Definition

Speech disorders refer to several conditions in which a person has difficulty communicating by mouth.

See also: Speech impairment

Alternative Names

Articulation deficiency; Voice disorders; Disfluency

Causes, incidence, and risk factors

Speech is one of the primary ways we communicate with those around us. It is an effective way to monitor normal growth and development as well as to identify potential problems.

Disfluencies are rhythm disorders that are usually characterized by the repetition of a sound, word, or phrase. Stuttering is perhaps the most serious disfluency.

Articulation deficiencies involve sounds made incorrectly or inappropriately.

Voice disorders involve abnormalities in the quality, pitch, and loudness of the sound.

There are many potential causes of speech impairment. The most common cause is mental retardation. Other causes may include:

Attention deficit disorder (ADD)
Autism
Cerebral palsy
Cleft palate
Cri-du-chat syndrome
Disorders of the palate
Gilles de la Tourette syndrome
Hearing impairment
Learning disability
Neurological disorders, including stroke, Parkinson's disease, and ALS
Schizophrenia
Tongue tie (ankyloglossia)
Vocal cord injury

Delayed speech development is one of the common symptoms of developmentally delayed children. It occurs in 5 - 10% of all children. Boys are three to four times as likely to have speech disorders as girls.

Symptoms

Disfluency:

Repetition of sounds, words, or phrases after age 4
Frustration with attempts to communicate
Head jerking while talking
Eye blinking while talking
Embarrassment with speech

Articulation Deficiency:

Unintelligible speech by age 3
Leaves out consonants at the beginning of words by age 3
Leaves out consonants at the end of words by age 4
Persistent problems with articulation after age 7
Leaves out sounds where they should occur
Distorts sounds
Substitutes an incorrect sound for a correct one

Voice disorders:

Pitch deviations
Deviations in the loudness and quality of the voice

Signs and tests

The following tests can help diagnose speech disorders:

Denver Articulation Screening Examination
Early Language Milestone Scale
Denver II
Peabody Picture Test Revised

A hearing test may also be done.

Treatment

The best treatment is prevention and early intervention by a speech pathologist. Speech training is an involved and time-consuming endeavor that can have profound results with consistent treatment.

Expectations (prognosis)

The prognosis depends on the cause of the disorder. Usually, speech can be improved with speech therapy. Prognosis improves with early intervention.

Complications

Speech disorders may lead to psychosocial problems associated with ineffective communication.

Calling your health care provider

Call your health care provider if:

Your child's speech is not developing according to normal milestones
If you think your child is in a high-risk group
Your child is showing signs of a speech disorder

Prevention

Mental retardation and hearing loss make children more likely to develop speech disorders. At-risk infants should be referred to an audiologist for an audiology exam. Audiological and speech therapy can then be started, if necessary.

As young children begin to speak, some disfluency is common. Children lack a large vocabulary and have difficulty expressing themselves. This results in broken speech. If you place excessive attention on the disfluency, a stuttering pattern may develop. The best way to prevent stuttering, therefore, is to avoid paying too much attention to the disfluency.

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