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Public Speaking Tips & Speech Topics

258 Speech Topics on Health [Persuasive, Informative, Argumentative]

Jim Peterson has over 20 years experience on speech writing. He wrote over 300 free speech topic ideas and how-to guides for any kind of public speaking and speech writing assignments at My Speech Class.

Here is our collection of persuasive and informative speech topics on health and fitness. Interesting issues and themes on topics from ionizing radiation of cell phones to food additives or infant nutrition. And yes, they are just to spice up your own thoughts!

In this article:

Informative

Argumentative.

• Wearing pajamas in bed is good for your health.
• Diet beverages are often not diet at all and regular not quite regular.
• Going barefoot in the summer time – yep, wearing no shoes – is healthy for your feet.
• Take a test to see if you are at risk for any dangerous disease or virus.
• Why you should not work too hard when you’re diabetic.
• Why breakfast is the most important meal of the day.
• Fast food restaurants should offer healthier options.
• Do you think schools should teach sex education?
• People who live in big cities will die sooner.
• Too much salt is bad for your health.
• The amount of meat consumed should be reduced.
• People should care more about sleep.
• Rape and sexual assault prevention and awareness should be taught in schools.
• How drinking too much soda causes health problems.
• How junk food is unhealthy for our bodies.
• Why you should take a vacation every year.
• Is toothpaste bad for health?
• Do you think there is too much sugar in our diets?
• Drug advertisements should be prohibited.
• Euthanasia could decrease suicide rates.
• We should use electroconvulsive therapy more.
• How to overcome stress.
• Stop putting steroids in animal food.
• Why you should become an organ donor.
• Why we should use homeopathic treatments.
• Why vaccines are beneficial.
• The dangers of sleepwalking.
• Are vaporizers bad for your health?
• Are e-cigs better than cigarettes?
• Diet pills are bad for your health.
• The importance of world Red Cross day.
• Why you should be a blood donor.
• People need to drink more water.
• Healthy eating tips.
• Everyone should be taught CPR.
• The danger of secondhand smoke.
• Why exercise is good for you.
• Why obesity is a big problem.
• The importance of making healthy food cheaper.
• Is gluten really bad for us?
• The dangerous effects of drugs.
• Should doctors be paid less?
• Why you should not wear high heels.
• Why you should not go to tanning beds.
• The cost of prescription drugs is too high.
• Smoking is bad for your health.
• Why you should take care of your teeth.
• Increase funding for medical research.
• Make more healthy choices.
• Why you should laugh every day.
• Wearing bike helmets should be encouraged.
• Cherish your friends.
• Alcoholics Anonymous deserves our support.
• Socialized medicine saves lives.
• Birth control pills should be more available.
• We need more resources to prevent infectious diseases.
• Eat more dark chocolate.
• Positive thinking will benefit your health.
• Stomach stapling should be reserved for extreme situations.
• Chewing tobacco is dangerous.
• Seat belt laws help save lives.
• Food additives are dangerous.
• Breastfeeding should be encouraged.
• Binge drinking awareness should be increased.
• Teen pregnancy prevention should be increased.
• Teen suicide awareness should be increased.
• Fire safety awareness should be increased.
• Organ donation should be encouraged.
• Eat less meat and you will Iive longer.
• Your body may actually speak louder than your words.
• Indoor air pollution is responsible for many diseases.
• A traditional health insurance plan where you choose the doctors is the best.
• Traditional medicine and healing practices have been used for thousands of years with great contributions.
• United Nations organization is responsible to reduce newborn mortality and maternal mortality in the upcoming ten years.
• Everyone should have access to safe blood products originated from a quality assurance system.
• Cook your poultry or risk a campylobacter bacterial infection …
• Cell phones are safe for health.
• Proper condoms reduce the risk of sexually transmitted infections spread primarily through person to person contacts.
• We must prevent that the financial crisis evaluates into a physical and mental wellness crisis.
• Most food additives are safe.
• Exposure to ionizing radiation can pose a substantial physical shape risk for vulnerable people.
• Adequate infant nutrition is essential for wellbeing the rest of a person’s life.
• Mitigating possible pandemic influenza effects should be a public priority.
• 80 percent of men suffer from prostate cancer but are completely ignorant about it.
• Abortion will endanger the health of a pregnant woman.
• Alcoholics Anonymous programs for alcoholics work.
• Balanced nutrition can prevent a heart attack.
• Condoms give women the power to protect themselves.
• Diabetes risk factors and complications must be highlighted better.
• Eating foods that contain bacterium Clostridium botulinum will cause foodborne, infant and wound botulism.
• Everyone must have easy access to healthcare services.
• Fat fast food loaded with sugar, salt and calories contributes to child obesity.
• Food should not be used for fuel.
• Hair loss in humans can be reversible through good nutrition.
• High blood pressure does put you at greater risk of having a stroke.
• Irradiated meat is not safe to eat.
• Not enough is done to prevent obesity in children.
• Patients with anorexia nervosa should be required to get palliative care.
• People with autism are not mad!
• Poor air quality is a real threat to our health.
• Soft drugs are not soft at all.
• Support the United Nations Children’s Fund initiatives like the nutrition goals!
• Teenagers are using too many risky methods to lose weight.
• The media coverage of the swine flu epidemic is over dramatized.
• The Munchausen’s syndrome needs to be dealt with better.
• There should be one uniform national healthcare system for all.
• Travel health needs to be given more importance.
• We are not drinking enough water.
• We only need one food safety agency.
• You will be fitter if you just cycled to work.

Here are some ideas for informative speech topics on physical and mental wellness – from health supplements to fitness tests and from spinning to back pain exercises.

You can use this list of speech topics in two ways:

• Take the public speaking topics as they are, and research all ins and outs.
• Associate and invent your mapping scheme.
• The role of the Center for Disease Control.
• The health problems of children born drug addicted.
• Eat healthy to live healthily.
• How does a headache happen?
• The effect of radiation.
• What are the effects of self-harm?
• Obesity facts and figures.
• The benefits of magnesium.
• Anxiety and its effects.
• The importance of sleep.
• How to avoid pesticides in vegetables.
• How to prevent elder abuse.
• How to avoid toxic chemicals in food.
• Autism and its effects.
• The different types of birth control.
• The benefits of stem cell research.
• The benefits of mindfulness.
• How to cure and prevent hangovers.
• Strategies for healthy eating.
• The benefits of being a vegetarian.
• What is spinocerebellar degeneration?
• How to reduce asthma attacks.
• The health benefits of ginger.
• The Alice in Wonderland syndrome.
• Why we should wash our hands.
• The health benefits of friendship.
• The importance of eye donation.
• Why Americans are so obese.
• The importance of childhood cancer awareness.
• The reason humans itch.
• The benefits of tea.
• The best natural medicines.
• How drinking too much can affect your health.
• How to stop the obesity epidemic.
• How to manage mental illness.
• How to prevent teen pregnancy.
• How to stop memory loss.
• The best health care plans.
• Xenophobia as a global situation.
• The best and worst abdominal exercises in a gym.
• Advantages and disadvantages of aqua aerobics for your muscles.
• How to determine your body fat percentage in three steps, and when are you in
• The effects of dietary health supplements on the long run are not certain.
• Increasing weight leads to increasing condition and risks.
• Why performance-enhancing substances such as steroids are banned in sports.
• Natural bodybuilding supplements and their benefits for normal athletes.
• Different types of Calisthenics exercises on music beats.
• Why do people apply to life extension nutrition – there is no life elixir or cocktail?
• Disadvantages of raw food diets – the flip-side topics to talk about are the
• Different methods of strength training programs for revalidating patients. Ideas for informative speech topics on fitness:
• Choosing a gym in your town, what to think of, get them a generic checklist.
• Workout myths and lies.
• The history of the Pilates system that was very popular in the nineties.
• Time-saving fitness training tips for busy persons.
• Ways to prepare for the types of physical tests, e.g. the Bruce, Beep.
• Designating a personal trainer helps you to keep on coming to the athletic club.
• Cardiovascular exercises that really work.
• Top stretching and warm up tips.
• Big three men’s salubriousness issues.
• How to get rid of blubbering cellulite adipose tissue on your waist.
• Comfortable workout clothing and activewear for women.
• What is spinning?
• Tips to stay motivated to go to the gym two or three times a week.
• Benefits of yoga workout routines.
• Back pain exercises to stretch and strengthen your back and supporting muscles.
• Different low-carb diets.
• Top five sunburn blocking tips, and do share your own wisdom, and empiricism
• Travel tips for a healthy vacation.
• How our immune system works to keep you physically strong and capable.
• Yoga diet and yogic meditation techniques.
• Strange Allergies and their symptoms and effects.
• Multiple Sclerosis symptoms, causes, treatment and life expectancy.
• Asthma solutions and natural remedies.
• Dental care how to prevent tooth decay.
• Stress management – reduce, prevent and cope with stress.
• Yoga tips for beginners and starters – ideal to demonstrate some postures.
• Why taking a vacation is good for your health.
• The effects of eating disorders.
• What is Down syndrome?
• Animal to human transplants could save lives.
• The body’s coping mechanisms when in a state of shock.
• Managing and controlling type 2 diabetes.
• How our culture affects organ donation.
• Simple AIDS prevention tips.
• How celiac disease affects our world.
• The benefits of walking without shoes.
• How smoking is harmful to your health.
• The benefits of being an organ donor.
• The dangers of texting while driving.
• The importance of vitamins and minerals.
• The nutritional value of pickles.
• The importance of wearing your seatbelt.
• The effects of caffeine on the body.
• The history of Psychology.
• Exercise combats health problems.
• High-risk pregnancy complications.
• What is narcissistic personality disorder?
• The effects of fast food on the body.
• How Monsanto affects our food.
• How the American diet has changed.
• The health benefits of dark chocolate.
• Plastic surgery is bad for your skin.
• The importance of anxiety and depression awareness.
• The benefits of regular exercise.
• How the circulatory system works.
• How to have a healthy pregnancy.
• How to get a really good sleep.
• Why the brain is so important.
• The effects of amyotrophic lateral sclerosis.
• Calcium is important
• Eating disorders in modern times.
• Herbal remedies that work for common diseases.
• Junk food and its relation to obesity.
• Obesity is the next health risk for the western world.
• Smoking bans and restrictions don’t work.
• Stretching exercises at the start of your day prevent injuries.
• The influenza vaccination effectiveness is poor.
• The losing battle with alcohol abuse.
• The necessity of mandatory HIV/AIDS testing
• The need for mandatory drug testing in our society.
• Why health care policies are important.
• A vegetarian diet is as healthy as a diet containing meat.
• Smoking a pipe is more harmful than smoking cigarettes.
• Attention Deficit Disorder (ADD) should be medicated.
• Stretching before and after exercise is overrated.
• Everyone should have free access to health care.
• Knowing your ancestry is important for health.
• Does access to condoms prevent teen pregnancy?
• Eating meat and dairy is bad for your body.
• Drug addiction is a disease not a choice.
• Health risks of smoking are exaggerated.
• Veganism is an unhealthy way to raise kids.
• The need for teen depression prevention.
• The Paleo diet can ruin your health.
• Is laughter good for you?
• All farmers should go organic.
• The health benefits of marijuana.
• Bread is bad for your health.
• The dangers of herbal remedies.
• The health benefits of avocados.
• Running is unhealthy.
• Alcoholics do not want help.
• Flu shots are necessary.
• Low carbohydrate diets are more effective than low fat diets.
• Smokers should be treated like drug addicts.
• The healthcare industry earns millions due to the cures they hide.
• Vegetarianism is another word for unhealthy dieting.
• Working night-shifts costs you ten years of your life.

More Speech Topics and Examples

207 Value Speech Topics – Get The Facts

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• Speech on Health

Health is Wealth Speech for Students

Many of you have been made familiar with the phrase ‘Health Is Wealth’ in your school. Just like the phrase reads, the health of an individual plays an important role in our lives and is no less valuable than wealth. It is our sole responsibility to take proper care of our health and maintain a proper lifestyle to keep it healthy. By the term ‘Health’ , we not only define our physical health but also equally prioritize our mental health. 

Thus, we have provided a long and short speech on health and fitness as a reference for the students. Speech on the importance of health is an important topic that must be introduced to all the students to help them be familiar with their mental as well as physical health. These speeches are provided for students of all categories along with a short 2 minute speech on health for the students of Class 1 and Class 2.

Long Speech on Health and Fitness in English

Given below is a long 500 words speech on health and fitness for the students of Class 7 to Class 12. This speech on the importance of health and fitness can be referred to by the students to prepare for their examination.  

Greetings everyone! Today I have been provided with an opportunity to deliver a speech on fitness and how our health plays a major role in maintaining our mental as well as physical fitness. Since we are in a generation where everything around us is so technologically advanced and fast, we often get too dependent on machines and technology. Due to our fast-paced and busy schedule, we give less importance to physical fitness and mental health. As a result, all we have become is physically inactive and lazy. But with this are we all heading towards a healthy lifestyle? Sadly, the answer is no. Gone are the days where we used to walk to the nearest stores and take the stairs of our buildings. Also, we are more addicted to eating junk foods and ordering food from outside. Therefore, this has given rise to several diseases starting from cardiovascular diseases, obesity, depression and anxiety.

Although there have been several medical technologies and treatments that can get you out of it, all it takes to stop this thing is self-control and a healthy lifestyle. As the saying goes, ‘Health is Wealth’, an individual can only enjoy all the valuables of life if he/she/they is both physically and mentally healthy. The health of an individual plays a major role in his/her/their life and must be taken care of. In spite of our busy schedules, it is our responsibility to prioritize our health and involve ourselves in some kind of physical activity. Physical exercises need not be always strenuous, it can also be done in the form of walking, cycling, yoga and meditation that brings calmness to both mind and body. 

But, is doing physical activity enough to stay healthy? Well, no. Most of the role to keep us healthy is played by the food we intake. It will be of no use if we intake junk and unhealthy food, rich in sugar and cholesterol levels and try to be healthy. Apart from exercising, it is equally important to drink plenty of water to keep ourselves hydrated. The level of fitness totally depends on the amount of activity our body can perform and the food we consume. Thus, inculcating a habit of eating healthy foods such as fruits, green vegetables and essential vitamins is really important. 

I hope this health is wealth speech was really helpful in motivating you all to stay physically and mentally healthy. So, it’s high time that we really put our health over everything and take proper care of it. Lastly, I would like to thank all of you for being here today and listening to my speech.

Short Speech on Health and Hygiene

A short speech on health and hygiene is given below as a reference for the students of Class 3 to Class 6. This health y speech in English is given in a simple language to help them understand the topic better and prepare them for any speech competition or exam.

A very warm welcome to everyone present here. Today, I am going to deliver a speech on health and hygiene. These two are strongly associated with each other because it is very important to maintain a hygienic environment to stay healthy. This can be done by maintaining cleanliness and incorporating the habit of hygiene in our lives.

Living an unhygienic lifestyle can lead to several skin diseases and infections. The health of a person determines how much a person is physically fit and active. When it comes to taking care of health, several factors come into play which includes eating healthy food, doing regular exercises, having a proper sleep cycle and maintaining oral hygiene. We have been taught since our childhood to brush our teeth twice a day and avoid eating sugary foods to prevent bad breath and cavity. But many of us often forget to inculcate these healthy habits in our daily life. Our daily schedule has become so busy that we often end up ignoring our health, which in the long term, affects our body. 

We can start leading a healthy life by taking small steps towards it such as switching from junk foods to fruits and vegetables, drinking plenty of water and walking every day for at least an hour. This, as a result, will help us concentrate well on our work and lead a life full of fitness.

10 Lines on Health

Here is a short 1 minute speech on health that is provided for the students of Class 1 and Class 2. They can take this speech as a reference for any examination or speech preparation.

Good morning to all of you present here. I am here to deliver a speech on health.

Our health is very important for us and helps us remain fit.

We should take proper care of our health in order to live a healthy life.

Staying healthy means we should have a healthy mind along with a healthy body as both are equally important.

We should exercise daily to keep our body fit and active.

Yoga, meditation and walking are always helpful to keep our body and mind peaceful.

Drinking plenty of water after any form of activity is important to keep our body hydrated.

We should also eat healthy food such as green vegetables, lots of fruits and salads.

We should avoid eating junk food from outside and cook tasty and healthy food ourselves because eating junk causes many health problems.

Also, we must sleep at least 8 hours a day to gain proper energy to work for the next day.

Last but not the least, I want to thank all of you for coming here and listening to my speech.

Get the best essay samples for all Classes at Vedantu to learn how to frame one in the best way possible. Learn from the experts regarding different topics and frame well to score more in the exams. You can also use these examples to practice for competitions. 

FAQs on Speech on Health

1. What is the benefit of the speech on health?

It is necessary for the students to prepare speeches because it helps the students in expressing themselves in a better manner. Also, speech develops the writing skill of the students, and along with the writing skill, it also helps in developing the speaking skill. For writing a speech on the topic of health, it is important for the students to study and think on the topic respectively. And hence, it also makes the students aware of the topic of health and fitness, and also it helps the students in thinking. Look through Vendantu’s website to get more insight on the same.

2. What are the tips to follow while preparing a speech on the topic of Health?

There are many steps that you must follow while preparing a speech on health, which are pointed out below:

Since you are giving the speech in English, it is important to have the correct pronunciation of all the words.

You must write a speech on health that everyone can understand.

After writing the speech, also try to remember the speech so that you can deliver a good speech during the event.

Also, you must practice giving the speech so that it becomes easy for you when the actual time comes for giving the speech.

Look through Vendantu’s website to get more insight on the same.

3. Why should I write a speech in the English language on the topic of Health?

It is important for the students to write the speech in the English language for quite many reasons. But one of the most important reasons is that English is the most spoken language in the world, and it has also achieved the status of Global language, more than that many companies of the European countries have made English one of the official languages for business. And hence learning English is of utmost importance in the modern world, and writing the speech on health in English gives the students some sort of practice and prepares them for the same. Look through Vendantu’s website to get more insight on the same.

4. Where can I find guidance for writing a speech on Health in English?

If you are looking for guidance in writing a speech in English on the subject of Health, then you have already arrived at the right place. Vedantu provides a complete speech on Health to the students in English. Vedantu provides speeches on a number of different types of topics to the students. For instance, This article has one  short speech on Health in English, one Long Speech on health in English, and lastly a speech in ten lines on the topic of health in English.

5. Why should I Refer to Vedantu for a speech on the topic of Health?

There is one essential aspect in the speech that makes it different from the other form of written composition, such as Essay, and that one essential aspect is that Speech is supposed to be delivered to the audience. And hence, it is important for the students to write the speech in such a manner that it is understandable to the audience. And hence, Vedantu provides the students with such a speech, which is prepared by the top educators, and also this speech is totally free of cost for all the students.

June 30, 2016

The Sound of Your Voice May Diagnose Disease

How you talk could reveal heart disease or concussions, say researchers and companies developing the novel technology

By Rebecca Robbins

PhotoDisc/Getty (MARS)

There’s long been talk in medicine about the need to listen more to the patient voice — and now that mantra is being taken literally.

Academics and entrepreneurs are rushing to develop technology to diagnose and predict everything from manic episodes to heart disease to  concussions based on an unusual source of data: How you talk.

A growing body of evidence suggests that an array of mental and physical conditions can make you slur your words, elongate sounds, or speak in a more nasal tone. They may even make your voice creak or jitter so briefly that it’s not detectable to the human ear. It’s still not absolutely clear that analyzing speech patterns can generate accurate — or useful — diagnoses. But the race is on to try.

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The latest player to enter the arena is  Sonde Health , a Boston company  launched Tuesday by the venture capital firm PureTech, based on technology licensed from researchers at the Massachusetts Institute of Technology. Sonde wants to develop software for consumers that can screen for depression as well as respiratory and cardiovascular conditions.

“Speaking is something that we do naturally every day,” Sonde COO Jim Harper said.

The company will start by analyzing audio clips of patients reading aloud, but aims to develop technology that can extract vocal features without actually having to record the words. The goal, Harper said, is to “move the monitoring into the background and to collect some of that with devices that people already own.”

Sonde will have plenty of competition: IBM is teaming its Watson supercomputer with academic researchers to try to predict from speech patterns whether patients are likely to develop a psychotic disorder. A Berlin  company  has worked on  diagnosing ADHD  with voice recordings. Another Boston company, Cogito, is developing  a voice analysis app that being used by the US Department of Veterans Affairs to monitor the mood of service members; it’s also being tested in patients with bipolar disorder and depression.

Even the Army is interested: Earlier this month, it launched a  partnership  with MIT researchers at the same lab working on the Sonde technology, with the goal of developing an Food and Drug Administration-approved device to detect  brain injury .

The field is so buzzy that some entrepreneurs are rushing right into the consumer market, making bold claims with little clinical evidence. One team raised more than $27,000 on the crowdfunding site  Indiegogo  on the promise to put out an app , slated to launch this summer, that will analyze “voice patterns to help you achieve optimal health and vitality.” (The crowdfunding campaign also referenced plans to gather data on “frequency biomarkers” related to symptoms of cancer.)

But it won’t be easy to make vocal diagnostics clinically useful, cautioned Christian Poellabauer, a computer scientist at the University of Notre Dame who studies biomarkers for neurological conditions. It can be very difficult to isolate the real cause of changes in speech patterns, he said. Recordings must be of high quality to be useful, and that can be costly. And you need lots of data to ensure that correlations are reliable.

Then there’s the issue of cultural differences: While testing voice analysis to diagnose concussions, for instance, Poellabauer’s team found that many young athletes hesitated or changed their tone when  saying the word “hell”  — for reasons that may well have had nothing to do with brain injury.

“Speech is a very, very, complicated mechanism,” Poellabauer said.

Another crucial question: Just how useful the information will be for patients, and whether clinicians will be equipped to help them know what to do with it.

“If you take this app and it says you’re slurring your speech and having a stroke, that could be useful. You go to the hospital immediately. On the other hand, if it says there’s a 38 percent chance you’re going to have a migraine in the next week, I’m not sure that’s so helpful to you. You probably knew that anyway,” said medical ethicist Arthur Caplan of New York University.

Caplan also suggested such technology might be used to predict the likelihood of a patient flying into a rage or losing self-control — and turn those momentary lapses into a pathology. “Where’s the line here between what you want monitored and what you don’t?” he asked.

Critics have also raised privacy concerns, suggesting that voice analysis technology might become so sophisticated that patients could be identified by their cadence and tone, even if their names weren’t attached to the speech sample.

“I don’t think that right now we have the technology to figure out who a person is, just based on their voice alone,” said Cheryl Corcoran, a schizophrenia researcher at Columbia University who has collaborated with IBM Watson. “But that’s technology that may very well exist in the future.”

Meghana Keshavan contributed to this report.

Republished with permission from  STAT . This article  originally appeared  on June 29, 2016.

Monica Marzinske, CCC-SLP

Speech-language therapy.

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Speaking clearly: Help for people with speech and language disorders

• Speech-Language

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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• Diseases & Conditions

Dysarthria occurs when the muscles you use for speech are weak or you have difficulty controlling them. Dysarthria often causes slurred or slow speech that can be difficult to understand.

Common causes of dysarthria include nervous system disorders and conditions that cause facial paralysis or tongue or throat muscle weakness. Certain medications also can cause dysarthria.

Treating the underlying cause of your dysarthria may improve your speech. You may also need speech therapy. For dysarthria caused by prescription medications, changing or discontinuing the medications may help.

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Signs and symptoms of dysarthria vary, depending on the underlying cause and the type of dysarthria. They may include:

• Slurred speech
• Slow speech
• Inability to speak louder than a whisper or speaking too loudly
• Rapid speech that is difficult to understand
• Nasal, raspy or strained voice
• Uneven or abnormal speech rhythm
• Uneven speech volume
• Monotone speech
• Difficulty moving your tongue or facial muscles

When to see a doctor

Dysarthria can be a sign of a serious condition. See your doctor if you have sudden or unexplained changes in your ability to speak.

In dysarthria, you may have difficulty moving the muscles in your mouth, face or upper respiratory system that control speech. Conditions that may lead to dysarthria include:

• Amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease)
• Brain injury
• Brain tumor
• Cerebral palsy
• Guillain-Barre syndrome
• Head injury
• Huntington's disease
• Lyme disease
• Multiple sclerosis
• Muscular dystrophy
• Myasthenia gravis
• Parkinson's disease
• Wilson's disease

Some medications, such as certain sedatives and seizure drugs, also can cause dysarthria.

Complications

Because of the communication problems dysarthria causes, complications can include:

• Social difficulty. Communication problems may affect your relationships with family and friends and make social situations challenging.
• Depression. In some people, dysarthria may lead to social isolation and depression.
• Daroff RB, et al., eds. Bradley's Neurology in Clinical Practice. 7th ed. Elsevier; 2016. https://www.clinicalkey.com. Accessed April 10, 2020.
• Dysarthria. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/dysarthria/. Accessed April 6, 2020.
• Maitin IB, et al., eds. Current Diagnosis & Treatment: Physical Medicine & Rehabilitation. McGraw-Hill Education; 2020. https://accessmedicine.mhmedical.com. Accessed April 10, 2020.
• Dysarthria in adults. American Speech-Language-Hearing Association. https://www.asha.org/PRPPrintTemplate.aspx?folderid=8589943481. Accessed April 6, 2020.
• Drugs that cause dysarthria. IBM Micromedex. https://www.micromedexsolutions.com. Accessed April 10, 2020.
• Lirani-Silva C, et al. Dysarthria and quality of life in neurologically healthy elderly and patients with Parkinson's disease. CoDAS. 2015; doi:10.1590/2317-1782/20152014083.
• Signs and symptoms of untreated Lyme disease. Centers for Disease Control and Prevention. https://www.cdc.gov/lyme/signs_symptoms/index.html. Accessed April 6, 2020.
• Neurological diagnostic tests and procedures fact sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Neurological-Diagnostic-Tests-and-Procedures-Fact. Accessed April 6, 2020.

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Language and Speech Disorders in Children

Helping children learn language, what to do if there are concerns.

• Detecting problems

Children are born ready to learn a language, but they need to learn the language or languages that their family and environment use. Learning a language takes time, and children vary in how quickly they master milestones in language and speech development. Typically developing children may have trouble with some sounds, words, and sentences while they are learning. However, most children can use language easily around 5 years of age.

Parents and caregivers are the most important teachers during a child’s early years. Children learn language by listening to others speak and by practicing. Even young babies notice when others repeat and respond to the noises and sounds they make. Children’s language and brain skills get stronger if they hear many different words. Parents can help their child learn in many different ways, such as

• Responding to the first sounds, gurgles, and gestures a baby makes.
• Repeating what the child says and adding to it.
• Talking about the things that a child sees.
• Asking questions and listening to the answers.
• Looking at or reading books.
• Telling stories.
• Singing songs and sharing rhymes.

This can happen both during playtime and during daily routines.

Parents can also observe the following:

• How their child hears and talks and compare it with typical milestones for communication skills external icon .
• How their child reacts to sounds and have their hearing tested if they have concerns .

Learn more about language milestones .  Watch milestones in action.

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Some languages are visual rather than spoken. American Sign Language uses visual signals, including gestures, facial expressions, and body movement to communicate.

Some children struggle with understanding and speaking and they need help. They may not master the language milestones at the same time as other children, and it may be a sign of a language or speech delay or disorder.

Language development has different parts, and children might have problems with one or more of the following:

• Not hearing the words (hearing loss).
• Not understanding the meaning of the words.
• Not knowing the words to use.
• Not knowing how to put words together.
• Knowing the words to use but not being able to express them.

Language and speech disorders can exist together or by themselves. Examples of problems with language and speech development include the following:

• Difficulty with forming specific words or sounds correctly.
• Difficulty with making words or sentences flow smoothly, like stuttering or stammering.
• Language delay – the ability to understand and speak develops more slowly than is typical
• Aphasia (difficulty understanding or speaking parts of language due to a brain injury or how the brain works).
• Auditory processing disorder (difficulty understanding the meaning of the sounds that the ear sends to the brain)

Learn more about language disorders external icon .

Language or speech disorders can occur with other learning disorders that affect reading and writing. Children with language disorders may feel frustrated that they cannot understand others or make themselves understood, and they may act out, act helpless, or withdraw. Language or speech disorders can also be present with emotional or behavioral disorders, such as attention-deficit/hyperactivity disorder (ADHD) or anxiety . Children with developmental disabilities including autism spectrum disorder may also have difficulties with speech and language. The combination of challenges can make it particularly hard for a child to succeed in school. Properly diagnosing a child’s disorder is crucial so that each child can get the right kind of help.

Detecting problems with language or speech

If a child has a problem with language or speech development, talk to a healthcare provider about an evaluation. An important first step is to find out if the child may have a hearing loss. Hearing loss may be difficult to notice particularly if a child has hearing loss only in one ear or has partial hearing loss, which means they can hear some sounds but not others. Learn more about hearing loss, screening, evaluation, and treatment .

A language development specialist like a speech-language pathologist external icon will conduct a careful assessment to determine what type of problem with language or speech the child may have.

Overall, learning more than one language does not cause language disorders, but children may not follow exactly the same developmental milestones as those who learn only one language. Developing the ability to understand and speak in two languages depends on how much practice the child has using both languages, and the kind of practice. If a child who is learning more than one language has difficulty with language development, careful assessment by a specialist who understands development of skills in more than one language may be needed.

Treatment for language or speech disorders and delays

Children with language problems often need extra help and special instruction. Speech-language pathologists can work directly with children and their parents, caregivers, and teachers.

Having a language or speech delay or disorder can qualify a child for early intervention external icon (for children up to 3 years of age) and special education services (for children aged 3 years and older). Schools can do their own testing for language or speech disorders to see if a child needs intervention. An evaluation by a healthcare professional is needed if there are other concerns about the child’s hearing, behavior, or emotions. Parents, healthcare providers, and the school can work together to find the right referrals and treatment.

What every parent should know

Children with specific learning disabilities, including language or speech disorders, are eligible for special education services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) external icon and Section 504 external icon , an anti-discrimination law.

Get help from your state’s Parent Training and Information Center external icon

The role of healthcare providers

Healthcare providers can play an important part in collaborating with schools to help a child with speech or language disorders and delay or other disabilities get the special services they need. The American Academy of Pediatrics has created a report that describes the roles that healthcare providers can have in helping children with disabilities external icon , including language or speech disorders.

More information

CDC Information on Hearing Loss

National Institute on Deafness and Other Communication Disorders external icon

Birth to 5: Watch me thrive external icon

The American Speech-Language-Hearing Association external icon

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Home / Blog

Speech Impediment Guide: Definition, Causes, and Resources

December 8, 2020 

Tables of Contents

What Is a Speech Impediment?

Types of speech disorders, speech impediment causes, how to fix a speech impediment, making a difference in speech disorders.

Communication is a cornerstone of human relationships. When an individual struggles to verbalize information, thoughts, and feelings, it can cause major barriers in personal, learning, and business interactions.

Speech impediments, or speech disorders, can lead to feelings of insecurity and frustration. They can also cause worry for family members and friends who don’t know how to help their loved ones express themselves.

Fortunately, there are a number of ways that speech disorders can be treated, and in many cases, cured. Health professionals in fields including speech-language pathology and audiology can work with patients to overcome communication disorders, and individuals and families can learn techniques to help.

Commonly referred to as a speech disorder, a speech impediment is a condition that impacts an individual’s ability to speak fluently, correctly, or with clear resonance or tone. Individuals with speech disorders have problems creating understandable sounds or forming words, leading to communication difficulties.

Some 7.7% of U.S. children — or 1 in 12 youths between the ages of 3 and 17 — have speech, voice, language, or swallowing disorders, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). About 70 million people worldwide, including some 3 million Americans, experience stuttering difficulties, according to the Stuttering Foundation.

Common signs of a speech disorder

There are several symptoms and indicators that can point to a speech disorder.

• Unintelligible speech — A speech disorder may be present when others have difficulty understanding a person’s verbalizations.
• Omitted sounds — This symptom can include the omission of part of a word, such as saying “bo” instead of “boat,” and may include omission of consonants or syllables.
• Added sounds — This can involve adding extra sounds in a word, such as “buhlack” instead of “black,” or repeating sounds like “b-b-b-ball.”
• Substituted sounds — When sounds are substituted or distorted, such as saying “wabbit” instead of “rabbit,” it may indicate a speech disorder.
• Use of gestures — When individuals use gestures to communicate instead of words, a speech impediment may be the cause.
• Inappropriate pitch — This symptom is characterized by speaking with a strange pitch or volume.

In children, signs might also include a lack of babbling or making limited sounds. Symptoms may also include the incorrect use of specific sounds in words, according to the American Speech-Language-Hearing Association (ASHA). This may include the sounds p, m, b, w, and h among children aged 1-2, and k, f, g, d, n, and t for children aged 2-3.

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Categories of Speech Impediments

Speech impediments can range from speech sound disorders (articulation and phonological disorders) to voice disorders. Speech sound disorders may be organic — resulting from a motor or sensory cause — or may be functional with no known cause. Voice disorders deal with physical problems that limit speech. The main categories of speech impediments include the following:

Fluency disorders occur when a patient has trouble with speech timing or rhythms. This can lead to hesitations, repetitions, or prolonged sounds. Fluency disorders include stuttering (repetition of sounds) or   (rapid or irregular rate of speech).

Resonance disorders are related to voice quality that is impacted by the shape of the nose, throat, and/or mouth. Examples of resonance disorders include hyponasality and cul-de-sac resonance.

Articulation disorders occur when a patient has difficulty producing speech sounds. These disorders may stem from physical or anatomical limitations such as muscular, neuromuscular, or skeletal support. Examples of articulation speech impairments include sound omissions, substitutions, and distortions.

Phonological disorders result in the misuse of certain speech sounds to form words. Conditions include fronting, stopping, and the omission of final consonants.

Voice disorders are the result of problems in the larynx that harm the quality or use of an individual’s voice. This can impact pitch, resonance, and loudness.

Impact of Speech Disorders

Some speech disorders have little impact on socialization and daily activities, but other conditions can make some tasks difficult for individuals. Following are a few of the impacts of speech impediments.

• Poor communication — Children may be unable to participate in certain learning activities, such as answering questions or reading out loud, due to communication difficulties. Adults may avoid work or social activities such as giving speeches or attending parties.
• Mental health and confidence — Speech disorders may cause children or adults to feel different from peers, leading to a lack of self-confidence and, potentially, self-isolation.

Resources on Speech Disorders

The following resources may help those who are seeking more information about speech impediments.

Health Information : Information and statistics on common voice and speech disorders from the NIDCD

Speech Disorders : Information on childhood speech disorders from Cincinnati Children’s Hospital Medical Center

Speech, Language, and Swallowing : Resources about speech and language development from the ASHA

Children and adults can suffer from a variety of speech impairments that may have mild to severe impacts on their ability to communicate. The following 10 conditions are examples of specific types of speech disorders and voice disorders.

1. Stuttering

This condition is one of the most common speech disorders. Stuttering is the repetition of syllables or words, interruptions in speech, or prolonged use of a sound.

This organic speech disorder is a result of damage to the neural pathways that connect the brain to speech-producing muscles. This results in a person knowing what they want to say, but being unable to speak the words.

This consists of the lost ability to speak, understand, or write languages. It is common in stroke, brain tumor, or traumatic brain injury patients.

4. Dysarthria

This condition is an organic speech sound disorder that involves difficulty expressing certain noises. This may involve slurring, or poor pronunciation, and rhythm differences related to nerve or brain disorders.

The condition of lisping is the replacing of sounds in words, including “th” for “s.” Lisping is a functional speech impediment.

6. Hyponasality

This condition is a resonance disorder related to limited sound coming through the nose, causing a “stopped up” quality to speech.

7. Cul-de-sac resonance

This speech disorder is the result of blockage in the mouth, throat, or nose that results in quiet or muffled speech.

8. Orofacial myofunctional disorders

These conditions involve abnormal patterns of mouth and face movement. Conditions include tongue thrusting (fronting), where individuals push out their tongue while eating or talking.

9. Spasmodic Dysphonia

This condition is a voice disorder in which spasms in the vocal cords produce speech that is hoarse, strained, or jittery.

10. Other voice disorders

These conditions can include having a voice that sounds breathy, hoarse, or scratchy. Some disorders deal with vocal folds closing when they should open (paradoxical vocal fold movement) or the presence of polyps or nodules in the vocal folds.

Speech Disorders vs. Language Disorders

Speech disorders deal with difficulty in creating sounds due to articulation, fluency, phonology, and voice problems. These problems are typically related to physical, motor, sensory, neurological, or mental health issues.

Language disorders, on the other hand, occur when individuals have difficulty communicating the meaning of what they want to express. Common in children, these disorders may result in low vocabulary and difficulty saying complex sentences. Such a disorder may reflect difficulty in comprehending school lessons or adopting new words, or it may be related to a learning disability such as dyslexia. Language disorders can also involve receptive language difficulties, where individuals have trouble understanding the messages that others are trying to convey.  

Resources on Types of Speech Disorders

The following resources may provide additional information on the types of speech impediments.

Common Speech Disorders: A guide to the most common speech impediments from GreatSpeech

Speech impairment in adults: Descriptions of common adult speech issues from MedlinePlus

Stuttering Facts: Information on stuttering indications and causes from the Stuttering Foundation

Speech disorders may be caused by a variety of factors related to physical features, neurological ailments, or mental health conditions. In children, they may be related to developmental issues or unknown causes and may go away naturally over time.

Physical and neurological issues. Speech impediment causes related to physical characteristics may include:

• Brain damage
• Nervous system damage
• Respiratory system damage
• Hearing difficulties
• Cancerous or noncancerous growths
• Muscle and bone problems such as dental issues or cleft palate

Mental health issues. Some speech disorders are related to clinical conditions such as:

• Autism spectrum disorder
• Down syndrome or other genetic syndromes
• Cerebral palsy or other neurological disorders
• Multiple sclerosis

Some speech impairments may also have to do with family history, such as when parents or siblings have experienced language or speech difficulties. Other causes may include premature birth, pregnancy complications, or delivery difficulties. Voice overuse and chronic coughs can also cause speech issues.

The most common way that speech disorders are treated involves seeking professional help. If patients and families feel that symptoms warrant therapy, health professionals can help determine how to fix a speech impediment. Early treatment is best to curb speech disorders, but impairments can also be treated later in life.

Professionals in the speech therapy field include speech-language pathologists (SLPs) . These practitioners assess, diagnose, and treat communication disorders including speech, language, social, cognitive, and swallowing disorders in both adults and children. They may have an SLP assistant to help with diagnostic and therapy activities.

Speech-language pathologists may also share a practice with audiologists and audiology assistants. Audiologists help identify and treat hearing, balance, and other auditory disorders.

How Are Speech Disorders Diagnosed?

Typically, a pediatrician, social worker, teacher, or other concerned party will recognize the symptoms of a speech disorder in children. These individuals, who frequently deal with speech and language conditions and are more familiar with symptoms, will recommend that parents have their child evaluated. Adults who struggle with speech problems may seek direct guidance from a physician or speech evaluation specialist.

When evaluating a patient for a potential speech impediment, a physician will:

• Conduct hearing and vision tests
• Evaluate patient records
• Observe patient symptoms

A speech-language pathologist will conduct an initial screening that might include:

• An evaluation of speech sounds in words and sentences
• An evaluation of oral motor function
• An orofacial examination
• An assessment of language comprehension

The initial screening might result in no action if speech symptoms are determined to be developmentally appropriate. If a disorder is suspected, the initial screening might result in a referral for a comprehensive speech sound assessment, comprehensive language assessment, audiology evaluation, or other medical services.

Initial assessments and more in-depth screenings might occur in a private speech therapy practice, rehabilitation center, school, childcare program, or early intervention center. For older adults, skilled nursing centers and nursing homes may assess patients for speech, hearing, and language disorders.

How Are Speech Impediments Treated?

Once an evaluation determines precisely what type of speech sound disorder is present, patients can begin treatment. Speech-language pathologists use a combination of therapy, exercise, and assistive devices to treat speech disorders.

Speech therapy might focus on motor production (articulation) or linguistic (phonological or language-based) elements of speech, according to ASHA. There are various types of speech therapy available to patients.

Contextual Utilization  — This therapeutic approach teaches methods for producing sounds consistently in different syllable-based contexts, such as phonemic or phonetic contexts. These methods are helpful for patients who produce sounds inconsistently.

Phonological Contrast — This approach focuses on improving speech through emphasis of phonemic contrasts that serve to differentiate words. Examples might include minimal opposition words (pot vs. spot) or maximal oppositions (mall vs. call). These therapy methods can help patients who use phonological error patterns.

Distinctive Feature — In this category of therapy, SLPs focus on elements that are missing in speech, such as articulation or nasality. This helps patients who substitute sounds by teaching them to distinguish target sounds from substituted sounds.

Core Vocabulary — This therapeutic approach involves practicing whole words that are commonly used in a specific patient’s communications. It is effective for patients with inconsistent sound production.

Metaphon — In this type of therapy, patients are taught to identify phonological language structures. The technique focuses on contrasting sound elements, such as loud vs. quiet, and helps patients with unintelligible speech issues.

Oral-Motor — This approach uses non-speech exercises to supplement sound therapies. This helps patients gain oral-motor strength and control to improve articulation.

Other methods professionals may use to help fix speech impediments include relaxation, breathing, muscle strengthening, and voice exercises. They may also recommend assistive devices, which may include:

• Radio transmission systems
• Personal amplifiers
• Picture boards
• Touch screens
• Text displays
• Speech-generating devices
• Hearing aids
• Cochlear implants

Resources for Professionals on How to Fix a Speech Impediment

The following resources provide information for speech therapists and other health professionals.

Assistive Devices: Information on hearing and speech aids from the NIDCD

Information for Audiologists: Publications, news, and practice aids for audiologists from ASHA

Information for Speech-Language Pathologists: Publications, news, and practice aids for SLPs from ASHA

Speech Disorder Tips for Families

For parents who are concerned that their child might have a speech disorder — or who want to prevent the development of a disorder — there are a number of activities that can help. The following are tasks that parents can engage in on a regular basis to develop literacy and speech skills.

• Introducing new vocabulary words
• Reading picture and story books with various sounds and patterns
• Talking to children about objects and events
• Answering children’s questions during routine activities
• Encouraging drawing and scribbling
• Pointing to words while reading books
• Pointing out words and sentences in objects and signs

Parents can take the following steps to make sure that potential speech impediments are identified early on.

• Discussing concerns with physicians
• Asking for hearing, vision, and speech screenings from doctors
• Requesting special education assessments from school officials
• Requesting a referral to a speech-language pathologist, audiologist, or other specialist

When a child is engaged in speech therapy, speech-language pathologists will typically establish collaborative relationships with families, sharing information and encouraging parents to participate in therapy decisions and practices.

SLPs will work with patients and their families to set goals for therapy outcomes. In addition to therapy sessions, they may develop activities and exercises for families to work on at home. It is important that caregivers are encouraging and patient with children during therapy.  

Resources for Parents on How to Fix a Speech Impediment

The following resources provide additional information on treatment options for speech disorders.

Speech, Language, and Swallowing Disorders Groups: Listing of self-help groups from ASHA

ProFind: Search tool for finding certified SLPs and audiologists from ASHA

Baby’s Hearing and Communication Development Checklist: Listing of milestones that children should meet by certain ages from the NIDCD

If identified during childhood, speech disorders can be corrected efficiently, giving children greater communication opportunities. If left untreated, speech impediments can cause a variety of problems in adulthood, and may be more difficult to diagnose and treat.

Parents, teachers, doctors, speech and language professionals, and other concerned parties all have unique responsibilities in recognizing and treating speech disorders. Through professional therapy, family engagement, positive encouragement and a strong support network, individuals with speech impediments can overcome their challenges and develop essential communication skills.

Additional Sources

American Speech-Language-Hearing Association, Speech Sound Disorders

Identify the Signs, Signs of Speech and Language Disorders

Intermountain Healthcare, Phonological Disorders

MedlinePlus, Speech disorders – children

National Institutes of Health, National Institutes on Deafness and Other Communication Disorders, “Quick Statistics About Voice, Speech, Language”

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Overcoming Speech Impediment: Symptoms to Treatment

There are many causes and solutions for impaired speech

• Types and Symptoms
• Speech Therapy
• Building Confidence

Speech impediments are conditions that can cause a variety of symptoms, such as an inability to understand language or speak with a stable sense of tone, speed, or fluidity. There are many different types of speech impediments, and they can begin during childhood or develop during adulthood.

Common causes include physical trauma, neurological disorders, or anxiety. If you or your child is experiencing signs of a speech impediment, you need to know that these conditions can be diagnosed and treated with professional speech therapy.

This article will discuss what you can do if you are concerned about a speech impediment and what you can expect during your diagnostic process and therapy.

FG Trade / Getty Images

Types and Symptoms of Speech Impediment

People can have speech problems due to developmental conditions that begin to show symptoms during early childhood or as a result of conditions that may occur during adulthood. 

The main classifications of speech impairment are aphasia (difficulty understanding or producing the correct words or phrases) or dysarthria (difficulty enunciating words).

Often, speech problems can be part of neurological or neurodevelopmental disorders that also cause other symptoms, such as multiple sclerosis (MS) or autism spectrum disorder .

There are several different symptoms of speech impediments, and you may experience one or more.

Can Symptoms Worsen?

Most speech disorders cause persistent symptoms and can temporarily get worse when you are tired, anxious, or sick.

Symptoms of dysarthria can include:

• Slurred speech
• Slow speech
• Choppy speech
• Hesitant speech
• Inability to control the volume of your speech
• Shaking or tremulous speech pattern
• Inability to pronounce certain sounds

Symptoms of aphasia may involve:

• Speech apraxia (difficulty coordinating speech)
• Difficulty understanding the meaning of what other people are saying
• Inability to use the correct words
• Inability to repeat words or phases
• Speech that has an irregular rhythm

You can have one or more of these speech patterns as part of your speech impediment, and their combination and frequency will help determine the type and cause of your speech problem.

Causes of Speech Impediment

The conditions that cause speech impediments can include developmental problems that are present from birth, neurological diseases such as Parkinson’s disease , or sudden neurological events, such as a stroke .

Some people can also experience temporary speech impairment due to anxiety, intoxication, medication side effects, postictal state (the time immediately after a seizure), or a change of consciousness.

Speech Impairment in Children

Children can have speech disorders associated with neurodevelopmental problems, which can interfere with speech development. Some childhood neurological or neurodevelopmental disorders may cause a regression (backsliding) of speech skills.

Common causes of childhood speech impediments include:

• Autism spectrum disorder : A neurodevelopmental disorder that affects social and interactive development
• Cerebral palsy :  A congenital (from birth) disorder that affects learning and control of physical movement
• Hearing loss : Can affect the way children hear and imitate speech
• Rett syndrome : A genetic neurodevelopmental condition that causes regression of physical and social skills beginning during the early school-age years.
• Adrenoleukodystrophy : A genetic disorder that causes a decline in motor and cognitive skills beginning during early childhood
• Childhood metabolic disorders : A group of conditions that affects the way children break down nutrients, often resulting in toxic damage to organs
• Brain tumor : A growth that may damage areas of the brain, including those that control speech or language
• Encephalitis : Brain inflammation or infection that may affect the way regions in the brain function
• Hydrocephalus : Excess fluid within the skull, which may develop after brain surgery and can cause brain damage

Do Childhood Speech Disorders Persist?

Speech disorders during childhood can have persistent effects throughout life. Therapy can often help improve speech skills.

Speech Impairment in Adulthood

Adult speech disorders develop due to conditions that damage the speech areas of the brain.

Common causes of adult speech impairment include:

• Head trauma 
• Nerve injury
• Throat tumor
• Stroke 
• Parkinson’s disease 
• Essential tremor
• Brain tumor
• Brain infection

Additionally, people may develop changes in speech with advancing age, even without a specific neurological cause. This can happen due to presbyphonia , which is a change in the volume and control of speech due to declining hormone levels and reduced elasticity and movement of the vocal cords.

Do Speech Disorders Resolve on Their Own?

Children and adults who have persistent speech disorders are unlikely to experience spontaneous improvement without therapy and should seek professional attention.

Steps to Treating Speech Impediment 

If you or your child has a speech impediment, your healthcare providers will work to diagnose the type of speech impediment as well as the underlying condition that caused it. Defining the cause and type of speech impediment will help determine your prognosis and treatment plan.

Sometimes the cause is known before symptoms begin, as is the case with trauma or MS. Impaired speech may first be a symptom of a condition, such as a stroke that causes aphasia as the primary symptom.

The diagnosis will include a comprehensive medical history, physical examination, and a thorough evaluation of speech and language. Diagnostic testing is directed by the medical history and clinical evaluation.

Diagnostic testing may include:

• Brain imaging , such as brain computerized tomography (CT) or magnetic residence imaging (MRI), if there’s concern about a disease process in the brain
• Swallowing evaluation if there’s concern about dysfunction of the muscles in the throat
• Electromyography (EMG) and nerve conduction studies (aka nerve conduction velocity, or NCV) if there’s concern about nerve and muscle damage
• Blood tests, which can help in diagnosing inflammatory disorders or infections

Your diagnostic tests will help pinpoint the cause of your speech problem. Your treatment will include specific therapy to help improve your speech, as well as medication or other interventions to treat the underlying disorder.

For example, if you are diagnosed with MS, you would likely receive disease-modifying therapy to help prevent MS progression. And if you are diagnosed with a brain tumor, you may need surgery, chemotherapy, or radiation to treat the tumor.

Therapy to Address Speech Impediment

Therapy for speech impairment is interactive and directed by a specialist who is experienced in treating speech problems . Sometimes, children receive speech therapy as part of a specialized learning program at school.

The duration and frequency of your speech therapy program depend on the underlying cause of your impediment, your improvement, and approval from your health insurance.

If you or your child has a serious speech problem, you may qualify for speech therapy. Working with your therapist can help you build confidence, particularly as you begin to see improvement.

Exercises during speech therapy may include:

• Pronouncing individual sounds, such as la la la or da da da
• Practicing pronunciation of words that you have trouble pronouncing
• Adjusting the rate or volume of your speech
• Mouth exercises
• Practicing language skills by naming objects or repeating what the therapist is saying

These therapies are meant to help achieve more fluent and understandable speech as well as an increased comfort level with speech and language.

Building Confidence With Speech Problems 

Some types of speech impairment might not qualify for therapy. If you have speech difficulties due to anxiety or a social phobia or if you don’t have access to therapy, you might benefit from activities that can help you practice your speech. 

You might consider one or more of the following for you or your child:

• Joining a local theater group
• Volunteering in a school or community activity that involves interaction with the public
• Signing up for a class that requires a significant amount of class participation
• Joining a support group for people who have problems with speech

Activities that you do on your own to improve your confidence with speaking can be most beneficial when you are in a non-judgmental and safe space.

Many different types of speech problems can affect children and adults. Some of these are congenital (present from birth), while others are acquired due to health conditions, medication side effects, substances, or mood and anxiety disorders. Because there are so many different types of speech problems, seeking a medical diagnosis so you can get the right therapy for your specific disorder is crucial.

Centers for Disease Control and Prevention. Language and speech disorders in children .

Han C, Tang J, Tang B, et al. The effectiveness and safety of noninvasive brain stimulation technology combined with speech training on aphasia after stroke: a systematic review and meta-analysis . Medicine (Baltimore). 2024;103(2):e36880. doi:10.1097/MD.0000000000036880

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, language .

Mackey J, McCulloch H, Scheiner G, et al. Speech pathologists' perspectives on the use of augmentative and alternative communication devices with people with acquired brain injury and reflections from lived experience . Brain Impair. 2023;24(2):168-184. doi:10.1017/BrImp.2023.9

Allison KM, Doherty KM. Relation of speech-language profile and communication modality to participation of children with cerebral palsy . Am J Speech Lang Pathol . 2024:1-11. doi:10.1044/2023_AJSLP-23-00267

Saccente-Kennedy B, Gillies F, Desjardins M, et al. A systematic review of speech-language pathology interventions for presbyphonia using the rehabilitation treatment specification system . J Voice. 2024:S0892-1997(23)00396-X. doi:10.1016/j.jvoice.2023.12.010

By Heidi Moawad, MD Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.

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Disorganized Speech: Signs, Causes, and How to Cope

Communication can be a window into your thoughts, making it an important clue in understanding possible mental health conditions.

Almost everyone experiences moments of confusion. You might have a word on the tip of your tongue and you just can’t get it out, or maybe you’ve forgotten where you’re going with a conversation.

Many things can impact thought clarity, but disorganized speech that prevents you from daily communication may be a sign of something more than forgetfulness.

Disorganized speech is also known as “formal thought disorder” since language is the primary way to detect changes in your thought patterns.

What is disorganized speech?

Disorganized speech is any interruption that makes communication difficult — and sometimes impossible — to understand.

Brief disorganized speech can be common and nonspecific, according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) .

But if it becomes severe enough to prevent effective communication, you may be experiencing formal thought disorder.

What’s formal thought disorder?

Disorganized speech is used interchangeably with “formal thought disorder.” This is because scattered communication is one of the primary ways disorganized thinking is identified.

Simply put, if your thoughts aren’t clear, your words may not be either.

Types and examples of disorganized speech

There are many ways your speech might be considered disorganized, but symptoms often fall into categories:

• Symbolism: pairing of thoughts with the correct meaning
• Tempo: the fluidity of words and conversation
• Processing: quality of thought content
• Continuity: direction of thought and conversation

Examples of specific types of disorganized speech may include:

• Paralogism: unusual word choice
• Verbal paraphasia: incorrect word usage
• Literal paraphasia: disordered sounds or sound sequence in words
• Neologism: creation of new words
• Displacement: citing a similar idea but not the correct one
• Contamination: fusing ideas into one another
• Accelerated thinking: rapid flow and increased volume of speech
• Flight of ideas: losing track of where a thought is going
• Inhibited thinking: slow processing of ideas
• Alogia: restricted speech and/or inadequate relay of information
• Circumstantial thinking: inability to determine essential information from unessential
• Desultory thinking: random topic jumps during conversation
• Derailment: sudden drop in train of thought
• Omission: inability to recall a main thought point
• Overinclusive thinking: conversation limits are never identified
• Echolalia: repetition of words or phrases
• Palilalia: fast repetition of words or phrases with decreasing audibility
• Thought blocking: Sudden gaps in thought for no obvious reason
• Verbigeration: nonsensical repetition of words
• Incoherence: complete speech disorganization; “word salad”

Signs of disorganized speech patterns

There’s no “one size fits all” way to describe disorganized speech. At its core, it can be any language-focused symptom that impairs communication.

If you’re experiencing disorganized speech, you may notice speech patterns related to:

• unexpected pauses
• incorrect words
• unusual pronunciation
• loss of thought placement
• lack of words
• excess of words
• slow or absent word processing

Possible causes

The exact cause of disorganized speech is still being investigated.

As a symptom closely associated with mental health conditions, disorganized speech may be partially due to differences in the central nervous system.

Language and words are skills you learn. They’re stored in your memories.

Many of the mental health conditions that feature symptoms of disorganized speech involve changes in regions of the brain related to memory, speech, and language.

Some 2017 research suggests changes in neural connectivity in these areas could affect communication.

If you’re unable to form the proper connections in the part of the brain that grants access to language memories, you may not be able to organize your thoughts into words.

Other factors may also influence disorganized speech. Times of extreme stress , anxiety, or fear could cause an interruption in your natural speech patterns.

Related mental health conditions

Disorganized speech is most commonly linked to schizophrenia — particularly disorganized schizophrenia .

But experiencing disorganized speech doesn’t necessarily point to schizophrenia in all cases.

Schizophrenia is a diagnosable mental health condition in the DSM-5. Disorganized speech is a symptom but not a disorder on its own.

In addition to schizophrenia, other mental health conditions that may present with symptoms of disorganized speech include:

• dementia (neurocognitive disorder)
• schizoaffective disorder
• bipolar disorder
• delusional disorder
• traumatic brain injury
• schizotypal personality disorder
• schizophreniform disorder
• some types of depression
• psychotic disorder
• Alzheimer’s disease
• attention-deficit hyperactivity disorder (ADHD)
• attenuated psychosis syndrome

Social anxiety

Living with disorganized speech can affect how you interact with those around you and may cause social problems for some.

Dealing with disorganized speech might generate feelings of frustration and irritation — for you and those who don’t understand that you’re experiencing something out of your control.

Over time, you may develop a tendency to isolate yourself. Worry and anxiety over when disorganized speech may happen next can keep you at home.

Treatment and management

Seeking professional treatment can be one of the best ways to learn to manage disorganized speech and see an improvement.

Treatment largely depends on addressing the underlying condition causing disorganized speech as a symptom.

Seeking treatment for a traumatic brain injury, for example, may be significantly different than treatment for bipolar disorder .

Your physician or therapist can help identify why you’re experiencing disorganized speech. If a mental health condition is contributing, successful treatment may involve:

• medications
• psychotherapy
• self-care or lifestyle changes

The medication you’re prescribed and the type of therapy recommended will depend on the condition your physician and therapist feel is at the heart of your symptoms.

Coping with disorganized speech

Aside from medications and therapy , there are many other strategies for coping with disorganized speech.

Self-care and simple lifestyle changes that can help you manage disorganized speech include:

• Social support: building a supportive network of understanding family and friends, joining support groups
• Building communication skills: participating in discussion groups around building social skills, developing alternative communication options with your therapist or counselor
• Medical self-care: staying on track with taking medications as directed, attending appointments regularly for the entire treatment protocol
• Lifestyle changes: developing stress-relief options and relaxation techniques, trying to eat a nutritious diet, focusing on sleep hygiene, exercising regularly, spending time outside

Disorganized speech can present in many different ways and may even prevent effective communication if it progresses. And while it can be a symptom of many mental health conditions, disorganized speech is not a diagnosis in itself.

Living with disorganized speech can be frustrating and may even cause social anxiety, stress, and isolation in some people.

However, disorganized speech can be managed with the proper treatment, which often involves addressing conditions causing this symptom.

Working with your doctor or physician to tailor a treatment plan to you is often the best first step. Depending on any underlying conditions, treatment plans for disorganized speech commonly involve a combination of:

• self-care and lifestyle changes

It’s not always easy to reach out for help with mental health conditions. If you’re ready to seek support but don’t know where to start, check out Psych Central’s guide to mental health help.

Last medically reviewed on February 11, 2022

10 sources collapsed

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
• Ban T. (n.d.). Glossary: Formal disorders of thought. https://inhn.org/archives/ban-collection/glossary-formal-disorders-of-thoughts.html
• Cokal D, et al. (2018). The language profile of formal thought disorder. https://www.nature.com/articles/s41537-018-0061-9
• Disorganized speech. (n.d.). https://dictionary.apa.org/disorganized-speech
• Disorganized symptoms of psychosis. (n.d.). https://www.thenationalcouncil.org/wp-content/uploads/2018/07/Disorganized-Symptoms-of-Psychosis-Slides.pdf?daf=375ateTbd56
• Hart M, et al. (2017). Rethinking thought disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464106/
• Jeronimo J, et al. (2018). Formal thought disorders — historical roots. https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00572/full
• Nordgaard J, et al. (2021). Formal thought disorder and self-disorder: An empirical study. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.640921/full
• Solomon M, et al. (2008). Formal thought disorder and the autism spectrum: relationship with symptoms, executive control, and anxiety. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519298/
• Wensing T, et al. (2017). Neural correlates of formal thought disorder: An activation likelihood estimation meta-analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685170/

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What to know about speech therapy

Speech therapy provides treatment and support for people experiencing speech disorders and communication problems. The approach is useful for treating several issues in both children and adults.

Speech is the expression of thoughts using articulate sounds. A speech disorder is an issue that prevents a person from communicating using spoken words. People may also refer to them as communication disorders.

Keep reading to learn more about speech therapy, including the conditions it may benefit, and how it works.

What is speech therapy?

Speech disorders can develop in multiple ways. They can occur due to:

• nerve injuries to the brain
• muscular paralysis
• structural abnormalities
• developmental disabilities

A 2015 study showed that around 8% of children aged between 3–17 years experienced a communication disorder during the last 12 months.

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), around 7.5 million people in the United States have trouble using their voices.

Speech therapy is an effective treatment for speech and communication disorders.

With speech therapy, a speech-language pathologist (SLP) provides treatment and support for people with speech disorders. They are health professionals trained to evaluate and treat those with speech, language, or swallowing disorders.

People often refer to SLPs as speech therapists.

How does it work?

An SLP will begin by assessing the individual. They can then identify different types of speech disorders and how they can treat them.

Speech therapy for children

A child may participate in speech therapy in a classroom as part of a small group or in a one-on-one setting. This depends on which speech disorder they are experiencing.

The SLP will use therapeutic exercises and activities to help them overcome their specific issues.

These include:

• Language activities: Involves playing and talking with the child while using pictures, books, and objects to stimulate language development. The SLP may also demonstrate correct pronunciation and use repetition exercises to help increase the child’s language skills.
• Articulation activities: These will involve the SLP working closely with a child to help them with their pronunciation. The SLP will demonstrate how to make specific sounds, often during play activities.
• Feeding and swallowing therapy: An SLP can work closely with a child with chewing or swallowing issues. The SLP can also use oral exercises to help strengthen the muscles in the mouth or work with different food textures to improve the child’s oral awareness.
• Exercises: The SLP may use a number of tongue, lip, and jaw exercises, alongside facial massage to help strengthen the muscles around the mouth. This can help them with future speech and communication.

An SLP will also provide the child with strategies and homework. These exercises allow them to work through certain activities with a parent or caregiver, so they can continue to practice at home.

Speech therapy for adults

An SLP can use several different techniques as part of adult speech therapy. These include:

• Social communication: The SLP may use problem-solving, memory activities, and conversation exercises to improve communication.
• Breathing exercises: An SLP may use breathing exercises to assist with resonance issues.
• Mouth exercises: These are a suitable way to strengthen oral muscles, which can help improve communication.
• Swallowing exercises: Medical issues, such as Parkinson’s disease, oral cancer, or a stroke, may cause swallowing difficulties. An SLP can use swallowing exercises to help a person manage these issues.

An SLP can use speech therapy to treat several conditions, which include the following:

Stuttering is a speech disorder that specialists characterize by the repetition of sounds, syllables, or words. A person with a stutter often repeats or prolongs words, syllables, or phrases.

A person with a stutter knows what they want to say but has trouble speaking clearly or in a manner that flows naturally.

People often also refer to a stutter as a stammer.

Learn more about stuttering here.

Aphasia is a disorder that causes a person to have difficulty with language or speech. Damage to the parts of the brain that are responsible for language may trigger aphasia. Strokes are a leading cause of the condition in adults.

A person with aphasia may lose their ability to express and understand language, and may also have difficulty reading or writing.

According to the NIDCD, around 1 million people in the U.S. are living with aphasia, while almost 180,000 acquire the condition each year.

Learn more about aphasia here.

Articulation disorders

Specialists classify articulation disorder as a disorder without associations to another speech or linguistic disability.

Articulation disorders refer to people experiencing issues with the production of sound involving the coordinated movements of the lips, tongue, teeth, palate, and respiratory system.

Those with these disorders may have difficulty making certain sounds, for example, saying “wabbit” instead of “rabbit.”

A person with phonological disorders can make these sounds correctly, but they may use them in the wrong position of a word.

People with articulation disorders often mispronounce words. Many individuals also have issues with other areas of language development.

Specific language impairment

A specific language impairment (SLI) is a disorder that causes issues with language skills development in children. It is a condition that is not due to a known neurological, sensory, or intellectual disability.

SLIs can affect the way a child speaks, listens, reads, and writes. Specialists sometimes refer to them as developmental language disorder, language delay, or developmental dysphasia.

SLI is one of the most common developmental disorders, affecting around 7–8% of kindergarten children .

The condition can impact a person as they enter adulthood. Speech therapy can improve an individual’s specific issues and help with their social and work life.

Resonance disorders

A blockage or obstruction to the regular airflow through a person’s mouth as they talk can trigger a resonance disorder. These disorders alter the vibrations responsible for speaking, leading to speech becoming unclear.

Healthcare providers often associate this speaking disorder with cleft palates and other neurological disorders.

Is it effective?

Several studies show speech therapy is an effective method for helping children and adults develop their communication skills.

One study of over 700 children with speech or language difficulties shows that speech therapy had a significant positive effect.

The results show that an average of 6 hours of speech therapy over 6 months significantly improved communication performance. Speech therapy was also much more effective than no treatment over the same period.

Another study looked at the effects of speech therapy on adults who had experienced a stroke and developed aphasia. The data suggest that speech therapy is effective in treating these communication issues.

The research also points to its efficacy in the early phase after a stroke, typically the first 6 months, and shows that intensive treatments have a greater effect.

Another study also suggests that speech therapy can be effective in treating people with aphasia. This study shows that 16 sessions of speech therapy across eight successive weeks helped improve communication skills.

Alternatives

There are some alternatives to speech therapy, which a person may use alongside speech therapy. These include:

Music therapy

Music therapy involves a number of specific music-led activities. These activities use music to strengthen language, communication, and social skills. A study shows it can help facilitate speech development in children.

Learn more about music therapy here.

Neurofeedback treatment

This treatment uses sensors attached to a person’s scalp, which record brainwave activity. Doctors then use a screen to display this activity. The person can then learn to control their brain functions as they communicate.

It is an effective treatment for speech problems in people who have experienced a stroke. However, it may have limited long-term benefits, with the research stating it cannot conclusively prove its efficacy.

Parent-implemented language interventions

This approach involves a parent or caregiver using routines and activities to help children develop their language skills. One study looked at parent-implemented language interventions with young children between 18–60 months of age.

The results showed that parents who implemented communication and language interventions had a significant, positive impact on the language skills of children with and without intellectual disabilities.

While speech and communication disorders are common in the U.S., speech therapy is proven to be an effective treatment for these disorders.

Speech therapy is effective for both children and adults, and SLPs can use various techniques to help a person improve their communication skills.

Last medically reviewed on January 6, 2021

• Neurology / Neuroscience
• Rehabilitation / Physical Therapy

How we reviewed this article:

• Aphasia. (2017). https://www.nidcd.nih.gov/health/aphasia
• Black, L. I., et al . (2015). Communication disorders and use of intervention services among children aged 3–17 years: United States, 2012. https://www.cdc.gov/nchs/products/databriefs/db205.htm
• Broomfield, J., et al. (2011). Is speech and language therapy effective for children with primary speech and language impairment? Report of a randomized control trial [Abstract]. https://pubmed.ncbi.nlm.nih.gov/22026565/
• Facts about cleft lip and cleft palate. (2020). https://www.cdc.gov/ncbddd/birthdefects/cleftlip.html
• Feeding and swallowing disorders in children. (n.d.). https://www.asha.org/public/speech/swallowing/feeding-and-swallowing-disorders-in-children/
• Groß, W., et al. (2010). Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921108/
• Kim, J., et al. (2017). Speech and linguistic features of children with articulation disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698671/
• Koyuncu, E., et al. (2016). Speech and language therapy for aphasia following subacute stroke. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116837/
• Mattioli, F. (2019) The clinical management and rehabilitation of post stroke aphasia in Italy: Evidences from the literature and clinical experience [Abstract]. https://pubmed.ncbi.nlm.nih.gov/30900098/
• Specific language impairment. (2019). https://www.nidcd.nih.gov/health/specific-language-impairment
• Speech disorder. (n.d.). https://www.nidcd.nih.gov/glossary/speech-disorder
• Speech-language pathologist. (n.d.). https://www.nidcd.nih.gov/glossary/speech-language-pathologist
• Speech problems – articulation and phonological disorders. (2018). https://www.rch.org.au/kidsinfo/fact_sheets/Articulation_and_phonological_disorders/
• Statistics on voice, speech, and language. (2016.). https://www.nidcd.nih.gov/health/statistics/statistics-voice-speech-and-language#:~:text=Source%3A%20Compiled%20from%20fact%20sheets,have%20trouble%20using%20their%20voices
• Stelck, E. H., et al. (2011). Current practices for evaluation of resonance disorders in North America [Abstract]. https://pubmed.ncbi.nlm.nih.gov/21491359/
• Stuttering. (2017). https://www.nidcd.nih.gov/health/stuttering#treated

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Aphasia affects a person's ability to use language. It often results from a stroke. Learn about aphasia and how to help a person who has it.

Apraxia is a neurological disorder that affects a person’s ability to perform everyday movements. Learn more about the symptoms, causes, and types in…

Music therapy utilizes the power of music for the treatment of mental health conditions, such as depression and anxiety. Learn how it works here.

Accelerated resolution therapy is a type of therapy some may use to treat PTSD. Learn more here.

VR therapy shows promise in helping treat a range of mental health conditions. It may help people learn skills, confront fears, and more.

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Publications, addressing real- world health issues.

It was 2000, and I was practicing speech-language pathology in a rural hospital outside Boise, on the Oregon border. There, I met a 5-year-old boy (we’ll call him Ben) who was getting ready to start kindergarten. There was a problem: Ben was still not talking in complete sentences, and he communicated mainly by echoing others’ words.

After my first session with Ben, it was clear he had autism spectrum disorder. Since the rural community did not have available expertise, Ben missed critical years of early language intervention. It took consultations with a multidisciplinary team of teachers and allied health specialists, but he progressed in basic communication skills and language expression.

With Ben on my mind, I decided to pursue my Ph.D. I was ultimately interested in being a university professor to prepare future health and education providers to support language-literacy in children with developmental disorders, including those in underserved communities. 

Almost 25 years later, I’m proud to say I saw great success with those goals, achieving funding through the National Institutes of Health to study new clinical methods and a grant through the U.S. Department of Education to fund health students to stay and serve in their rural communities. A great privilege was seeing one of the funded graduates fill a position that had been vacant for more than two decades in a rural Native American school district.

Today, my passions expand to encompass the multidisciplinary aspects of health and to create new opportunities for education and clinical research.

Already steeped in the Jesuit value of cura personalis (whole- person care), the school has a strong history of community engagement, experiential learning, and excellent faculty, programs and students. We are now expanding from nursing and human physiology to broader health programming so that any potential student who wants to help others but may not be seeking a career in direct patient care can find a rewarding path.

The University of Washington-Gonzaga University Health Partnership affords a natural connection to UW’s well- established rural medicine training and research. As the Gonzaga arm of the Health Partnership, GU’s School of Health Sciences is ready to drive applied implementation science research and work alongside UW medical students to build interprofessional health teams. Imagine the potential we have to support communities that historically have been underserved and provide them the same quality care available to others!

Indeed, I am honored to be part of Gonzaga’s vital humanistic mission, helping to develop students who will become health science leaders who treat mentees, clients and patients with the same whole-person care they receive in their education. It is a privilege to spearhead the launch of new programs, including the Public Health department (undergraduate degree starting in fall 2024 and the distance-accessible graduate degree in the coming year).

I look forward to more conversations with community partners to study and address real-world health challenges, continuing a journey that all started with Ben.

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Speech Deficits in Serious mental Illness: A Cognitive Resource Issue?

Alex s. cohen.

a Department of Psychology, Louisiana State University

Jessica E. McGovern

Thomas j. dinzeo.

b Department of Psychology, Rowan University

Michael A. Covington

c Institute for Artificial Intelligence, The University of Georgia

Speech deficits, notably those involved in psychomotor retardation, blunted affect, alogia and poverty of content of speech, are pronounced in a wide range of serious mental illnesses (e.g., schizophrenia, unipolar depression, bipolar disorders). The present project evaluated the degree to which these deficits manifest as a function of cognitive resource limitations. We examined natural speech from 52 patients meeting criteria for serious mental illnesses (i.e., severe functional deficits with a concomitant diagnosis of schizophrenia, unipolar and/or bipolar affective disorders) and 30 non-psychiatric controls using a range of objective, computer-based measures tapping speech production (“alogia”), variability (“blunted vocal affect”) and content (“poverty of content of speech”). Subjects produced natural speech during a baseline condition and while engaging in an experimentally-manipulated cognitively-effortful task. For correlational analysis, cognitive ability was measured using a standardized battery. Generally speaking, speech deficits did not differ as a function of SMI diagnosis. However, every speech production and content measure was significantly abnormal in SMI versus control groups. Speech variability measures generally did not differ between groups. For both patients and controls as a group, speech during the cognitively-effortful task was sparser and less rich in content. Relative to controls, patients were abnormal under cognitive load with respect only to average pause length. Correlations between the speech variables and cognitive ability were only significant for this same variable: average pause length. Results suggest that certain speech deficits, notably involving pause length, may manifest as a function of cognitive resource limitations. Implications for treatment, research and assessment are discussed.

1. Introduction

Serious mental illness (SMI) – defined in terms of serious functional impairments due to a diagnosable mental illness (e.g., schizophrenia, major depression, bipolar disorders), carries a profound burden of illness and disability. Mounting evidence suggests that there are often commonalities in individuals with SMI with respect to symptom presentation (e.g., Insel et al., 2010 ), functional impairments (e.g., Pini et al., 2001 , Simonsen et al., 2011 ), neurobiology (e.g., Ng et al., 2008 ) and treatment response (e.g., Roth et al., 2004 ) related variables in ways that transcend traditional diagnostic boundaries ( NIMH, 2013 ). In response, there have been repeated calls to understand the mechanisms underlying symptoms in mental illness beyond those involved with traditionally-defined diagnostic groups. In the present paper, we evaluate whether cognitive liabilities underlie speech deficits in individuals with SMI using highly sensitive objective measures and both experimental and correlational methods.

Deficits in speech communication, defined in terms of reduced production (e.g., alogia), variability (e.g., blunted affect) and content (e.g., poverty of content – speech that lacks meaning, irrespective of quantity of speech) are a staple of SMI (e.g., depression, schizophrenia, bipolar disorder; American Psychiatric Association [APA], 2013, Cohen et al., 2012 , Tremeau et al., 2005 ). These deficits are often chronic in course, medication resistant and related to poor prognosis ( Kirkpatrick et al., 2001 ). Despite these symptoms reflecting important Research Domain Criteria (RDoC) as “Production of Non-Facial Communication”, and hence, being potentially instrumental for understanding pathophysiological processes and improving diagnosis ( Cohen et al., 2012 ; Insel et al., 2010 ; NIMH, 2013 ), our understanding of their nature is poor. An unfortunate obstacle in understanding and measuring speech deficits is a reliance on interviewer-based rating scales ( Horan et al., 2011 ; Kirkpatrick et al., 2011 ). Data from these scales are relatively insensitive to change given the limited range of response options and ambiguous operational definitions, produce ordinal data that are inappropriate for parametric statistics, often cover wide temporal swaths, and are imprecise for isolating specific behaviors from other negative traits/symptoms ( Alpert et al., 2002 , Cohen et al., 2008 , Cohen and Elvavag, 2014 ). Moreover, these scales have limited resolution for understanding how expressive deficits modulate within individuals, how they differ across individuals, and how they are uniquely related to cognitive, functional, pathophysiological, genetic and other variables. Thus, it is little surprise that our mechanistic understanding of speech deficits is poor. Emerging computerized technologies have allowed for assessment of speech deficits with near perfect inter-rater reliability and greater sensitivity and specificity than clinical rating scales ( Alpert et al., 2002 ; Cohen et al., 2008 , Cohen and Hong, 2011 , Cohen et al., 2012 ).

There is reason to think that speech deficits may reflect a broader cognitive resource issue in patients with serious mental illness. A substantial amount of research from a range of disciplines suggests that humans have a limited amount of cognitive resources at any given time, and allocating resources towards one task (e.g., remembering a phone number or name, operating a motor vehicle) limits the resources available for speech (e.g., Plass, Moreno, and Branken, 2010 ). To date, at least six studies have found evidence that depletion of cognitive resources, conducted using experimental methods, results in reduction of speech quantity ( Barch and Berenbaum, 1994 , Barch and Berenbaum 1996 , Cohen et al., 2012a , Cohen et al., 2014a , Tuček et al., 2012 ; Yin et al., 2007 ). Some of these studies have also documented changes in speech variability ( Cohen et al., 2012a , Cohen et al., 2014a , Tuček et al., 2012 ; Yin et al., 2007 ) and speech content ( Barch and Berenbaum, 1994 ; Barch and Berenbaum 1996 ) as well.

There is good reason to suspect that cognitive resource limitations may reflect a mechanism by which speech deficits manifest. First, patients with SMI show a broad range of cognitive deficits and these deficits are, in at least some studies, similar across diagnostic categories ( Cohen et al., 2012 ; Simonsen et al., 2011 ). Second, poorer cognitive ability has been associated with negative symptoms in schizophrenia (e.g, Cohen et al., 2007 ), severity of melancholia in depression (e.g., Austin, et al., 1999 ), and with social functioning in bipolar disorder ( Burdick et al., 2010 ) using interview-based rating scales. Third, correlational studies have demonstrated a link between cognitive deficits (e.g., processing speed) and abnormal speech production and speech variability in patients with SMI (e.g., Cohen et al., 2013 ; Gur et al., 2006 ). Finally, several experimental studies have demonstrated that increased cognitive load in patients with schizophrenia was associated with decreased speech production and poverty of content ( Barch and Berenbaum, 1996 , Melinder and Barch, 2003 ).

There are critical limitations in our understanding of the link between neurocognition and speech deficits in SMI. Of note, experimental studies examining patients (i.e., Barch and Berenbaum, 1996 , Melinder and Barch, 2003 ) failed to include control groups, so it is unclear whether speech is actually abnormal in any regard relative to the population. Moreover, prior studies employing objective or computerized analysis of speech tended to focus solely on speech production at the expense of speech variability and speech content. Furthermore, prior studies have employed limited indices of speech production (e.g., word counts) and variability (e.g., mean volume, variability of F0). This is a critical point highlighted in a recent meta-analysis of objective measures of speech deficits in schizophrenia ( Cohen et al., 2014b ) – that there has been little consistency in which speech variables are reported across studies (e.g., eight different variables of speech production reported across 13 studies), and considerable disparity in magnitude of deficit across these variables (range of d ’s = −.20 – −2.56). In the present study, we addressed these limitations and conducted the most sophisticated study to date clarifying the cognitive underpinnings of speech deficits in SMI. We employed both correlational and experimental approaches, and a broad set of sophisticated and diverse computer-based measures of natural speech indicated in a recent psychometric investigation from our group ( Cohen et al., 2014c ).

2.1. Participants

Participants were recruited from outpatient community mental health clinics and group homes based on meeting federal criteria for having an SMI defined in terms of adults (i.e., age 18 or older) who currently, or in the past year, meet criteria for a diagnosable mental, behavioral, or emotional disorder that results in functional impairment which substantially interferes with one or more major life activities (i.e., per the ADAMHA Reorganization Act). Participants included 52 patients with Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV; APA, 1994 ) diagnosed schizophrenia ( n = 35) or unipolar major depressive or bipolar disorders ( n = 17). Note that there was substantial blurring between these diagnostic categories in that a significant portion of individuals diagnosed with schizophrenia also had a history of depression and mania (19% and 22%, respectively), and that a significant portion of patients diagnosed with affective disorders had a history of psychosis (33%). Hence, the primary focus of this study involved collapsing patients into an SMI group – though traditional diagnosis was retained as a variable of interest for some analyses. Diagnoses were made based on information obtained from the patients’ medical records and from a structured clinical interview (SCID-IV; First et al., 1996 ). Exclusion criteria included: a) Global Assessment of Functioning (GAF; APA, 1994 ) rating below 30, b) documented evidence of mental retardation from the medical records, c) current or historical DSM-IV diagnosis of drug dependence with symptoms of severe physiological symptoms (e.g., delirium tremens, “blacking out”), and d) history of significant head trauma (requiring overnight hospitalization). All patients were clinically stable at the time of testing and were receiving pharmacotherapy. Controls ( n = 30) were recruited from the community using the above exclusion criteria with the exception that they be free of current and past psychotic and affective disorders (per a SCID interview). Participants received $40 for their participation. This study was approved by the appropriate Human Subject Review Boards and all participants offered informed consent prior to participating in the study. Demographic and clinical information is included in Table 1 .

Descriptive statistics for demographic and clinical variables for the control and serious mental illness (SMI) groups.

2.2. Diagnostic and Symptom Ratings

Psychiatric symptoms were measured using the Expanded Brief Psychiatric Rating Scale (BPRS; Lukoff et al., 1986 ). BPRS ratings were made using information obtained from medical records, the patients’ treatment teams and self-report and behavioral observations made during the research interview. Factor subscale scores reflecting positive, depression/anxiety and mania/excitement symptoms were computed ( Ventura et al., 2000 ). Negative symptoms were measured using the Scale for the Assessment of Negative Symptom (SANS; Andreasen, 1984 ) global scores. Preliminary diagnoses and ratings were made by one of four doctoral-level students who were trained to criterion (Intra-class Correlation Coefficient values > .70).

2.3. Speech Tasks

Subjects were seated in front of a computer monitor and asked to perform two separate 90-second speaking tasks involving topics without demonstrative positive or negative emotional valence (i.e., hobbies, foods, daily routines) during which participants were encouraged to speak as much as possible (see Cohen et al., 2012a ; Cohen et al., 2013a ). During a “baseline” narrative task condition, participants provided speech while passively watching symbols appear on the monitor. Six different visual symbols were presented at 1,500, 2,000 and 2,500 millisecond inter-stimulus intervals. During a “high-load” narrative task, participants spoke while performing a one-back test. This task involved forced-choice responding (i.e., “match”, “non-match”) to stimuli when consecutively appearing visual symbols on a computer screen were identical. The visual stimuli and their presentation were identical across the two conditions. Four patients were excluded from the present study for not responding to the cognitive task (accuracy < 10%). Order of task and speech topic was randomized.

2.4. Speech Production and Speech Variability

The Computerized Assessment from Natural Speech protocol (CANS; Cohen et al., 2010 ; Cohen et al., 2009 ) was employed. The CANS system organizes sound files into “frames” for analysis, which for the present study was set at a rate of 100 frames per second. During each frame, frequency and volume are quantified, and information about pauses, utterances, intonation and emphasis are extracted. Our selection of these variables was based on a recent psychometric analysis of 1350 young adults using this procedure ( Cohen et al., 2014b ). We examined the following variables in this study: pause number – total count of all pauses (>150 ms) in the speech sample, pause length – average length of pauses (in milliseconds), utterance length – average length of utterances (in milliseconds), intonation – average standard deviation of fundamental frequency values computed separately for each utterance, intensity – average intensity values (i.e., volume) computed within each utterance, emphasis – average standard deviation of intensity values, computed separately for each utterance. Based on recent evidence that formant values are important for understanding schizophrenia ( Covington et al., 2012 ), the standard deviation of the Formant 1 (indicating tongue height) and Formant 2 (indicating tongue position from front to back) values were also computed. All fundamental frequency values were log-transformed to control for their nonlinear distribution. Additionally, speech production was measured using word count (described below).

Speech content was measured in terms of filler words and semantic and vocabulary density. Word count (as a measure of speech production) and use of word filler/nonfluencies was measured using computerized lexical analysis of the transcribed speech samples via the Linguistic Inquiry and Word Count (LIWC) program ( Pennebaker, 2001 ). We examined nonfluency (e.g., “er”, “um”, “hm”) and filler (e.g., “I mean”, “you know”, “blah”, multiple word repetitions [“I, I, I went the store]) categories, which were combined together. Semantic complexity (i.e., idea density) was measured using CPIDR 5.1 (Computerized Propositional Idea Density Rater, program version 5.1.4637.21009; Covington, 2012 ). CPIDR is a free, validated, computerized part-of-speech tagger that counts the number of propositions or assertions (verbs, adjectives, adverbs, prepositions, and subordinating conjunctions with some adjustment rules) and divides those by the total number of words in the text ( Brown et al., 2008 ). A parameter known as “speech mode” was used to eliminate hesitation words (e.g., um, uh) and repetitions from the total word count, thereby reducing the impact of hesitant speech and avoiding a redundant measure of such words. Vocabulary (i.e., lexical) diversity was measured using a moving-average type-token ratio, i.e., the average of the vocabulary length in a moving text sequence of 20 consecutive words ( Covington and McFall, 2010 ). Higher scores of the latter two variables indicate more semantically complex and vocabulary-rich text that expresses a greater variety of meaning per volume.

2.5. Cognition Ability

Basic cognitive ability was measured using the Brief Assessment of Cognition in Schizophrenia (BACS; Keefe, 1999 ), a battery assessing executive functions, psychomotor speed, attention, verbal memory and working memory. Due to potential circularity in examining speech production as a function of verbal fluency, the verbal fluency score was excluded.

2.6. Analyses

The analyses were conducted in four steps. First, we computed zero-order correlations between our 12 speech measures of interest to determine whether any of the variables were redundant with each other, defined as an r value > .85 (i.e., sharing 72% of variance). Second, we examined potential demographic and cognitive differences between the SMI and control groups that might inform subsequent analyses. We also compared patients with schizophrenia and those without on all dependent, clinical and descriptive measures. Additionally, the effects of speech topic (i.e., randomized across conditions), depression and demographic variables on the consequent results were considered. Third, we compared the SMI and control groups on speech characteristics for the baseline and high-load tasks using repeated-measures ANOVAs. We predicted significant group, condition, and interaction effects such that a) all subjects would show a declination in speech characteristics as a function of increasing cognitive load, b) patients overall would show less speech production, variability and content, and c) the speech of patients would show a more dramatic declination in speech characteristics under load compared to controls. Fourth, we computed correlations between speech characteristics (from the baseline condition) and general psychiatric symptom ratings, negative symptom ratings and cognitive performance variables. Although these correlations were largely exploratory, we expected that speech characteristics would be associated with cognitive ability (i.e., BACS) negative and depressive symptoms but not other psychiatric symptoms. All analyses in this study were two-tailed and all variables were normally distributed (skew < 1.5). Extreme scores (> 3.5 SD) were trimmed (i.e., replaced with values 3.5 SD).

3.1. Zero-Order Correlations

Zero-order correlations (see Table 2 ) suggested that the variables were relatively independent of each other. The only variables approaching redundancy (i.e., r > .85) were between the word count and Pause Length variables for controls ( r = −.83) and the Pause Number and Pause Mean variables for the patients ( r = −.80).

Zero-order correlation matrix of speech variables for controls (italicized) and patients.

3.2 Demographic and Descriptive Variables

Education and GAF scores were significantly different between the patient and control groups ( p ’s < .05), but there were no other significant differences (see Table 1 ). Patients meeting criteria for schizophrenia versus those that did not were not statistically dissimilar in age, education level, current GAF, any of the cognitive ability scores, performance on the n-back portion of the high-load task or severity of any of manic/excitement, depression/anxiety or negative symptoms ratings. Patients with schizophrenia versus those without were more likely to be male (75% versus 45%; X 2 5.41, p = .02) and had more severe positive symptoms ( t [56] = 2.71, p = .01). The patient groups only significantly differed in four of 24 speech variables (i.e., 12 variables for baseline and high-load conditions). Schizophrenia patients showed lower intonation during both baseline and high-load conditions ( t ’s[50] = 2.89 and 3.03, p ’s = .006 and .004 respectively), lower baseline intensity ( t [50] = 2.29, p = .03) and greater baseline word counts ( t [50] = 2.05, p = .045). Each of these results was nonsignificant when sex was controlled for. With one exception (i.e., baseline word count; F [2, 78] = 3.98, p = .02), speech variables did not differ as a function of speech topic. The results in sections 3.2 and 3.3 did not appreciably change when speech condition, demographic variables or severity of depressive symptoms were controlled for.

3.3. Group Comparisons on Speech Characteristics

Significant condition effects were observed for each of the four speech production and three content variables such that increased cognitive demands were associated with lower word counts, fewer pauses with longer lengths (i.e., lower N, longer Length), shorter utterance lengths, less semantically and lexically rich speech and increased word fillers ( Table 3 ). With the exception of increasing intensity , none of the speech variability measures changed between conditions. Group effects were observed for some of the speech production (i.e., three of four), content (i.e., three of seven) and variability (i.e., two of five) measures. Overall, patients showed significantly fewer words, fewer pauses with longer lengths, greater F1 variability, louder speech, and less semantically and lexically rich speech. A significant interaction was observed for pause length . Post-hoc analyses of the interactions, using t -tests, revealed that pauses and utterances became disproportionately longer for patients versus controls as the cognitive demands of the task increased (see Figure 1 ).

Comparison of mean pause times for baseline and high-load conditions for control (Grey Bar) and serious mental illness (Black Bar) groups.

Means and standard deviations of speech variables for baseline and high-load conditions for control (Con) and serious mental illness (SMI) groups with F values from mixed-design analyses of variance.

3.4. Speech Characteristics, Symptoms and Cognitive Ability

Generally speaking, there were few significant correlations between general psychiatric symptoms and speech characteristics ( Table 4 ), though positive symptoms were associated with greater F1 variability . On the other hand, negative symptoms, notably flat affect and alogia, showed a range of speech correlates. More severe ratings of flat affect and alogia were both significantly associated with lower word counts, greater pause lengths and fewer pauses. Flat affect was also associated with greater intonation , louder speech and less semantically and lexically rich speech. Generally speaking, few of the correlations between speech and cognitive ability were statistically significant. As hypothesized, greater p ause mean values were significantly associated with poorer working memory and psychomotor performance, and fewer p ause numbers were associated with poorer psychomotor performance, but few other statistically correlations were observed.

Correlations between speech variables and positive/disorganization and negative symptom ratings and cognition scores.

Given the heterogeneity of symptoms included in the BPRS factor scores, correlations were separately computed between speech characteristics and individual BPRS symptom ratings. Generally, speaking, speech characteristics were not significantly related to BPRS items reflecting the prior month (e.g., depression, anxiety, hostility); only six of possible 168 correlations were statistically significant. In contrast, more significant correlations were observed in BPRS items based solely on interview behavior; 17 of 120. Nearly all of these correlations (16 of 19) were related to Blunted affect, emotional withdrawal and motor retardation. In general, these symptoms showed the same pattern of correlates as the SANS Flat affect and Alogia scores noted above, involving word count, pause length, pause N, intonation, intensity and idea and vocabulary density .

4. Discussion

There are five notable findings from this study. First, patients with SMI were deficient in nearly every aspect of speech production and content measured in this study. Second, consistent with prior studies ( Barch and Berenbaum, 1994 , Barch and Berenbaum 1996 , Cohen et al., 2012a , Cohen et al., 2014a , Tuček et al., 2012 ; Yin et al., 2007 ) depletion of cognitive resources resulted in people (both with and without SMI) producing less speech, and speech that was less semantically and lexically rich. Third, consistent with prior research (e.g., Cohen et al., 2012 ), patients with schizophrenia and those with affective disorders did not differ much in speech characteristics. Fourth, depletion of cognitive resources adversely affected the speech of SMI patients more so than controls in only one domain – involving average pause length. This was not simply a matter of controls producing more words or fewer pauses, as the groups were not abnormal in reduction in these variables under cognitive load. Finally, correlational analyses provided evidence of a link between cognitive deficits and average pause lengths.

Lack of significant interaction effects aside, cognitive resources were experimentally linked to poor speech production and content for patients (as in Barch and Berenbaum, 1994 , Barch and Berenbaum 1996 ), so clearly cognition plays an important role in these abilities. Thus, the present results suggest that relatively isolated facets of speech, namely involving production and content, are tied to cognitive resources in SMI patients in ways that other speech deficits (e.g., speech variability) may not be. From a clinical perspective, this suggests that alogia and blunted vocal affect, two cardinal negative symptoms in schizophrenia, may be mechanistically distinct. The relationship between cognition and speech production/content is not surprising in some ways, as many known cognitive domains are critical to these functions (e.g., language functions, verbal fluency, verbal memory). Moreover, it stands to reason that speech production and content, insofar as they are motivated and deliberate behaviors, require the sort of “on-line” attentional/working memory resources tapped in this study. What is not clear is if or why pause lengths are dependent on cognitive resources in ways other aspects of speech production aren’t. It could be that speech production is itself a mechanistically heterogeneous ability such that pause production has meaningfully different underpinnings than other aspects of speech production. Alternatively, it could be that pause length is simply a more sensitive measure for understanding cognitive resources than other aspects of speech production, which is why it showed significant group by condition interactions whereas other measures didn’t. Understanding how cognition is tied to speech production and content, and how they are mechanistically similar and different to other types of speech deficits (and other behavioral deficits) seems an important line for future research.

There are some important novel implications of a “cognitive-resource” theory of speech deficits in SMI. First, it seems reasonable to speculate that speech production deficits, at least in terms of abnormal pause lengths, may be ameliorated by improving cognitive resources in some manner. That is, by relieving cognitive resources limitations, for example, by employing cognitive compensation strategies (e.g., limiting activities requiring multi-tasking) or by bolstering capacity or efficiency more generally (e.g., cognitive remediation), it may be possible to relieve deficits in speech production and content. Relatedly, multi-tasking in potentially high risk situations (e.g., talking on the phone while driving) may be particularly dangerous for patients with SMI. Second, from an assessment perspective, the present data highlight the importance of context when assessing speech deficits. Speech is a dynamic phenomenon and varies considerably as a function of a range of variables. In this manner, it is important to consider cognitive demands when assessing speech. For example, the cognitive load, and consequent speech, involved in responding to relatively straightforward concrete questions (i.e., what did you have for lunch yesterday?) may be quite different than that associated with more abstract questions (i.e., what were you like as a child?). Ideally, deficits in speech production could be measured under controlled conditions where cognitive load can be directly controlled or manipulated – an important consideration as new measures of negative symptoms are being implemented ( Horan, et al., 2011 ; Kirkpatrick et al., 2011 ).

Several additional findings warrant discussion. The present study failed to replicate a prior finding that abnormal formant variability was associated with negative symptoms in patients with schizophrenia ( Covington et al., 2012 ). Differences in speaking task across this prior study (i.e., involving one minute of speech extracted from a clinical interview), and the present study may be responsible. The present study also failed to replicate relationships between cognitive ability and measures of speech variability see in Cohen et al., (2012) . The present study used more sophisticated and precise measures of speech, and it is possible that the measures employed in the prior study were not independent of pause mean. Finally, in the present study, computer-based measures of speech were significantly correlated with clinical symptom ratings involving behavioral assessment but not to those involving month-long assessment epochs. These findings highlight that computer-based measures likely tap “state” symptoms as opposed to those reflecting longer time periods. This is an important consideration for adapting computer-based technology to clinical use.

The present study conceptualized cognition as a general construct reflecting “mental effort”, and it is presently unclear the degree to which specific cognitive abilities contribute to speech deficits. Clarifying this would be important for future research. Moreover, the present study did not employ a true “baseline” measure of speech, as even the baseline condition was cognitively taxing to some degree. This this may explain why patients were abnormal in many speech characteristics during this putatively “low” load task. Finally, the sample size in this study, while typical for a laboratory-based study of this kind, was modest. Limited power may explain some of the null findings. Despite these potential limitations, the present study found important links between cognition and speech deficits in SMI patients, and highlight the emerging utility of computerized analysis of speech for providing a mechanistic understanding of symptoms in this population.

Acknowledgments

Funding: Funding for this study was provided by a Louisiana Board of Regents and National Institute of Mental Health (R03 MH092622) grant to the primary author. The funding agencies had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

The authors wish to acknowledge the subjects for their participation, lab members for their help processing and collecting data and MMO Behavioral Health Systems for their assistance in subject outreach.

Contributors. Alex S Cohen was the primary investigator for this project and designed the study and wrote the bulk of the manuscript. Jessica McGovern, Thomas Dinzeo and Michael Covington helped manage the literature searches, the analyses and provided conceptual material to the planning and presentation of this project. All authors contributed to and have approved the final manuscript.

Conflicts of Interest: There are no conflicts of interest to report.

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Actress Anna Paquin suffering from speech, mobility issues

(WJW) – Actress Anna Paquin is dealing with health problems that have caused mobility issues.

The 41-year-old walked the red carpet in New York City Wednesday night using a cane for assistance.

Paquin is starring in “A Bit of Light,” a film directed by her husband, Stephen Moyer.

Paquin shared with PEOPLE that she needed a cane to walk and had been experiencing difficulties with her speech.

“It hasn’t been easy,” she told PEOPLE .

Paquin has reportedly been dealing with the health issues for 2 years.

“Small intense independent films like this are very close to my heart,” Paquin wrote in a social media post promoting the film and story with PEOPLE .

Paquin won the Academy Award for Best Support Actress in “The Piano” at the age of 11, which was also her acting debut.

“A Bit of Light” is set for U.S. release on Friday, April 5. See the trailer here .

For the latest news, weather, sports, and streaming video, head to Fox 8 Cleveland WJW.

Why is RFK Jr.'s voice raspy? He has a neurological disorder called spasmodic dysphonia

• Robert F. Kennedy Jr. was diagnosed with spasmodic dysphonia around 1996.
• One symptom of the rare neurological disorder is a raspy voice.
• There is no cure for the condition, but patients can undergo speech therapy or counseling.

Robert F. Kennedy Jr. , the nephew of John F. Kennedy, has stepped back into the spotlight recently, not only for his longshot run to secure the 2024 Democratic party nomination but also for using his campaign to promote conspiracy theories about vaccines and COVID-19.

A Morning Consult survey suggested Kennedy's favorability among Democratic voters remains low, at a 38% approval rating, but his family's political lineage and his controversial views have garnered the candidate some considerable attention. The poll had a margin of error of +/- 2 percentage points. 

While on the campaign trail, people are once again asking about Kennedy's distinctly raspy voice.

Kennedy, 69, previously revealed he was diagnosed in his early 40s with a rare neurological condition called spasmodic dysphonia.

"It began as a mild tremble for a couple of years," Kennedy told Oprah Winfrey in a 2007 interview , adding that he believed his condition worsened over the years.

Here's what we know about the disorder.

What is spasmodic dysphonia?

Spasmodic dysphonia is a neurological disorder that causes involuntary spasms in the muscles of the voice box, also known as the larynx, according to John Hopkins Medicine.

In other words, the vocal cords don't vibrate as they typically should.

This condition can strain an individual's ability to speak, sometimes causing their voice to sound hoarse or breathy. Humming, laughing, singing, swallowing, and crying can also be impacted.

There are three kinds of spasmodic dysphonia.

The most common type is adductor spasmodic dysphonia, in which the vocal cords tighten up, causing a person's voice to sound strained, according to the Cleveland Clinic, a nonprofit medical center .

Related stories

Abductor spasmodic dysphonia is where the muscle spasms cause the vocal folds to stay open. In this case, a person's voice can sound breathy, according to the medical center.

Some people can have a rare mix of both types.

What causes spasmodic dysphonia?

The exact cause of spasmodic dysphonia is unknown, according to Michigan Medicine of the University of Michigan .

"Spasmodic dysphonia is thought to be caused by abnormal functioning in an area of the brain called the basal ganglia," according to the National Institute on Deafness and Other Communication Disorders . "The basal ganglia help coordinate the movements of muscles throughout the body. "

Research has also found abnormalities in the areas of the cerebral cortex — the area of the brain that controls muscle movement, the NIDCD wrote.

Spasmodic dysphonia may also be inherited, but a specific gene for the disorder has not yet been identified.

Is spasmodic dysphonia painful?

The condition is not known to be painful, but it does make the ability to speak difficult.

When asked if it hurts to talk, Kennedy told Winfrey: "No, but it's an effort."

Kennedy recently told NewsNation that he feels the condition makes it "problematical" for people to listen to him.

"I cannot listen to myself on TV," he joked. "So I feel sorry for you guys having to listen to me."

Can spasmodic dysphonia be cured?

Symptoms of spasmodic dysphonia, which is a chronic condition, often develop around middle age, according to the American Speech-Language-Hearing Association .

The symptoms can also be more acute when under stress.

There is no cure for the condition, according to the University of Pennsylvania Health System . But there are treatment options available, including speech therapy and psychological counseling to treat mild cases. Botox injections are also an option.

"Each Botox injection provides about three months of relief from symptoms and there is no limit to the number of Botox injections you may receive for this condition," according to Penn Medicine.

How rare is spasmodic dysphonia?

The disorder is rare and impacts about 1 per 100,000 people, according to a 2011 study published in The Journal of Neuroscience .

Other notable people with spasmodic dysphonia include "Hellboy" actress Selma Blair, CBS News correspondent Jeff Pegues, and journalist Diane Rehm.

Kennedy's campaign team could not provide comment before the time of this story's publishing.

Watch: Billie Eilish just won International Female Solo Artist at the BRIT Awards. Here's how she incorporates ASMR into her music.

• Main content

Anna Paquin, 41, Uses A Cane On Red Carpet And Opens Up About 'Difficult' Two Years Battling Illness

"It hasn't been easy."

• The 41-year-old actress shared that she’s been dealing with undisclosed health issues for the past two years that have made mobility and speech a challenge.
• A source also told People that Anna will hopefully make a full recovery.

Anna Paquin is getting attention after hitting the red carpet using a cane . The 41-year-old actress shared that she’s been dealing with undisclosed health issues that have made mobility a challenge.

The Oscar winner, who stars in the new movie A Bit of Light, told People that it’s been a “difficult” two years.

"It hasn't been easy," she said, noting that she’s also had some issues with her speech. However, a source also told People that Anna will hopefully make a full recovery.

Still, Anna said that she’s excited to support her new movie, which was directed by her husband of 14 years, True Blood alum Stephen Moyer.

"My first love was independent filmmaking," she said. "That's how I entered the film industry. I was working with people who were all about telling stories and telling them with integrity and truth."

Anna also shared that Stephen is her “favorite person” to direct her—and said she wouldn’t be working with him if she didn’t think he was good at what he does. “I'm not sentimental when it comes to work,” she said.

Anna didn’t dive more into her health, but she previously told TODAY that privacy is important to her. “I’ve always been very private. I’m not as neurotic about it as I was when I was younger,” she said. “I don’t want people to know too much about my real, inner private life.”

Stephen also keeps the couple’s life together pretty under wraps, although he shares little behind-the-scenes glimpses of married life with them here and there.

Worth noting: He also called Anna his “incredibly talented soul mate” on Instagram back in 2022:

Get better soon, Anna!

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Anna Paquin Uses Cane At Film Premiere While Dealing With Mobility And Speech Issues

General Assignment Reporter, HuffPost

Oscar winner Anna Paquin walked with a cane Wednesday at the premiere of her new movie amid speculation about her health.

In attendance for a New York City screening of “A Bit of Light,” an indie drama directed by her husband, Stephen Moyer, that she stars in, Paquin used a black walking stick for assistance on the red carpet and told People of the “difficult” last two years in which she’s been grappling with mobility and speech problems.

“It hasn’t been easy,” the “True Blood” alum said.

While her exact condition remained undisclosed, an unnamed source told People that Paquin, 41, “will hopefully make a full recovery.”

Page Six reported that Paquin has not appeared on a red carpet since October 2022 at the Raindance Film Festival in London, where she did not use a cane. That event was also for a screening of “A Bit of Light,” E! News noted .

HuffPost reached out to Paquin’s reps for further comment.

In “A Bit of Light,” Paquin plays an alcoholic mother named Ella who has lost custody of her daughters.

The actor, who shares 11-year-old twins with Moyer, discussed the role with People and said that, despite not relating to the character, she understood the complexities of parenthood that the role highlights.

“Not everyone ends up having the journey with motherhood that they have hoped or had planned,” Paquin said. “We’re all flawed and imperfect, and Ella is kind of on some level repeating some sort of familial patterns as far as stuffing feelings down.”

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In Her First Red Carpet Appearance In Two Years, Anna Paquin Discussed Health Issues That Have Resulted In Mobility And Speech Difficulties

"It hasn't been easy."

BuzzFeed Staff

Anna Paquin discussed her ongoing health issues at the premiere of A Bit of Light.

The movie, directed by Anna's husband Stephen Moyer, is based on a play of the same name and follows a recovering alcoholic. It first debuted in 2022 but is set for wider release this month.

At last night's premiere, Anna's first public event since 2022, she used a cane. The 41-year-old told People that over the past two years, an undisclosed health condition had led her to have some mobility and speech difficulties.

"It hasn't been easy," she told the publication, with a source adding that she will hopefully make a full recovery.

That being said, working on an independent film — her "first love" — with her husband has proven to be a joyous experience. "He's my favorite person to play with," she said of Stephen, saying that she wouldn't work with him if she didn't think highly of his directorial skills. "I'm not sentimental when it comes to work."

A Bit of Light is in select theaters April 5.

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Anna Paquin’s latest premiere glam included a matching cane, amid reported health issues

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At her latest red carpet event, actor Anna Paquin posed for pictures in a sparkling black dress, ankle booties — and a matching cane to top off the sleek look.

The “Irishman” and “X-Men” actor showed off that last item Wednesday evening at the New York premiere for her film “A Bit of Light,” where she also revealed she has been living with undisclosed health issues for two “difficult” years.

“It hasn’t been easy,” Paquin , 41, told People .

The magazine reported on Wednesday that the actor’s health issues have impacted her mobility, prompting the need for a cane. With the undisclosed ailment, Paquin also told the outlet that she has experienced some difficulties with her speech.

A source told People that they are hopeful that Paquin will make a full recovery. More details about the actor’s condition have not been revealed.

A representative for the Oscar-winning “The Piano” star did not immediately respond to The Times’ request for additional comment Thursday.

In “ A Bit of Light ,” distributed by Quiver, Paquin stars as a woman named Ella struggling to reconnect with her two daughters. Amid her efforts, Ella finds friendship in a teenage boy (Luca Hogan) who helps Ella “rediscover her self-worth,” according to the film’s trailer.

At the premiere, Paquin also told People that she takes comfort in her work amid her health issues, noting “my first love was independent filmmaking.”

Anna Paquin has 7 lines in ‘The Irishman.’ And Robert De Niro is OK with that

Robert De Niro and Anna Paquin have weighed in on the controversy surrounding the latter’s limited lines in Martin Scorsese’s “The Irishman.”

Dec. 2, 2019

“That’s how I entered the film industry. I was working with people who are all about telling stories and telling them with integrity and truth,” she said.

Among Paquin’s “A Bit of Light” collaborators is her husband, actor and director Stephen Moyer. The spouses share 11-year-old fraternal twins Charlie and Poppy.

“A Bit of Light” also stars Ray Winstone, Pippa Bennett-Warner and Youssef Kerkour. The film hits select theaters and video-on-demand platforms on Friday.

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Alexandra Del Rosario is an entertainment reporter on the Los Angeles Times Fast Break Desk. Before The Times, she was a television reporter at Deadline Hollywood, where she first served as an associate editor. She has written about a wide range of topics including TV ratings, casting and development, video games and AAPI representation. Del Rosario is a UCLA graduate and also worked at the Hollywood Reporter and TheWrap.

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Anna Paquin walks red carpet with a cane amid health issues

Anna Paquin appeared on the red carpet with a cane this week while promoting her new film, “A Bit of Light.”

The actor,  41, posed for photos with her husband, Stephen Moyer, who also worked on the film, at the event.

In one picture, Paquin is sporting a black dress and black booties while holding on to a matching cane for support. In another, the star wraps one arm around Moyer while holding on to a cane with the other.

While  talking with People  on the red carpet, Paquin shared very few details about the health challenges she’s currently experiencing.

“It hasn’t been easy,” she said.

However, the star did note that she has experienced mobility and speech issues while facing certain health challenges over the last two years.

While talking about “A Bit of Light,” Paquin spoke highly of her husband, who directed the indie drama.

“He’s my favorite person to play with,” she said.

Paquin added that she doesn’t play favorites with Moyer just because they’re married and explained that she wouldn’t work with him if she didn’t believe in his talent.

“I’m not sentimental when it comes to work,” she said.

Paquin and Moyer got married in 2010 and  have two children . In “A Bit of Light,” Paquin plays an alcoholic mom who loses custody of her kids. While she couldn’t personally connect with the storyline, the actor noted that everyone has a different parenting journey.

“It’s very relatable because there’s so many ways that people can get in their own way, or sort of learn to cope with trauma,” she said.

Paquin also gushed about her love for “independent filmmaking” and said she was thrilled to return to the genre that earned her an Oscar at age 11 when she starred in “The Piano.”

“That’s how I entered the film industry. I was working with people who were all about telling stories and telling them with integrity and truth,” she said.