-word pauses. This is when you pause for a noticeably long time at a point in a word where it's unnecessary.

Blocking. This is frequent pausing - either silently or with a sound (like "um" or "ah") - while you're talking. Its name refers to feeling like something's blocking your flow of words.

Word switching. This is when you stutter on a word or phrase and switch to a different word or phrase to get around it.

Overstressing. This means you put too much stress or tension on part or all of a word.

Repeating single-syllable words. This is repeating a word that consists of a single sound, such as "I" or "the."

Other characteristics of stuttering

People who have this condition may also do or experience the following:

Spasm overflow. Muscle movements that cause stuttering can cause "overflow." That causes spasms to "spill over" to parts of your face, neck, shoulders and arms.

Gestures or actions that develop with and worsen when you stutter. People who stutter often develop movement habits that appear when they stutter. Examples include unusual blinking, looking away, grimacing your face and clenching your fists.

How you feel can affect the symptoms. Stuttering symptoms often worsen when you're tired, excited, anxious or stressed. It can also happen when you talk about new or complicated topics. Symptoms often get better when you're rested or relaxed.

Other vocal activities don't cause it. Stuttering usually doesn't happen during certain activities, like talking to objects or pets, reading aloud and singing.

Stuttering can contribute to other mental health conditions. Stuttering can cause feelings of frustration, embarrassment or shame. People who stutter are more likely to have mental health conditions like anxiety or depression.

What causes stuttering?

Experts don't fully understand why stuttering happens. However, they suspect that several factors can contribute to it.

Family history. You're three times more likely to stutter if you have a first-degree relative (a parent or sibling) who stutters.

Genetics. DNA mutations may contribute to stuttering. Genetics also seem to influence whether this condition improves or goes away over time.

Brain structure differences. People who stutter are more likely to have differences in certain brain areas. These are usually areas that control speaking muscles or muscle coordination.

Diagnosis and Tests

How is stuttering diagnosed?

A provider diagnosing stuttering will start with listening for any of the condition's symptoms. They'll also ask about your (or your child's) health history, when the symptoms started, and when they usually happen.

Your child's pediatrician will often diagnose your child's stuttering. This usually happens after you notice and mention the symptoms, or after your child's pediatrician notices symptoms during a checkup.

Most people with persistent stuttering received a developmental stuttering diagnosis as a child. However, it's possible - though rare - for adults with a persistent stutter not to have had a formal diagnosis during childhood.

Medical tests aren't usually necessary to diagnose developmental stuttering or persistent stuttering.

Acquired stuttering

Tests are likely if you begin stuttering unexpectedly as an adult. Stuttering like this can be a sign of aphasia. Conditions that can cause aphasia include traumatic brain injury (also known as TBI), strokes and brain tumors (including cancer).

These include imaging, diagnostic or lab tests. Examples include:

Management and Treatment

How is stuttering treated?

Speech therapy is the main form of treatment for all forms of stuttering. In children, this involves learning and activities that help stuttering symptoms improve until they go away. Speech therapy activities and techniques depend on the stuttering type, symptoms and severity. Therapy frequency and session length can also play a role.

Medications aren't common for treating stuttering directly. However, medications can treat mental health conditions like anxiety or depression, which often happen with and contribute to stuttering. Depression medicines (antidepressants) and anti-anxiety medications are examples of medications used this way.

Complications/side effects of treatments

The possible complications and side effects of stuttering treatments depend on the treatments themselves and other factors. Speech therapy typically has no risks of complications or side effects. Medication side effects or complications are rare but still possible.

Your healthcare provider can tell you more about possible complications and side effects. They can also explain ways to avoid or minimize the possible impacts.

Prevention

Is stuttering preventable?

The only form of stuttering that's preventable is acquired stuttering. The best way to prevent it is to prevent or reduce your risk of conditions like stroke or TBI.

Outlook / Prognosis

What's the outlook for this condition?

Stuttering isn't a dangerous condition, and most people recover from it. Treatment - especially speech therapy - can speed up recovery.

However, stuttering can seriously affect mental health. Nearly 40% of children between 12 and 17 who stutter also have conditions like anxiety or depression.

Adults who stutter are twice as likely to develop similar conditions and three times more likely to develop personality disorders. Diagnosis and treatment for mental health conditions can help limit how they affect stuttering.

How long does stuttering last?

Up to 90% of children with developmental stuttering will recover on their own by the time they turn 18. For those who recover fully, stuttering doesn't return unless it's acquired stuttering.

Persistent stuttering, while rare, does happen. When it does, it's usually a lifelong condition. However, it's still treatable, and many adults can learn to compensate for and manage it.

Acquired stuttering can be either permanent or temporary. This usually depends on what caused it. When it happens due to severe or permanent brain damage, it's likely that this type of stuttering will also be permanent. Your healthcare provider can explain what's most likely to happen in your case.

Living With

How do I take care of myself?

If your child has symptoms of developmental stuttering, you should talk to their pediatrician. Early diagnosis and treatment can help your child with speaking, and help them process and deal with feelings like embarrassment or shame.

If you have a persistent stutter, speech therapy can also help you. Speech therapy can help teach you ways to work around the condition's effects.

Mental health care

Caring for your or your child's mental health is always important, and it's even more important when you or your child has a condition like stuttering. Talking to a psychiatrist, therapist or another mental health professional can help with conditions like anxiety or depression.

Mental health care in children is especially important, as it can help reduce the severity of stuttering's effects on mental health. Children with stuttering are often the targets of teasing or bullying, making anxiety or depression about their condition even worse.

When should I see my healthcare provider?

If you or your child has stuttering, you should see your healthcare provider as recommended. Most children recover from stuttering and eventually won't need to see a provider for this condition.

When should I go to the ER?

The only form of stuttering that needs emergency medical care is acquired stuttering that appears suddenly, especially with any other stroke symptoms. When acquired stuttering develops gradually, it's important to see a healthcare provider as soon as you notice symptoms. Symptoms that appear and gradually worsen can be signs of other brain conditions.

Is stuttering a form of anxiety?

No, stuttering is a condition that's totally different from anxiety. However, there's a strong, two-way link between the conditions. That means stuttering can make anxiety develop or get worse, and stuttering often gets worse when you feel anxious.

Can a stutter be cured?

There's no cure for stuttering, but you can recover from it. Speech therapy and other treatments can help make recovery faster and easier.

Frequently Asked Questions

If my child has stuttering, what can I do to help them?

If your child has stuttering, you can do several things to help them:

Lead by example. Show your child how to speak at a slower, relaxed pace by doing so yourself.

Don't punish them for stuttering. This can have the opposite effect and make anxiety and other mental health effects of stuttering much worse.

Listen to them. Make sure your child knows they have your attention. Don't rush to talk when they finish. Talking to them at their eye level and with eye contact can also help.

Don't interrupt or focus on errors. Focus on what your child says, not how they say it. Avoid finishing their sentences or giving them advice while they're speaking.

Build their self-esteem. Praise what your child does well outside of how they talk. Tell them clearly when they do well in nonspeaking activities and how you feel about what they did.

Spend time with them. Time together with your child - without distractions like TV or devices - can help your child's confidence and mental health.

Don't make them feel they have to hide it. If your child stutters, let them know it's okay to talk about it. Discussing feelings of frustration or embarrassment may ease their negative feelings about the condition.

Make sure they know you support them. Be sure to tell your child that you support them no matter what. They need to hear that stuttering doesn't affect their worth as a person.

What is the difference between stuttering vs. stammering?

Historically, stuttering and stammering described two related - but not quite the same - disruptions in how you talk.

Stuttering. Repeatedly making the same sound while trying to speak.

Stammering. Repeated gaps or pauses while trying to speak.

Most people who stutter do both of these. Because these two usually happen together, it's common to use these terms interchangeably.
A note from Cleveland Clinic
Stuttering can be frustrating or embarrassing no matter your age when you develop it. It's common to feel anxious or ashamed of the condition. However, stuttering is a medical condition, and it's no reason to feel ashamed.

Many people recover from this condition and go on to become extremely successful. There's no shortage of famous or successful people who had stuttering, including world leaders, movie stars, professional athletes and more. Speech therapy and other treatment options can help you find the rhythm in your own words and make yourself confidently understood.

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Stuttering: What It Is, Causes, Treatment & Types

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Stuttering is a speech disorder that affects the rhythm and flow of how you talk. This disorder disrupts how you speak, causing unintended sounds, pauses or other problems with talking smoothly. There are a few different subtypes of stuttering: Developmental stuttering (child-onset fluency disorder).

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Michael:
The term “learning disabilities”, sometimes referred to as specific learning disabilities, is an umbrella term that covers a range of neurologically based disorders in learning and various degrees of severity of such disorders. Predecessor terms include: minimal brain damage and minimal brain dysfunction.

Broadly speaking, these disorders involve difficulty in one or more, but not uniformly in all, basic psychological processes: (1) input (auditory and visual perception), (2) integration (sequencing, abstraction, and organization), (3) memory (working, short term, and long term memory), (4) output (expressive language), and (5) motor (fine and gross motor).

Learning disabilities vary from individual to individual and may present in a variety of ways. Learning disabilities may manifest as difficulty: (1) processing information by visual and auditory, means, which may impact upon reading, spelling, writing, and understanding or using language, (2) prioritizing, organizing, doing mathematics, and following instructions, (3) storing or retrieving information from short or long term memory, (4) using spoken language, and (5) clumsiness or difficulty with handwriting.

Learning disabilities are not emotional disturbances, intellectual disabilities, or sensory impairments. They are not caused by inadequate parenting or lack of educational opportunity.

Cognitive assessment, including psychoeducational or neuropsychological evaluation, is of critical importance in diagnosing a learning disability. Learning disabilities may be diagnosed by qualified school or educational psychologists, by clinical psychologists, and by clinical neuropsychologists who are trained and experienced in the assessment of learning disabilities.

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Dorothy:
Comorbidity is defined as the “simultaneous presence of two or more diseases or medical conditions as a patient.” (Oxford Language 2022) A student with comorbidities may present differently in students in a classroom setting. A student may have ADHD and also have fine and gross motor difficulties. This might cause them to be easily frustrated as their brain is operating in overdrive, but they will struggle to carry out their tasks they are wanting to complete. One may also have both learning and language disabilities. This can make things more difficult and challenging for reading and writing, especially with areas of comprehension.