a speech disorder that involves problem with flow of speech

Fluency vs Articulation Disorders: What's the Difference?

While fluency and articulation disorders may seem alike at a glance, they are distinct in their characteristics, from symptoms to intervention strategies.

Understanding these differences is key to addressing each disorder appropriately. In this article, our experts  will dissect both fluency and articulation disorders, shedding light on their core distinctions, underlying causes, early signs, and treatment methods.

In this article, we will discuss:

How Can You Distinguish Fluency vs. Articulation Disorders?

What is a Fluency Disorder? What is an Articulation Disorder? How Do You Treat Fluency vs Articulation Disorders?

When Should You Seek Professional Help?

Recognizing the difference between fluency and articulation disorders is crucial as each impacts speech in unique ways. Fluency disorders, such as stuttering, are characterized by interruptions in the flow of speech. These disruptions can include repetitions of sounds, syllables, prolongations of sounds, or blocks of airflow or voice during speech.

Articulation disorders, in contrast, involve difficulties in physically producing speech sounds, leading to distortions, substitutions, or omissions of sounds. Understanding these differences is fundamental to effectively address and treat each condition.

Conquer Fluency & Articulation Disorders Today!

What is a Fluency Disorder?

A fluency disorder, commonly known as stuttering, involves disruptions in the normal flow and timing of speech. This disorder is characterized not just by the physical symptoms but also by the emotional and psychological impact on the individual. Those with fluency disorders might experience anxiety or self-consciousness about speaking, further complicating the condition.

What Causes Fluency Disorders?

The causes of fluency disorders are complex and multifactorial. They can include genetic predisposition, neurological factors, and environmental influences. In some individuals, emotional and psychological factors may also contribute to the development or exacerbation of the disorder.

What are the Symptoms of Fluency Disorders?

The symptoms of fluency disorders are primarily related to the disruption of speech flow:

Repetitions: Repeating sounds, syllables, or words.

Prolongations:  Stretching out a sound.

Blocks:  Inability to produce sound.

Secondary Behaviors:  Physical gestures or facial movements used in an attempt to overcome speech disruptions.

What is an Articulation Disorder?

An articulation disorder is characterized by difficulties in physically producing speech sounds. It extends beyond simple pronunciation issues and involves challenges with the coordination of the mouth and speech organs for clear speech. Articulation disorders can make speech difficult to understand.

What Causes Articulation Disorders?

The causes of articulation disorders are diverse. They may stem from physical abnormalities like structural differences in the jaw or palate, including conditions such as cleft palate. Neurological issues affecting muscle control, and hearing loss, which limits auditory feedback necessary for developing accurate speech sounds, are also contributing factors.

What are the Symptoms of Articulation Disorders?

An articulation disorder is identified through specific types of speech errors:

Substitutions:  Replacing one sound with another.

Omissions:  Leaving out sounds in words.

Distortions:  Producing sounds in an unusual manner.

Additions : Inserting extra sounds into words.

How Do You Treat Fluency vs Articulation Disorders?

Treatment for fluency and articulation disorders requires distinct approaches, each tailored to the specific challenges of the condition.

Fluency Disorder Treatment:

Speech Therapy:  Focusing on techniques to improve the flow of speech.

Psychological Support: Addressing emotional and psychological aspects related to the disorder.

Techniques to Reduce Anxiety:  Helping to ease the stress associated with speaking.

Articulation Disorder Treatment:

Speech Therapy:  Teaching correct production of problematic sounds.

Motor Exercises : Improving coordination and movement of speech organs.

Practice and Repetition: Regular practice in different contexts.

Both disorders benefit from early intervention and personalized treatment plans. Speech-language pathologists play a crucial role in diagnosing and treating these disorders with a variety of techniques and strategies.

If signs of fluency or articulation disorders, such as speech disruptions or consistent speech sound errors, are observed, a professional evaluation is important. Early intervention is key in effectively addressing these disorders.

At Better Speech we know you deserve speech therapy that works. Our team specializes in diagnosing and treating a variety of speech and language disorders. Reach out to our skilled Speech-Language Pathologists for guidance on managing and improving communication skills. At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.

Frequently Asked Questions

Can someone have both a fluency and an articulation disorder.

Yes, it's possible for an individual to have both a fluency disorder like stuttering and an articulation disorder. This scenario requires a comprehensive approach in therapy, addressing both the fluency aspects and the articulation of specific sounds.

How effective is speech therapy for these disorders?

How long does it take to see improvement with speech therapy, how can parents support speech therapy for these disorders, how do fluency and articulation disorders impact school and work.

About the Author

Aycen Zambuto

I’m a seasoned educator in speech therapy with over six years of experience helping people navigate challenges in communication. Throughout this time, I’ve found joy in guiding individuals through a variety of therapeutic journeys, from toddlers with apraxia to seniors with dysphonia.

I’m passionate about demystifying this complex world of speech therapy and helping readers around the globe achieve clear and effective communication. When I’m not writing about speech, you’ll often find me reading, traveling or spending time with friends and family.

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Fluency Disorder

What is a fluency disorder.

Having a fluency disorder means you have trouble speaking in a fluid or flowing way. You may say the whole word or parts of the word more than once. Or you may pause awkwardly between words. This is called stuttering. You may speak fast and jam words together, or say "uh" often. This is called cluttering.

These changes in speech sounds are called disfluencies. Many people have a few disfluencies in their speech. But if you have a fluency disorder, you will have many disfluencies when you talk. Speaking and being understood may be a daily struggle.

What causes a fluency disorder?

Experts don’t know the exact causes of fluency disorders. They may be genetic and run in families. They can happen at the same time as another speech disorder. The symptoms of a fluency disorder can be made worse by emotions such as stress or anxiety.

Who is at risk for a fluency disorder?

Theories have included organic, behavioral, and psychological causes of fluency disorders. If members of your family have a fluency disorder, you may be at higher risk to develop one.

What are the symptoms of a fluency disorder?

A fluency disorder causes problems with the flow, rhythm, and speed of speech. If you stutter, your speech may sound interrupted or blocked. It may sound as if you're trying to say a sound, but it doesn't come out. You may repeat part or all of a word as you to say it. You may drag out syllables. Or you may talk breathlessly, or seem tense while trying to speak.

A different type of fluency disorder is called clutter. If you clutter, you often speak fast and blend some words together or cut off parts of them. You may sound like you're slurring or mumbling. And you may stop and start speech and say "um" or "uh" often when talking.

Some people use accessory or secondary behaviors to prevent or hide disfluencies. These can include:

• Covering your mouth or pretending to cough or yawn to cover up stuttering
• Not speaking, even when you want to or need to
• Not using certain words that seem to cause stuttering
• Pretending to forget what you wanted to say
• Changing the order of words in sentences
• Using "filler" sounds between words to make the rate of speech sound more normal

Children with fluency disorders also may develop beliefs that can hurt them later on. For instance, a child who stutters may decide that speaking is too hard. Feeling fear, anxiety, anger, and shame about speaking are also common.

How is a fluency disorder diagnosed?

Experts feel it's important to assess and address speech disorders early. Children who struggle with speech can find school and community activities challenging or painful. They can't communicate their thoughts. They may also have problems making friends.

A fluency disorder can be diagnosed by a speech-language pathologist (SLP). An SLP will ask about your health history and listen to you speak. You may have an oral-mechanism exam and have your speech-language skills tested.

How is a fluency disorder treated?

Once you're diagnosed, an SLP can use exercises and strategies to help you speak more fluently. A fluency disorder can't be cured. But an SLP uses different methods to help you manage speech day-to-day. These methods can reduce the number of disfluencies in your daily speaking.

An SLP can help you lower your own stress around moments of fluency problems. The SLP will work on changing your negative feelings, thoughts, and beliefs about your speech. They will help you reduce the use of accessory behaviors. You will learn strategies such as speaking in shorter sentences, and controlling your breathing and how fast you speak. An SLP will often talk with family, caregivers, and teachers about the disorder and how to help.

Living with a fluency disorder

If someone you know has a fluency disorder:

• Use available resources. Public schools are required to assess children with communication disorders. If the child meets certain criteria, the school must provide treatment services. If you have a child as young as age 3 with communication problems, contact your local public school’s office. Talk with the principal about assessment options.
• Be patient and supportive. It's frustrating to try to understand someone with a fluency disorder. But it can be much more frustrating for the person who has it. Be as patient as you can while the person works on their speech.
• Be kind. Making fun of a person with a fluency disorder is a form of bullying. It's destructive and may take away the person’s desire to communicate.
• Join a support group. Many fluency disorders, such as stuttering, have support groups. Spending time with other families coping with fluency disorders can be helpful.

When should I call my healthcare provider?

Call your healthcare provider if you have:

• Symptoms that get worse
• New symptoms

Key points about fluency disorders

• A fluency disorder causes problems with the flow, rhythm, and speed of speech.
• Stuttering is 1 example. Another type is cluttering. That's when you speak fast and jam words together or say “uh” often.
• It's important to assess and address speech disorders early.
• A fluency disorder can be diagnosed by a speech-language pathologist (SLP).
• A fluency disorder can’t be cured. But an SLP can use exercises and strategies to help you speak more fluently.

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

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

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• Special Education

• Understanding Speech Disabilities and Language Disorders

Speech disabilities and language disorders often intersect, but they are unique in their own right. As parents or caregivers of kids with special needs, it’s crucial to grasp the nuances of each , ensuring your child gets the best possible support. This article aims to shed light on this topic.

What are Speech Disabilities?

Speech disabilities refer to difficulties in producing sounds correctly or fluently, or problems with voice quality. It impacts the way a person communicates daily. Imagine knowing what you want to say, but the words just won’t come out right? Frustrating, isn’t it?

Types of speech disabilities

Speech disabilities and impairments come in many different forms, affecting individuals in different ways. The following are some of the types of speech disabilities explained shortly.

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Fluency disorder

Fluency disorder is characterized by disruptions in the flow of speech . An individual with fluency disorder might elongate a sound (like “sssssnake” for “snake”), repeat a sound or syllable (like “wa-wa-wa-water” for “water”), or experience unintended pauses. While these can happen to anyone occasionally, for someone with a fluency disorder, especially stuttering, it’s a consistent struggle. The person knows precisely what they want to say but faces interruptions in getting the words out smoothly.

Voice disorder

Your voice is like an orchestra, and every part of it needs to work harmoniously. However, a voice disorder disrupts this harmony. This can look like the pitch is too high or too low when compared to others of the same age, gender, or cultural background. Sometimes the voice might sound breathy, raspy, or strained . Picture a worn-out violin string – it doesn’t produce the right sound when played. Chronic hoarseness, vocal fatigue, or even pain when speaking are also common symptoms. Factors like vocal cord damage, tumors, or even certain behaviors, like excessive shouting, can lead to voice disorders.

Articulation disorder

Remember playing darts and missing the bullseye? That’s analogous to having an articulation disorder . It involves difficulties in pronouncing certain sounds, causing words to be slurred, omitted, substituted, or added . For instance, a child might say “wabbit” instead of “rabbit” or “thpoon” instead of “spoon.” The reasons can vary, from physical abnormalities like cleft palate to learned habits that just didn’t correct over time.

Language disorder

Language doesn’t just consist of words, it’s also about how the words are strung together. Putting words together in a sentence is a learned skill, and sometimes individuals with a language disorder may struggle with doing this. It could be difficult for individuals with language disorder to string together words to build sentences. They also can build sentences that are simpler compared to those built by their peers. Their vocabulary might be limited, or they might use words and phrases incorrectly. This isn’t about laziness or a lack of intelligence; it’s a genuine struggle with processing and producing language.

It’s not just about the words, but how they’re strung together. Someone with a language disorder might find it hard to put words together into sentences, or the sentences they form may be simplistic compared to their peers. Their vocabulary might be limited, or they might use words and phrases incorrectly. This isn’t about laziness or a lack of intelligence; it’s a genuine struggle with processing and producing language, relating to the receptive language .

Conversely, expressive disorders are like having a box full of puzzle pieces but not knowing how to fit them together. The ideas are there, waiting to be shared, but connecting them into coherent sentences is the obstacle. These children might have a limited vocabulary or rely heavily on generic words like “stuff” or “things.” They know what they want to express, but the words elude them, making conversations and storytelling challenging.

Understanding these speech disabilities provides a foundation for empathy and tailored support. Whether you’re a parent, caregiver, or educator, it’s about adapting and finding the tools to help these individuals find their voice.

Common causes and risk factors

Many factors can lead to speech and language disorders. It’s a blend of genetics, environmental factors, and sometimes, pure chance. Here’s a closer look:

Premature birth

Babies born before 37 weeks often face multiple challenges, one of which could be speech and language issues.

Genetic factors

Like eye or hair color, speech disorders can sometimes run in families.

Brain injury

Injuries, especially during crucial developmental years, can lead to speech or language issues.

Exposure to harmful substances

Alcohol or drugs during pregnancy can influence a child’s speech and language development.

Is a Speech Impediment Considered a Disability?

Defining disability in the context of speech impediments.

Not every speech impediment is considered a disability. However, if it significantly interferes with daily communication, it may be classified as one.

Legal considerations and rights

In many jurisdictions, speech impediments that impact one’s ability to communicate or learn might fall under disability rights. It ensures access to equal opportunities and protections.

Speech and Language Disorder: Key Differences

Understanding speech disorders.

These are issues with the “production” of sounds.

Understanding language disorders

This pertains to difficulty understanding or using words in context.

Language Disorder vs. Speech Disorder

In the vast area of communication, language and speech disorders present as intertwined threads , often mistaken for each other but holding distinct patterns and nuances. While speech disorders pertain to the physical act of voice production, like the clarity of pronunciation or rhythm of speaking, language disorders delve into the more intricate world of processing and conveying ideas.

Imagine having all the colors to paint but not knowing how to mix them to create the desired shade; that’s akin to having words but struggling to form coherent sentences, a hallmark of language disorders . On the other hand, speech disorders can be seen similar to having a slightly frayed brush, where the words are there, but their delivery is flawed. Recognizing the subtle dance between these two is pivotal for targeted therapeutic interventions and comprehensive understanding.

Overlapping symptoms and distinctions

While both deal with communication, speech is about how we say words, while language is about how we use these words to share ideas.

Diagnostic criteria and assessments

Specialists use various tools and observations to diagnose these disorders. One might involve analyzing how a child responds to instructions, while another might focus on how they pronounce certain words.

Speech Therapy and Special Education

In the realm of special education, speech therapy emerges as a cornerstone, bridging gaps and fostering communication growth for individuals with speech and language challenges. Speech-language pathologists work alongside educators, tailoring interventions that mesh seamlessly with educational curriculums.

Their combined efforts not only enhance the communicative abilities of these students but also bolster their confidence and self-esteem, equipping them to navigate the academic world and social landscapes with greater ease and efficacy. The synergy of speech therapy and special education showcases the profound impact of interdisciplinary approaches on holistic child development.

Educators, health professionals, and parents will work together to define special education eligibility and to create a unique special education plan called an Individualized Education Plan or IEP . It is also possible and sometimes logical to seek out alternative means of communication .

Role of speech therapy in special education settings

It’s immense! Speech therapists or pathologists work closely with special education professionals to design strategies and interventions to help children communicate better.

Understanding speech and language disorders is more than just deciphering terms. It’s about empathizing with the challenges many face daily and recognizing the significance of early interventions and therapies. By being informed, caregivers and parents can better advocate for their child’s needs and rights.

What’s the primary difference between speech and language disorders?

Speech disorders are about sound production, while language disorders focus on understanding or using words in context.

Is stuttering a fluency disorder?

Yes, stuttering is the most common type of fluency disorder.

Are all speech impediments disabilities?

Not necessarily. They’re only considered disabilities if they significantly impede daily communication.

How can speech therapy help my child?

Speech therapists use various techniques to improve sound production, fluency, and language understanding and use.

Do genetics play a role in speech disorders?

Yes, in some cases, speech or language disorders can run in families.

This article is examined by Clinical Child Psychologist and Ph. D. Researcher Kevser Çakmak, and produced by Otsimo Editorial Team.

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This post does not provide medical advice. See Additional Information.

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• is speech considered special education
• speech language disorder
• types of speech and language disorders
• what are language disorders

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Types of Speech Disorders: Causes, Symptoms, and Treatments

Understand the different types of speech disorders and the available treatments to help improve speech and communication.

Speech disorders are conditions that affect a person's ability to produce speech sounds correctly or fluently. There are several different types of speech disorders, each with its own unique causes, symptoms, and treatments.

Articulation disorders are the most common type of speech disorder. They occur when a person has difficulty pronouncing certain sounds or words. This can make their speech difficult to understand, and may lead to social, academic, and emotional difficulties. Treatment for articulation disorders typically involves working with a speech therapist to learn how to produce the correct sounds and to practice them regularly.

Another type of speech disorder is fluency disorders, which include stuttering and cluttering. These disorders affect a person's ability to speak fluently and smoothly, and may cause them to repeat sounds or words, pause frequently, or speak too quickly. Treatment for fluency disorders may involve therapy to help the person learn strategies to control their speech and reduce their anxiety about speaking.

Language disorders are another type of speech disorder that affect a person's ability to understand and use language correctly. This can make it difficult for them to communicate effectively, and may lead to academic and social difficulties. Treatment for language disorders typically involves working with a speech therapist to develop language skills through a range of activities and exercises.

Overall, there are many different types of speech disorders, each with its own unique causes, symptoms, and treatments. If you or someone you know is experiencing difficulties with speech or language, it's important to seek out the services of a qualified speech therapist for evaluation and treatment.

Ready to Start Your Speech Therapy Search?

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Health Encyclopedia

Fluency disorder, what is a fluency disorder.

Having a fluency disorder means you have trouble speaking in a fluid or flowing way. You may say the whole word or parts of the word more than once. Or you may pause awkwardly between words. This is called stuttering. You may speak fast and jam words together, or say "uh" often. This is called cluttering.

These changes in speech sounds are called disfluencies. Many people have a few disfluencies in their speech. But if you have a fluency disorder, you will have many disfluencies when you talk. Speaking and being understood may be a daily struggle.

What causes a fluency disorder?

Experts don’t know the exact causes of fluency disorders. They may be genetic and run in families. They can happen at the same time as another speech disorder. The symptoms of a fluency disorder can be made worse by emotions such as stress or anxiety.

Who is at risk for a fluency disorder?

Theories have included organic, behavioral, and psychological causes of fluency disorders. If members of your family have a fluency disorder, you may be at higher risk to develop one.

What are the symptoms of a fluency disorder?

A fluency disorder causes problems with the flow, rhythm, and speed of speech. If you stutter, your speech may sound interrupted or blocked. It may sound as if you're trying to say a sound, but it doesn't come out. You may repeat part or all of a word as you to say it. You may drag out syllables. Or you may talk breathlessly, or seem tense while trying to speak.

A different type of fluency disorder is called clutter. If you clutter, you often speak fast and blend some words together or cut off parts of them. You may sound like you're slurring or mumbling. And you may stop and start speech and say "um" or "uh" often when talking.

Some people use accessory or secondary behaviors to prevent or hide disfluencies. These can include:

Covering your mouth or pretending to cough or yawn to cover up stuttering

Not speaking, even when you want to or need to

Not using certain words that seem to cause stuttering

Pretending to forget what you wanted to say

Changing the order of words in sentences

Using "filler" sounds between words to make the rate of speech sound more normal

Children with fluency disorders also may develop beliefs that can hurt them later on. For instance, a child who stutters may decide that speaking is too hard. Feeling fear, anxiety, anger, and shame about speaking are also common.

How is a fluency disorder diagnosed?

Experts feel it's important to assess and address speech disorders early. Children who struggle with speech can find school and community activities challenging or painful. They can't communicate their thoughts. They may also have problems making friends.

A fluency disorder can be diagnosed by a speech-language pathologist (SLP). An SLP will ask about your health history and listen to you speak. You may have an oral-mechanism exam and have your speech-language skills tested.

How is a fluency disorder treated?

Once you're diagnosed, an SLP can use exercises and strategies to help you speak more fluently. A fluency disorder can't be cured. But an SLP uses different methods to help you manage speech day-to-day. These methods can reduce the number of disfluencies in your daily speaking.

An SLP can help you lower your own stress around moments of fluency problems. The SLP will work on changing your negative feelings, thoughts, and beliefs about your speech. They will help you reduce the use of accessory behaviors. You will learn strategies such as speaking in shorter sentences, and controlling your breathing and how fast you speak. An SLP will often talk with family, caregivers, and teachers about the disorder and how to help.

Living with a fluency disorder

If someone you know has a fluency disorder:

Use available resources. Public schools are required to assess children with communication disorders. If the child meets certain criteria, the school must provide treatment services. If you have a child as young as age 3 with communication problems, contact your local public school’s office. Talk with the principal about assessment options.

Be patient and supportive. It's frustrating to try to understand someone with a fluency disorder. But it can be much more frustrating for the person who has it. Be as patient as you can while the person works on their speech.

Be kind. Making fun of a person with a fluency disorder is a form of bullying. It's destructive and may take away the person’s desire to communicate.

Join a support group. Many fluency disorders, such as stuttering, have support groups. Spending time with other families coping with fluency disorders can be helpful.

When should I call my healthcare provider?

Call your healthcare provider if you have:

Symptoms that get worse

New symptoms

Key points about fluency disorders

A fluency disorder causes problems with the flow, rhythm, and speed of speech.

Stuttering is 1 example. Another type is cluttering. That's when you speak fast and jam words together or say “uh” often.

It's important to assess and address speech disorders early.

A fluency disorder can be diagnosed by a speech-language pathologist (SLP).

A fluency disorder can’t be cured. But an SLP can use exercises and strategies to help you speak more fluently.

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

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

Before your visit, write down questions you want answered.

Bring someone with you to help you ask questions and remember what your provider tells you.

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

Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

Ask if your condition can be treated in other ways.

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

Know what to expect if you do not take the medicine or have the test or procedure.

If you have a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your provider if you have questions.

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10 Most Common Speech-Language Disorders & Impediments

As you get to know more about the field of speech-language pathology you’ll increasingly realize why SLPs are required to earn at least a master’s degree . This stuff is serious – and there’s nothing easy about it.

In 2016 the National Institute on Deafness and Other Communication Disorders reported that 7.7% of American children have been diagnosed with a speech or swallowing disorder. That comes out to nearly one in 12 children, and gets even bigger if you factor in adults.

Whether rooted in psycho-speech behavioral issues, muscular disorders, or brain damage, nearly all the diagnoses SLPs make fall within just 10 common categories…

Types of Speech Disorders & Impediments

Apraxia of speech (aos).

Apraxia of Speech (AOS) happens when the neural pathway between the brain and a person’s speech function (speech muscles) is lost or obscured. The person knows what they want to say – they can even write what they want to say on paper – however the brain is unable to send the correct messages so that speech muscles can articulate what they want to say, even though the speech muscles themselves work just fine. Many SLPs specialize in the treatment of Apraxia .

There are different levels of severity of AOS, ranging from mostly functional, to speech that is incoherent. And right now we know for certain it can be caused by brain damage, such as in an adult who has a stroke. This is called Acquired AOS.

However the scientific and medical community has been unable to detect brain damage – or even differences – in children who are born with this disorder, making the causes of Childhood AOS somewhat of a mystery. There is often a correlation present, with close family members suffering from learning or communication disorders, suggesting there may be a genetic link.

Mild cases might be harder to diagnose, especially in children where multiple unknown speech disorders may be present. Symptoms of mild forms of AOS are shared by a range of different speech disorders, and include mispronunciation of words and irregularities in tone, rhythm, or emphasis (prosody).

Stuttering – Stammering

Stuttering, also referred to as stammering, is so common that everyone knows what it sounds like and can easily recognize it. Everyone has probably had moments of stuttering at least once in their life. The National Institute on Deafness and Other Communication Disorders estimates that three million Americans stutter, and reports that of the up-to-10-percent of children who do stutter, three-quarters of them will outgrow it. It should not be confused with cluttering.

Most people don’t know that stuttering can also include non-verbal involuntary or semi-voluntary actions like blinking or abdominal tensing (tics). Speech language pathologists are trained to look for all the symptoms of stuttering , especially the non-verbal ones, and that is why an SLP is qualified to make a stuttering diagnosis.

The earliest this fluency disorder can become apparent is when a child is learning to talk. It may also surface later during childhood. Rarely if ever has it developed in adults, although many adults have kept a stutter from childhood.

Stuttering only becomes a problem when it has an impact on daily activities, or when it causes concern to parents or the child suffering from it. In some people, a stutter is triggered by certain events like talking on the phone. When people start to avoid specific activities so as not to trigger their stutter, this is a sure sign that the stutter has reached the level of a speech disorder.

The causes of stuttering are mostly a mystery. There is a correlation with family history indicating a genetic link. Another theory is that a stutter is a form of involuntary or semi-voluntary tic. Most studies of stuttering agree there are many factors involved.

Dysarthria is a symptom of nerve or muscle damage. It manifests itself as slurred speech, slowed speech, limited tongue, jaw, or lip movement, abnormal rhythm and pitch when speaking, changes in voice quality, difficulty articulating, labored speech, and other related symptoms.

It is caused by muscle damage, or nerve damage to the muscles involved in the process of speaking such as the diaphragm, lips, tongue, and vocal chords.

Because it is a symptom of nerve and/or muscle damage it can be caused by a wide range of phenomena that affect people of all ages. This can start during development in the womb or shortly after birth as a result of conditions like muscular dystrophy and cerebral palsy. In adults some of the most common causes of dysarthria are stroke, tumors, and MS.

A lay term, lisping can be recognized by anyone and is very common.

Speech language pathologists provide an extra level of expertise when treating patients with lisping disorders . They can make sure that a lisp is not being confused with another type of disorder such as apraxia, aphasia, impaired development of expressive language, or a speech impediment caused by hearing loss.

SLPs are also important in distinguishing between the five different types of lisps. Most laypersons can usually pick out the most common type, the interdental/dentalised lisp. This is when a speaker makes a “th” sound when trying to make the “s” sound. It is caused by the tongue reaching past or touching the front teeth.

Because lisps are functional speech disorders, SLPs can play a huge role in correcting these with results often being a complete elimination of the lisp. Treatment is particularly effective when implemented early, although adults can also benefit.

Experts recommend professional SLP intervention if a child has reached the age of four and still has an interdental/dentalised lisp. SLP intervention is recommended as soon as possible for all other types of lisps. Treatment includes pronunciation and annunciation coaching, re-teaching how a sound or word is supposed to be pronounced, practice in front of a mirror, and speech-muscle strengthening that can be as simple as drinking out of a straw.

Spasmodic Dysphonia

Spasmodic Dysphonia (SD) is a chronic long-term disorder that affects the voice. It is characterized by a spasming of the vocal chords when a person attempts to speak and results in a voice that can be described as shaky, hoarse, groaning, tight, or jittery. It can cause the emphasis of speech to vary considerably. Many SLPs specialize in the treatment of Spasmodic Dysphonia .

SLPs will most often encounter this disorder in adults, with the first symptoms usually occurring between the ages of 30 and 50. It can be caused by a range of things mostly related to aging, such as nervous system changes and muscle tone disorders.

It’s difficult to isolate vocal chord spasms as being responsible for a shaky or trembly voice, so diagnosing SD is a team effort for SLPs that also involves an ear, nose, and throat doctor (otolaryngologist) and a neurologist.

Have you ever heard people talking about how they are smart but also nervous in large groups of people, and then self-diagnose themselves as having Asperger’s? You might have heard a similar lay diagnosis for cluttering. This is an indication of how common this disorder is as well as how crucial SLPs are in making a proper cluttering diagnosis .

A fluency disorder, cluttering is characterized by a person’s speech being too rapid, too jerky, or both. To qualify as cluttering, the person’s speech must also have excessive amounts of “well,” “um,” “like,” “hmm,” or “so,” (speech disfluencies), an excessive exclusion or collapsing of syllables, or abnormal syllable stresses or rhythms.

The first symptoms of this disorder appear in childhood. Like other fluency disorders, SLPs can have a huge impact on improving or eliminating cluttering. Intervention is most effective early on in life, however adults can also benefit from working with an SLP.

Muteness – Selective Mutism

There are different kinds of mutism, and here we are talking about selective mutism. This used to be called elective mutism to emphasize its difference from disorders that caused mutism through damage to, or irregularities in, the speech process.

Selective mutism is when a person does not speak in some or most situations, however that person is physically capable of speaking. It most often occurs in children, and is commonly exemplified by a child speaking at home but not at school.

Selective mutism is related to psychology. It appears in children who are very shy, who have an anxiety disorder, or who are going through a period of social withdrawal or isolation. These psychological factors have their own origins and should be dealt with through counseling or another type of psychological intervention.

Diagnosing selective mutism involves a team of professionals including SLPs, pediatricians, psychologists, and psychiatrists. SLPs play an important role in this process because there are speech language disorders that can have the same effect as selective muteness – stuttering, aphasia, apraxia of speech, or dysarthria – and it’s important to eliminate these as possibilities.

And just because selective mutism is primarily a psychological phenomenon, that doesn’t mean SLPs can’t do anything. Quite the contrary.

The National Institute on Neurological Disorders and Stroke estimates that one million Americans have some form of aphasia.

Aphasia is a communication disorder caused by damage to the brain’s language capabilities. Aphasia differs from apraxia of speech and dysarthria in that it solely pertains to the brain’s speech and language center.

As such anyone can suffer from aphasia because brain damage can be caused by a number of factors. However SLPs are most likely to encounter aphasia in adults, especially those who have had a stroke. Other common causes of aphasia are brain tumors, traumatic brain injuries, and degenerative brain diseases.

In addition to neurologists, speech language pathologists have an important role in diagnosing aphasia. As an SLP you’ll assess factors such as a person’s reading and writing, functional communication, auditory comprehension, and verbal expression.

Speech Delay – Alalia

A speech delay, known to professionals as alalia, refers to the phenomenon when a child is not making normal attempts to verbally communicate. There can be a number of factors causing this to happen, and that’s why it’s critical for a speech language pathologist to be involved.

The are many potential reasons why a child would not be using age-appropriate communication. These can range anywhere from the child being a “late bloomer” – the child just takes a bit longer than average to speak – to the child having brain damage. It is the role of an SLP to go through a process of elimination, evaluating each possibility that could cause a speech delay, until an explanation is found.

Approaching a child with a speech delay starts by distinguishing among the two main categories an SLP will evaluate: speech and language.

Speech has a lot to do with the organs of speech – the tongue, mouth, and vocal chords – as well as the muscles and nerves that connect them with the brain. Disorders like apraxia of speech and dysarthria are two examples that affect the nerve connections and organs of speech. Other examples in this category could include a cleft palette or even hearing loss.

The other major category SLPs will evaluate is language. This relates more to the brain and can be affected by brain damage or developmental disorders like autism. There are many different types of brain damage that each manifest themselves differently, as well as developmental disorders, and the SLP will make evaluations for everything.

Issues Related to Autism

While the autism spectrum itself isn’t a speech disorder, it makes this list because the two go hand-in-hand more often than not.

The Centers for Disease Control and Prevention (CDC) reports that one out of every 68 children in our country have an autism spectrum disorder. And by definition, all children who have autism also have social communication problems.

Speech-language pathologists are often a critical voice on a team of professionals – also including pediatricians, occupational therapists, neurologists, developmental specialists, and physical therapists – who make an autism spectrum diagnosis .

In fact, the American Speech-Language Hearing Association reports that problems with communication are the first detectable signs of autism. That is why language disorders – specifically disordered verbal and nonverbal communication – are one of the primary diagnostic criteria for autism.

So what kinds of SLP disorders are you likely to encounter with someone on the autism spectrum?

A big one is apraxia of speech. A study that came out of Penn State in 2015 found that 64 percent of children who were diagnosed with autism also had childhood apraxia of speech.

This basic primer on the most common speech disorders offers little more than an interesting glimpse into the kind of issues that SLPs work with patients to resolve. But even knowing everything there is to know about communication science and speech disorders doesn’t tell the whole story of what this profession is all about. With every client in every therapy session, the goal is always to have the folks that come to you for help leave with a little more confidence than when they walked in the door that day. As a trusted SLP, you will build on those gains with every session, helping clients experience the joy and freedom that comes with the ability to express themselves freely. At the end of the day, this is what being an SLP is all about.

Ready to make a difference in speech pathology? Learn how to become a Speech-Language Pathologist today

• Emerson College - Master's in Speech-Language Pathology online - Prepare to become an SLP in as few as 20 months. No GRE required. Scholarships available.
• Arizona State University - Online - Online Bachelor of Science in Speech and Hearing Science - Designed to prepare graduates to work in behavioral health settings or transition to graduate programs in speech-language pathology and audiology.
• NYU Steinhardt - NYU Steinhardt's Master of Science in Communicative Sciences and Disorders online - ASHA-accredited. Bachelor's degree required. Graduate prepared to pursue licensure.
• Calvin University - Calvin University's Online Speech and Hearing Foundations Certificate - Helps You Gain a Strong Foundation for Your Speech-Language Pathology Career.
• George Mason University - George Mason University's Graduate Programs in Special Education, Autism Spectrum Disorders, and Applied Behavior Analysis. - Prepares you for a rewarding career as a Speech and Language Pathologist.

Monica Marzinske, CCC-SLP

Speech-language therapy.

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Speaking clearly: Help for people with speech and language disorders

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Speaking and language abilities vary from person to person. Some people can quickly articulate exactly what they are thinking or feeling, while others struggle being understood or finding the right words.

These struggles could be due to a speech or language disorder if communication struggles cause ongoing communication challenges and frustrations. Speech and language disorders are common.

It's estimated that 5% to 10% of people in the U.S. have a communication disorder. By the first grade, about 5% of U.S. children have a noticeable speech disorder. About 3 million U.S. adults struggle with stuttering and about 1 million U.S. adults have aphasia. These conditions make reading, speaking, writing and comprehending difficult.

People with speech and language disorders can find hope in rehabilitation. Speech-language pathologists can evaluate and treat these disorders. This can lead to a happier, healthier and more expressive life.

Types of speech and language disorders

Speech and language disorders come in many forms, each with its own characteristics:.

• Aphasia People with aphasia have difficulty with reading, writing, speaking or understanding information they've heard. The intelligence of a person with aphasia is not affected.
• Dysarthria People with dysarthria demonstrate slurred or imprecise speech patterns that can affect the understanding of speech.
• Apraxia A person with this disorder has difficulty coordinating lip and tongue movements to produce understandable speech.
• Dysphagia This condition refers to swallowing difficulties, including food sticking in the throat, coughing or choking while eating or drinking, and other difficulties.
• Stuttering This speech disorder involves frequent and significant problems with normal fluency and flow of speech. People who stutter know what they want to say but have difficulty saying it.
• Articulation disorder People with this disorder have trouble learning how to make specific sounds. They may substitute sounds, such as saying "fum" instead of "thumb".
• Phonological disorder Phonological processes are patterns of errors children use to simplify language as they learn to speak. A phonological disorder may be present if these errors persist beyond the age when most other children stop using them. An example is saying "duh" instead of "duck."
• Voice Voice disorders include vocal cord paralysis, vocal abuse and vocal nodules, which could result in vocal hoarseness, changes in vocal volume and vocal fatigue.
• Cognitive communication impairment People with cognitive communication impairment have difficulty with concentration, memory, problem-solving, and completion of tasks for daily and medical needs.

Speech and language disorders are more common in children. It can take time to develop the ability to speak and communicate clearly. Some children struggle with finding the right word or getting their jaws, lips or tongues in the correct positions to make the right sounds.

In adults, speech and language disorders often are the result of a medical condition or injury. The most common of these conditions or injuries are a stroke, brain tumor, brain injury, cancer, Parkinson's disease, multiple sclerosis, Lou Gehrig's disease or other underlying health complications.

Treatment options

Speech and language disorders can be concerning, but speech-language pathologists can work with patients to evaluate and treat these conditions. Each treatment plan is specifically tailored to the patient.

Treatment plans can address difficulties with:

• Speech sounds, fluency or voice
• Understanding language
• Sharing thoughts, ideas and feelings
• Organizing thoughts, paying attention, remembering, planning or problem-solving
• Feeding and swallowing
• Vocabulary or improper grammar use

Treatment typically includes training to compensate for deficiencies; patient and family education; at-home exercises; or neurological rehabilitation to address impairments due to medical conditions, illnesses or injury.

Treatment options are extensive and not limited by age. Children and adults can experience the benefits of treatment.

If you or a loved one are struggling with speech and language issues, you are not alone. Millions of people experience similar daily challenges. Better yet, help is available.

Monica Marzinske is a speech-language pathologist  in New Prague , Minnesota.

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