# data[].attributes.body
Genetic abnormalities

Emotional stress

Any trauma to brain or infection problems or changes in the structure or shape of the muscles and bones used to make speech sounds.

Damage to parts of the brain or the nerves (such as from cerebral palsy) Hearing loss.Acid from the stomach moving upward (GERD)

Cancer of the throat

Cleft palate or other problems with the palate

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

Laryngeal webs or clefts

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

Hearing loss

# data[].attributes.attachment_link.readable_text
Definition

A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others. This can make the child's speech difficult to understand.

Common speech disorders are:

Articulation disorders

Phonological disorders

Disfluency

Voice disorders or resonance disorders

Speech disorders are different from language disorders in children. Language disorders refer to someone having difficulty with:

Getting their meaning or message across to others (expressive language)

Understanding the message coming from others (receptive language)

Alternative Names

Articulation deficiency; Articulation disorder; Phonological disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering; Cluttering; Stammering; Childhood onset fluency disorder

Causes

Speech is one of the main ways in which we communicate with those around us. It develops naturally, along with other signs of normal growth and development. Disorders of speech and language are common in preschool age children.

Disfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be the most serious disfluency. It may be caused by:

Genetic abnormalities

Emotional stress

Any trauma to brain or infection

Articulation and phonological disorders may occur in other family members. Other causes include:

Problems or changes in the structure or shape of the muscles and bones used to make speech sounds. These changes may include cleft palate and tooth problems.

Damage to parts of the brain or the nerves (such as from cerebral palsy) that control how the muscles work together to create speech.

Hearing loss.

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

Acid from the stomach moving upward (GERD)

Cancer of the throat

Cleft palate or other problems with the palate

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

Laryngeal webs or clefts (a birth defect in which a thin layer of tissue is between the vocal cords)

Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or ulcers) on the vocal cords

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

Hearing loss

Symptoms

DISFLUENCY

Stuttering is the most common type of disfluency.

Symptoms of disfluency can include:

Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my doll. I...I see you.)

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

Making words longer (I am Boooobbby Jones.)

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

Tension in the voice or sounds

Frustration with attempts to communicate

Head jerking while talking

Eye blinking while talking

Embarrassment with speech

ARTICULATION DISORDER

The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."

Certain sounds (like "r", "l", or "s") may be consistently distorted or changed (such as making the 's' sound with a whistle).

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

PHONOLOGICAL DISORDER

The child does not use some or all of the speech sounds to form words as expected for their age.

The last or first sound of words (most often consonants) may be left out or changed.

The child may have no problem pronouncing the same sound in other words (a child may say "boo" for "book" and "pi" for "pig", but may have no problem saying "key" or "go").

VOICE DISORDERS

Other speech problems include:

Hoarseness or raspiness to the voice

Voice may break in or out

Pitch of the voice may change suddenly

Voice may be too loud or too soft

Person may run out of air during a sentence

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

Exams and Tests

Your health care provider will ask about your child's developmental and family history. The provider will do some neurological screening and check for:

Fluency of speech

Any emotional stress

Any underlying condition

Effect of speech disorder on daily life

Some other evaluation tools used to identify and diagnose speech disorders are:

Denver Articulation Screening Examination.

Leiter International Performance scale-3.

Goldman-Fristoe Test of Articulation 3 (GFTA-3).

Arizona Articulation and Phonology Scale 4th Revision (Arizona-4).

Prosody-voice screening profile.

A hearing test may also be done to rule out hearing loss as a cause of the speech disorder.

Treatment

Children may outgrow milder forms of speech disorders. The type of treatment will depend on the severity of the speech disorder and its cause.

Speech therapy may help with more severe symptoms or any speech problems that do not improve.

In therapy, the therapist may teach your child how to use their tongue to create certain sounds.

If a child has a speech disorder, parents are encouraged to:

Avoid expressing too much concern about the problem, which can actually make matters worse by making the child more self-conscious.

Avoid stressful social situations whenever possible.

Listen patiently to the child, make eye contact, don't interrupt, and show love and acceptance. Avoid finishing sentences for them.

Set aside time for talking.

Support Groups

The following organizations are good resources for information on speech disorder and its treatment:

Outlook (Prognosis)

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

Possible Complications

Speech disorders may lead to challenges with social interactions due to difficulty communicating.

When to Contact a Medical Professional

Call your provider if:

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

You think your child is in a high-risk group.

Your child is showing signs of a speech disorder.

Prevention

Hearing loss is a risk factor for speech disorders. At-risk infants should be referred to an audiologist for a hearing test. Hearing and speech therapy can then be started, if necessary.

As young children begin to speak, some disfluency is common, and most of the time, it goes away without treatment. If you place too much attention on the disfluency, a stuttering pattern may develop.

References

American Speech-Language-Hearing Association website. Voice disorders. www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/. Accessed April 12, 2022.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

Zajac DJ. Evaluation and management of speech disorders for the patient with cleft palate. In: Fonseca RJ, ed. Oral and Maxillofacial Surgery. 3rd ed. St Louis, MO: Elsevier; 2018:chap 32.

Version Info

Last reviewed on 2/24/2022

Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

# data[].attributes.attachment_link.title
Speech and Language Disorders - Symptoms and Causes

# data[].attributes.attachment_link.description
A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others.

# data[].attributes.body
Repetition of sounds, words, or parts of words or phrases after age 4

Putting in (interjecting) extra sounds or words

Making words longer

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

Tension in the voice or sounds

Frustration with attempts to communicate

Head jerking while talking

Eye blinking while talking

Embarrassment with speech

# data[].attributes.attachment_link.readable_text
Definition

A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others. This can make the child's speech difficult to understand.

Common speech disorders are:

Articulation disorders

Phonological disorders

Disfluency

Voice disorders or resonance disorders

Speech disorders are different from language disorders in children. Language disorders refer to someone having difficulty with:

Getting their meaning or message across to others (expressive language)

Understanding the message coming from others (receptive language)

Alternative Names

Articulation deficiency; Articulation disorder; Phonological disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering; Cluttering; Stammering; Childhood onset fluency disorder

Causes

Speech is one of the main ways in which we communicate with those around us. It develops naturally, along with other signs of normal growth and development. Disorders of speech and language are common in preschool age children.

Disfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be the most serious disfluency. It may be caused by:

Genetic abnormalities

Emotional stress

Any trauma to brain or infection

Articulation and phonological disorders may occur in other family members. Other causes include:

Problems or changes in the structure or shape of the muscles and bones used to make speech sounds. These changes may include cleft palate and tooth problems.

Damage to parts of the brain or the nerves (such as from cerebral palsy) that control how the muscles work together to create speech.

Hearing loss.

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

Acid from the stomach moving upward (GERD)

Cancer of the throat

Cleft palate or other problems with the palate

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

Laryngeal webs or clefts (a birth defect in which a thin layer of tissue is between the vocal cords)

Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or ulcers) on the vocal cords

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

Hearing loss

Symptoms

DISFLUENCY

Stuttering is the most common type of disfluency.

Symptoms of disfluency can include:

Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my doll. I...I see you.)

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

Making words longer (I am Boooobbby Jones.)

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

Tension in the voice or sounds

Frustration with attempts to communicate

Head jerking while talking

Eye blinking while talking

Embarrassment with speech

ARTICULATION DISORDER

The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."

Certain sounds (like "r", "l", or "s") may be consistently distorted or changed (such as making the 's' sound with a whistle).

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

PHONOLOGICAL DISORDER

The child does not use some or all of the speech sounds to form words as expected for their age.

The last or first sound of words (most often consonants) may be left out or changed.

The child may have no problem pronouncing the same sound in other words (a child may say "boo" for "book" and "pi" for "pig", but may have no problem saying "key" or "go").

VOICE DISORDERS

Other speech problems include:

Hoarseness or raspiness to the voice

Voice may break in or out

Pitch of the voice may change suddenly

Voice may be too loud or too soft

Person may run out of air during a sentence

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

Exams and Tests

Your health care provider will ask about your child's developmental and family history. The provider will do some neurological screening and check for:

Fluency of speech

Any emotional stress

Any underlying condition

Effect of speech disorder on daily life

Some other evaluation tools used to identify and diagnose speech disorders are:

Denver Articulation Screening Examination.

Leiter International Performance scale-3.

Goldman-Fristoe Test of Articulation 3 (GFTA-3).

Arizona Articulation and Phonology Scale 4th Revision (Arizona-4).

Prosody-voice screening profile.

A hearing test may also be done to rule out hearing loss as a cause of the speech disorder.

Treatment

Children may outgrow milder forms of speech disorders. The type of treatment will depend on the severity of the speech disorder and its cause.

Speech therapy may help with more severe symptoms or any speech problems that do not improve.

In therapy, the therapist may teach your child how to use their tongue to create certain sounds.

If a child has a speech disorder, parents are encouraged to:

Avoid expressing too much concern about the problem, which can actually make matters worse by making the child more self-conscious.

Avoid stressful social situations whenever possible.

Listen patiently to the child, make eye contact, don't interrupt, and show love and acceptance. Avoid finishing sentences for them.

Set aside time for talking.

Support Groups

The following organizations are good resources for information on speech disorder and its treatment:

Outlook (Prognosis)

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

Possible Complications

Speech disorders may lead to challenges with social interactions due to difficulty communicating.

When to Contact a Medical Professional

Call your provider if:

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

You think your child is in a high-risk group.

Your child is showing signs of a speech disorder.

Prevention

Hearing loss is a risk factor for speech disorders. At-risk infants should be referred to an audiologist for a hearing test. Hearing and speech therapy can then be started, if necessary.

As young children begin to speak, some disfluency is common, and most of the time, it goes away without treatment. If you place too much attention on the disfluency, a stuttering pattern may develop.

References

American Speech-Language-Hearing Association website. Voice disorders. www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/. Accessed April 12, 2022.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

Zajac DJ. Evaluation and management of speech disorders for the patient with cleft palate. In: Fonseca RJ, ed. Oral and Maxillofacial Surgery. 3rd ed. St Louis, MO: Elsevier; 2018:chap 32.

Version Info

Last reviewed on 2/24/2022

Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

# data[].attributes.attachment_link.title
Speech and Language Disorders - Symptoms and Causes

# data[].attributes.attachment_link.description
A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others.

# data[].attributes.body
which a person has problems creating or forming the speech sounds needed to communicate with others

# data[].attributes.attachment_link.readable_text
Definition

A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others. This can make the child's speech difficult to understand.

Common speech disorders are:

Articulation disorders

Phonological disorders

Disfluency

Voice disorders or resonance disorders

Speech disorders are different from language disorders in children. Language disorders refer to someone having difficulty with:

Getting their meaning or message across to others (expressive language)

Understanding the message coming from others (receptive language)

Alternative Names

Articulation deficiency; Articulation disorder; Phonological disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering; Cluttering; Stammering; Childhood onset fluency disorder

Causes

Speech is one of the main ways in which we communicate with those around us. It develops naturally, along with other signs of normal growth and development. Disorders of speech and language are common in preschool age children.

Disfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be the most serious disfluency. It may be caused by:

Genetic abnormalities

Emotional stress

Any trauma to brain or infection

Articulation and phonological disorders may occur in other family members. Other causes include:

Problems or changes in the structure or shape of the muscles and bones used to make speech sounds. These changes may include cleft palate and tooth problems.

Damage to parts of the brain or the nerves (such as from cerebral palsy) that control how the muscles work together to create speech.

Hearing loss.

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

Acid from the stomach moving upward (GERD)

Cancer of the throat

Cleft palate or other problems with the palate

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

Laryngeal webs or clefts (a birth defect in which a thin layer of tissue is between the vocal cords)

Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or ulcers) on the vocal cords

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

Hearing loss

Symptoms

DISFLUENCY

Stuttering is the most common type of disfluency.

Symptoms of disfluency can include:

Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my doll. I...I see you.)

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

Making words longer (I am Boooobbby Jones.)

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

Tension in the voice or sounds

Frustration with attempts to communicate

Head jerking while talking

Eye blinking while talking

Embarrassment with speech

ARTICULATION DISORDER

The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."

Certain sounds (like "r", "l", or "s") may be consistently distorted or changed (such as making the 's' sound with a whistle).

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

PHONOLOGICAL DISORDER

The child does not use some or all of the speech sounds to form words as expected for their age.

The last or first sound of words (most often consonants) may be left out or changed.

The child may have no problem pronouncing the same sound in other words (a child may say "boo" for "book" and "pi" for "pig", but may have no problem saying "key" or "go").

VOICE DISORDERS

Other speech problems include:

Hoarseness or raspiness to the voice

Voice may break in or out

Pitch of the voice may change suddenly

Voice may be too loud or too soft

Person may run out of air during a sentence

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

Exams and Tests

Your health care provider will ask about your child's developmental and family history. The provider will do some neurological screening and check for:

Fluency of speech

Any emotional stress

Any underlying condition

Effect of speech disorder on daily life

Some other evaluation tools used to identify and diagnose speech disorders are:

Denver Articulation Screening Examination.

Leiter International Performance scale-3.

Goldman-Fristoe Test of Articulation 3 (GFTA-3).

Arizona Articulation and Phonology Scale 4th Revision (Arizona-4).

Prosody-voice screening profile.

A hearing test may also be done to rule out hearing loss as a cause of the speech disorder.

Treatment

Children may outgrow milder forms of speech disorders. The type of treatment will depend on the severity of the speech disorder and its cause.

Speech therapy may help with more severe symptoms or any speech problems that do not improve.

In therapy, the therapist may teach your child how to use their tongue to create certain sounds.

If a child has a speech disorder, parents are encouraged to:

Avoid expressing too much concern about the problem, which can actually make matters worse by making the child more self-conscious.

Avoid stressful social situations whenever possible.

Listen patiently to the child, make eye contact, don't interrupt, and show love and acceptance. Avoid finishing sentences for them.

Set aside time for talking.

Support Groups

The following organizations are good resources for information on speech disorder and its treatment:

Outlook (Prognosis)

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

Possible Complications

Speech disorders may lead to challenges with social interactions due to difficulty communicating.

When to Contact a Medical Professional

Call your provider if:

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

You think your child is in a high-risk group.

Your child is showing signs of a speech disorder.

Prevention

Hearing loss is a risk factor for speech disorders. At-risk infants should be referred to an audiologist for a hearing test. Hearing and speech therapy can then be started, if necessary.

As young children begin to speak, some disfluency is common, and most of the time, it goes away without treatment. If you place too much attention on the disfluency, a stuttering pattern may develop.

References

American Speech-Language-Hearing Association website. Voice disorders. www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/. Accessed April 12, 2022.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

Zajac DJ. Evaluation and management of speech disorders for the patient with cleft palate. In: Fonseca RJ, ed. Oral and Maxillofacial Surgery. 3rd ed. St Louis, MO: Elsevier; 2018:chap 32.

Version Info

Last reviewed on 2/24/2022

Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

# data[].attributes.attachment_link.title
Speech and Language Disorders - Symptoms and Causes

# data[].attributes.attachment_link.description
A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others.

# data[].attributes.body
Avoid expressing too much concern about the problems.

Avoid stressful social situations whenever possible.

Listen patiently to the child, make eye contact,

Set aside time for talking.

American Institute for Stuttering

American Speech-Language-Hearing Association (ASHA)

The Stuttering Foundation

National Stuttering Association (NSA)

# data[].attributes.attachment_link.readable_text
Definition

A speech disorder is a condition in which a person has problems creating or forming the speech sounds needed to communicate with others. This can make the child's speech difficult to understand.

Common speech disorders are:

Articulation disorders

Phonological disorders

Disfluency

Voice disorders or resonance disorders

Speech disorders are different from language disorders in children. Language disorders refer to someone having difficulty with:

Getting their meaning or message across to others (expressive language)

Understanding the message coming from others (receptive language)

Alternative Names

Articulation deficiency; Articulation disorder; Phonological disorder; Voice disorders; Vocal disorders; Disfluency; Communication disorder - speech disorder; Speech disorder - stuttering; Cluttering; Stammering; Childhood onset fluency disorder

Causes

Speech is one of the main ways in which we communicate with those around us. It develops naturally, along with other signs of normal growth and development. Disorders of speech and language are common in preschool age children.

Disfluencies are disorders in which a person repeats a sound, word, or phrase. Stuttering may be the most serious disfluency. It may be caused by:

Genetic abnormalities

Emotional stress

Any trauma to brain or infection

Articulation and phonological disorders may occur in other family members. Other causes include:

Problems or changes in the structure or shape of the muscles and bones used to make speech sounds. These changes may include cleft palate and tooth problems.

Damage to parts of the brain or the nerves (such as from cerebral palsy) that control how the muscles work together to create speech.

Hearing loss.

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

Acid from the stomach moving upward (GERD)

Cancer of the throat

Cleft palate or other problems with the palate

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

Laryngeal webs or clefts (a birth defect in which a thin layer of tissue is between the vocal cords)

Noncancerous growths (polyps, nodules, cysts, granulomas, papillomas, or ulcers) on the vocal cords

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

Hearing loss

Symptoms

DISFLUENCY

Stuttering is the most common type of disfluency.

Symptoms of disfluency can include:

Repetition of sounds, words, or parts of words or phrases after age 4 (I want...I want my doll. I...I see you.)

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

Making words longer (I am Boooobbby Jones.)

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

Tension in the voice or sounds

Frustration with attempts to communicate

Head jerking while talking

Eye blinking while talking

Embarrassment with speech

ARTICULATION DISORDER

The child is not able to produce speech sounds clearly, such as saying "coo" instead of "school."

Certain sounds (like "r", "l", or "s") may be consistently distorted or changed (such as making the 's' sound with a whistle).

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

PHONOLOGICAL DISORDER

The child does not use some or all of the speech sounds to form words as expected for their age.

The last or first sound of words (most often consonants) may be left out or changed.

The child may have no problem pronouncing the same sound in other words (a child may say "boo" for "book" and "pi" for "pig", but may have no problem saying "key" or "go").

VOICE DISORDERS

Other speech problems include:

Hoarseness or raspiness to the voice

Voice may break in or out

Pitch of the voice may change suddenly

Voice may be too loud or too soft

Person may run out of air during a sentence

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

Exams and Tests

Your health care provider will ask about your child's developmental and family history. The provider will do some neurological screening and check for:

Fluency of speech

Any emotional stress

Any underlying condition

Effect of speech disorder on daily life

Some other evaluation tools used to identify and diagnose speech disorders are:

Denver Articulation Screening Examination.

Leiter International Performance scale-3.

Goldman-Fristoe Test of Articulation 3 (GFTA-3).

Arizona Articulation and Phonology Scale 4th Revision (Arizona-4).

Prosody-voice screening profile.

A hearing test may also be done to rule out hearing loss as a cause of the speech disorder.

Treatment

Children may outgrow milder forms of speech disorders. The type of treatment will depend on the severity of the speech disorder and its cause.

Speech therapy may help with more severe symptoms or any speech problems that do not improve.

In therapy, the therapist may teach your child how to use their tongue to create certain sounds.

If a child has a speech disorder, parents are encouraged to:

Avoid expressing too much concern about the problem, which can actually make matters worse by making the child more self-conscious.

Avoid stressful social situations whenever possible.

Listen patiently to the child, make eye contact, don't interrupt, and show love and acceptance. Avoid finishing sentences for them.

Set aside time for talking.

Support Groups

The following organizations are good resources for information on speech disorder and its treatment:

Outlook (Prognosis)

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

Possible Complications

Speech disorders may lead to challenges with social interactions due to difficulty communicating.

When to Contact a Medical Professional

Call your provider if:

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

You think your child is in a high-risk group.

Your child is showing signs of a speech disorder.

Prevention

Hearing loss is a risk factor for speech disorders. At-risk infants should be referred to an audiologist for a hearing test. Hearing and speech therapy can then be started, if necessary.

As young children begin to speak, some disfluency is common, and most of the time, it goes away without treatment. If you place too much attention on the disfluency, a stuttering pattern may develop.

References

American Speech-Language-Hearing Association website. Voice disorders. www.asha.org/Practice-Portal/Clinical-Topics/Voice-Disorders/. Accessed April 12, 2022.

Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 52.

Trauner DA, Nass RD. Developmental language disorders. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

Zajac DJ. Evaluation and management of speech disorders for the patient with cleft palate. In: Fonseca RJ, ed. Oral and Maxillofacial Surgery. 3rd ed. St Louis, MO: Elsevier; 2018:chap 32.

Version Info

Last reviewed on 2/24/2022

Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Speech and Language Disorders - Symptoms and Causes

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

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Working with people who have a speech impairment

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In my classroom, i would have my kids work with a speech person to help and guide them and what to do and how to help them. By doing this it will help guide them and if a student asks i would explain to them what a stutter is and how it isn't a bad thing .