speech disorder

Bipolar Disorder
Therapy Center
When To See a Therapist
Types of Therapy
Best Online Therapy
Best Couples Therapy
Best Family Therapy
Managing Stress
Sleep and Dreaming
Understanding Emotions
Self-Improvement
Healthy Relationships
Student Resources
Personality Types
Guided Meditations
Verywell Mind Insights
2024 Verywell Mind 25
Mental Health in the Classroom
Editorial Process
Meet Our Review Board
Crisis Support

What Is a Speech Sound Disorder?

Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.

Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania.

Halfpoint Images / Getty Images

Speech sound disorders are a blanket description for a child’s difficulty in learning, articulating, or using the sounds/sound patterns of their language. These difficulties are usually clear when compared to the communication abilities of children within the same age group.

Speech developmental disorders may indicate challenges with motor speech. Here, a child experiences difficulty moving the muscles necessary for speech production. This child may also face reduced coordination when attempting to speak.

Speech sound disorders are recognized where speech patterns do not correspond with the movements/gestures made when speaking.

Speech impairments are a common early childhood occurrence—an estimated 2% to 13% of children live with these difficulties. Children with these disorders may struggle with reading and writing. This can interfere with their expected academic performance. Speech sound disorders are often confused with language conditions such as specific language impairment (SLI).

This article will examine the distinguishing features of this disorder. It will also review factors responsible for speech challenges, and the different ways they can manifest. Lastly, we’ll cover different treatment methods that make managing this disorder possible.

Symptoms of Speech Sound Disorder

A speech sound disorder may manifest in different ways. This usually depends on the factors responsible for the challenge, or how extreme it is.

There are different patterns of error that may signal a speech sound disorder. These include:

Removing a sound from a word
Including a sound in a word
Replacing hard to pronounce sounds with an unsuitable alternative
Difficulty pronouncing the same sound in different words (e.g., "pig" and "kit")
Repeating sounds or words
Lengthening words
Pauses while speaking
Tension when producing sounds
Head jerks during speech
Blinking while speaking
Shame while speaking
Changes in voice pitch
Running out of breath while speaking

It’s important to note that children develop at different rates. This can reflect in the ease and ability to produce sounds. But where children repeatedly make sounds or statements that are difficult to understand, this could indicate a speech disorder.

Diagnosis of Speech Sound Disorders

For a correct diagnosis, a speech-language pathologist can determine whether or not a child has a speech-sound disorder.

This determination may be made in line with the requirements of the DSM-5 diagnostic criteria . These guidelines require that:

The child experience persistent difficulty with sound production (this affects communication and speech comprehension)
Symptoms of the disorder appear early during the child’s development stages
This disorder limits communication. It affects social interactions, academic achievements, and job performance.
The disorder is not caused by other conditions like a congenital disorder or an acquired condition like hearing loss . Hereditary disorders are, however, exempted.

Causes of Speech Sound Disorders

There is no known cause of speech sound disorders. However, several risk factors may increase the odds of developing a speech challenge. These include:

Gender : Male children are more likely to develop a speech sound disorder
Family history : Children with family members living with speech disorders may acquire a similar challenge.
Socioeconomics : Being raised in a low socioeconomic environment may contribute to the development of speech and literacy challenges.
Pre- and post-natal challenges : Difficulties faced during pregnancy such as maternal infections and stressors may worsen the chances of speech disorders in a child. Likewise, delivery complications, premature birth, and low-birth-weight could lead to speech disorders.
Disabilities : Down syndrome, autism , and other disabilities may be linked to speech-sound disorders.
Physical challenges : Children with a cleft lip may experience speech sound difficulties.
Brain damage : These disorders may also be caused by an infection or trauma to a child’s brain . This is seen in conditions like cerebral palsy where the muscles affecting speech are injured.

Types of Speech Sound Disorders

By the time a child turns three, at least half of what they say should be properly understood. By ages four and five, most sounds should be pronounced correctly—although, exceptions may arise when pronouncing “l”, “s”,”r”,”v”, and other similar sounds. By seven or eight, harder sounds should be properly pronounced.

A child with a speech sound disorder will continue to struggle to pronounce words, even past the expected age. Difficulty with speech patterns may signal one of the following speech sound disorders:

This refers to interruptions while speaking. Stuttering is the most common form of disfluency. It is recognized for recurring breaks in the free flow of speech. After the age of four, a child with disfluency will still repeat words or phrases while speaking. This child may include extra words or sounds when communicating—they may also make words longer by stressing syllables.

This disorder may cause tension while speaking. Other times, head jerking or blinking may be observed with disfluency.

Children with this disorder often feel frustrated when speaking, it may also cause embarrassment during interactions.

Articulation Disorder

When a child is unable to properly produce sounds, this may be caused by inexact placement, speed, pressure, or movement from the lips, tongue, or throat.

This usually signals an articulation disorder, where sounds like “r”, “l”, or “s” may be changed. In these cases, a child’s communication may be understood by only close family members.

Phonological Disorder

A phonological disorder is present where a child is unable to make the speech sounds expected of their age. Here, mistakes may be made when producing sounds. Other times, sounds like consonants may be omitted when speaking.

Voice Disorder

Where a child is observed to have a raspy voice, this may be an early sign of a voice disorder. Other indicators include voice breaks, a change in pitch, or an excessively loud or soft voice.

Children that run out of breath while speaking may also live with this disorder. Likewise, children may sound very nasally, or can appear to have inadequate air coming out of their nose if they have a voice disorder.

Childhood apraxia of speech occurs when a child lacks the proper motor skills for sound production. Children with this condition will find it difficult to plan and produce movements in the tongue, lips, jaw, and palate required for speech.

Treatment of Speech Sound Disorder

Parents of children with speech sound disorders may feel at a loss for the next steps to take. To avoid further strain to the child, it’s important to avoid showing excessive concern.

Instead, listening patiently to their needs, letting them speak without completing their sentences, and showing usual love and care can go a long way.

For professional assistance, a speech-language pathologist can assist with improving a child’s communication. These pathologists will typically use oral motor exercises to enhance speech.

These oral exercises may also include nonspeech oral exercises such as blowing, oral massages and brushing, cheek puffing, whistleblowing, etc.

Nonspeech oral exercises help to strengthen weak mouth muscles, and can help with learning the common ways of communicating.

Parents and children with speech sound disorders may also join support groups for information and assistance with the condition.

A Word From Verywell

It can be frustrating to witness the challenges in communication. But while it's understandable to long for typical communication from a child—the differences caused by speech disorders can be managed with the right care and supervision. Speaking to a speech therapist, and showing love o children with speech disorders can be important first steps in overcoming these conditions.

Eadie P, Morgan A, Ukoumunne OC, Ttofari Eecen K, Wake M, Reilly S. Speech sound disorder at 4 years: prevalence, comorbidities, and predictors in a community cohort of children . Dev Med Child Neurol . 2015;57(6):578-584. doi:10.1111/dmcn.12635

McLeod S, Harrison LJ, McAllister L, McCormack J. Speech sound disorders in a community study of preschool children . Am J Speech Lang Pathol . 2013;22(3):503-522. doi:10.1044/1058-0360(2012/11-0123)

Murphy CF, Pagan-Neves LO, Wertzner HF, Schochat E. Children with speech sound disorder: comparing a non-linguistic auditory approach with a phonological intervention approach to improve phonological skills . Front Psychol . 2015;6:64. Published 2015 Feb 4. doi:10.3389/fpsyg.2015.00064

Penn Medicine. Speech and Language Disorders-Symptoms and Causes .

PsychDB. Speech Sound Disorder (Phonological Disorder) .

Sices L, Taylor HG, Freebairn L, Hansen A, Lewis B. Relationship between speech-sound disorders and early literacy skills in preschool-age children: impact of comorbid language impairment . J Dev Behav Pediatr . 2007;28(6):438-447. doi:10.1097/DBP.0b013e31811ff8ca

American Speech-Language-Hearing Association. Speech Sound Disorders: Articulation and Phonology .

American Speech-Language-Hearing Association. Speech Sound Disorders .

MedlinePlus. Phonological Disorder .

National Institute on Deafness and Other Communication Disorders. Articulation Disorder .

National Institute of Health. Phonological Disorder.

Lee AS, Gibbon FE. Non-speech oral motor treatment for children with developmental speech sound disorders . Cochrane Database Syst Rev . 2015;2015(3):CD009383. Published 2015 Mar 25. doi:10.1002/14651858.CD009383.pub2

By Elizabeth Plumptre Elizabeth is a freelance health and wellness writer. She helps brands craft factual, yet relatable content that resonates with diverse audiences.

An official website of the United States government

Here’s how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock Locked padlock icon ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Health Topics
Drugs & Supplements
Medical Tests
Medical Encyclopedia
About MedlinePlus
Customer Support

Speech and Communication Disorders

Living with, related issues, see, play and learn.

No links available

Statistics and Research

Clinical trials.

Journal Articles

Reference Desk

Find an expert, patient handouts.

Many disorders can affect our ability to speak and communicate. They range from saying sounds incorrectly to being completely unable to speak or understand speech. Causes include:

Hearing disorders and deafness
Voice problems , such as dysphonia or those caused by cleft lip or palate
Speech problems like stuttering
Developmental disabilities
Learning disabilities
Autism spectrum disorder
Brain injury

Some speech and communication problems may be genetic. Often, no one knows the causes. By first grade, about 5% of children have noticeable speech disorders. Speech and language therapy can help.

NIH: National Institute on Deafness and Other Communication Disorders

Speech and Language Impairments (Center for Parent Information and Resources) Also in Spanish

Speech to Speech Relay Service (Federal Communications Commission)
Telecommunications Relay Service (TRS) (Federal Communications Commission)
Aphasia vs. Apraxia (American Stroke Association)

Journal Articles References and abstracts from MEDLINE/PubMed (National Library of Medicine)

Article: Development and validation of a predictive model for poor prognosis of...
Article: Communication strategies for adults in palliative care: the speech-language therapists' perspective.
Article: Pain assessment tools in adults with communication disorders: systematic review and...
Speech and Communication Disorders -- see more articles
Speech Problems (Nemours Foundation)
Apraxia (Medical Encyclopedia) Also in Spanish
Dysarthria (Medical Encyclopedia) Also in Spanish
Phonological disorder (Medical Encyclopedia) Also in Spanish
Selective mutism (Medical Encyclopedia) Also in Spanish
Speech impairment in adults (Medical Encyclopedia) Also in Spanish

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

An official website of the United States government

Here's how you know

Official websites use .gov A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Apraxia of Speech

On this page:

What is apraxia of speech?

What are the types and causes of apraxia of speech, what are the symptoms of apraxia of speech, how is apraxia of speech diagnosed, how is apraxia of speech treated, what research is being done to better understand apraxia of speech, where can i find additional information about apraxia of speech.

Apraxia of speech (AOS)—also known as acquired apraxia of speech, verbal apraxia, or childhood apraxia of speech (CAS) when diagnosed in children—is a speech sound disorder. Someone with AOS has trouble saying what he or she wants to say correctly and consistently. AOS is a neurological disorder that affects the brain pathways involved in planning the sequence of movements involved in producing speech. The brain knows what it wants to say, but cannot properly plan and sequence the required speech sound movements.

AOS is not caused by weakness or paralysis of the speech muscles (the muscles of the jaw, tongue, or lips). Weakness or paralysis of the speech muscles results in a separate speech disorder, known as dysarthria . Some people have both dysarthria and AOS, which can make diagnosis of the two conditions more difficult.

The severity of AOS varies from person to person. It can be so mild that it causes trouble with only a few speech sounds or with pronunciation of words that have many syllables. In the most severe cases, someone with AOS might not be able to communicate effectively by speaking, and may need the help of alternative communication methods.

There are two main types of AOS: acquired apraxia of speech and childhood apraxia of speech.

Acquired AOS can affect someone at any age, although it most typically occurs in adults. Acquired AOS is caused by damage to the parts of the brain that are involved in speaking and involves the loss or impairment of existing speech abilities. It may result from a stroke, head injury, tumor, or other illness affecting the brain. Acquired AOS may occur together with other conditions that are caused by damage to the nervous system. One of these is dysarthria, as mentioned earlier. Another is aphasia , which is a language disorder. (For more information, see the NIDCD fact sheet Aphasia .)
Childhood AOS is present from birth. This condition is also known as developmental apraxia of speech, developmental verbal apraxia, or articulatory apraxia. Childhood AOS is not the same as developmental delays in speech, in which a child follows the typical path of speech development but does so more slowly than is typical. The causes of childhood AOS are not well understood. Imaging and other studies have not been able to find evidence of brain damage or differences in the brain structure of children with AOS. Children with AOS often have family members who have a history of a communication disorder or a learning disability. This observation and recent research findings suggest that genetic factors may play a role in the disorder. Childhood AOS appears to affect more boys than girls.

People with either form of AOS may have a number of different speech characteristics, or symptoms:

Distorting sounds. People with AOS may have difficulty pronouncing words correctly. Sounds, especially vowels, are often distorted. Because the speaker may not place the speech structures (e.g., tongue, jaw) quite in the right place, the sound comes out wrong. Longer or more complex words are usually harder to say than shorter or simpler words. Sound substitutions might also occur when AOS is accompanied by aphasia.
Making inconsistent errors in speech. For example, someone with AOS may say a difficult word correctly but then have trouble repeating it, or may be able to say a particular sound one day and have trouble with the same sound the next day.
Groping for sounds. People with AOS often appear to be groping for the right sound or word, and may try saying a word several times before they say it correctly.
Making errors in tone, stress, or rhythm. Another common characteristic of AOS is the incorrect use of prosody. Prosody is the rhythm and inflection of speech that we use to help express meaning. Someone who has trouble with prosody might use equal stress, segment syllables in a word, omit syllables in words and phrases, or pause inappropriately while speaking.

Children with AOS generally understand language much better than they are able to use it. Some children with the disorder may also have other speech problems, expressive language problems, or motor-skill problems.

Professionals known as speech-language pathologists play a key role in diagnosing and treating AOS. Because there is no single symptom or test that can be used to diagnose AOS, the person making the diagnosis generally looks for the presence of several of a group of symptoms, including those described earlier. Ruling out other conditions, such as muscle weakness or language production problems (e.g., aphasia), can help with the diagnostic process.

In some cases, people with acquired AOS recover some or all of their speech abilities on their own. This is called spontaneous recovery.

Children with AOS will not outgrow the problem on their own. They also do not acquire the basics of speech just by being around other children, such as in a classroom. Therefore, speech-language therapy is necessary for children with AOS as well as for people with acquired AOS who do not spontaneously recover all of their speech abilities.

Speech-language pathologists use different approaches to treat AOS, and no single approach has been proven to be the most effective. Therapy is tailored to the individual and is designed to treat other speech or language problems that may occur together with AOS. Frequent, intensive, one-on-one speech-language therapy sessions are needed for both children and adults with AOS. (The repetitive exercises and personal attention needed to improve AOS are difficult to deliver in group therapy.) Children with severe AOS may need intensive speech-language therapy for years, in parallel with normal schooling, to obtain adequate speech abilities.

In severe cases, adults and children with AOS may need to find other ways to express themselves. These might include formal or informal sign language; a notebook with pictures or written words that can be pointed to and shown to other people; or an electronic communication device—such as a smartphone, tablet, or laptop computer—that can be used to write or produce speech. Such assistive communication methods can also help children with AOS learn to read and better understand spoken language by stimulating areas of the brain involved in language and literacy.

Researchers are searching for the causes of childhood AOS, including the possible role of abnormalities in the brain or other parts of the nervous system. They are also looking for genetic factors that may play a role in childhood AOS. Other research on childhood AOS aims to identify more specific criteria and new techniques to diagnose the disorder and to distinguish it from other communication disorders.

Research on acquired AOS includes studies to pinpoint the specific areas of the brain that are involved in the disorder. In addition, researchers are studying the effectiveness of various treatment approaches for both acquired and childhood AOS.

The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.

For more information, contact us at:

NIDCD Information Clearinghouse 1 Communication Avenue Bethesda, MD 20892-3456 Toll-free voice: (800) 241-1044 Toll-free TTY: (800) 241-1055 Email: [email protected]

NIH Pub. No. 13-7466 September 2016

Aphasia usually happens suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). The severity of aphasia depends on a number of things, including the cause and the extent of the brain damage.

The main treatment for aphasia involves treating the condition that causes it, as well as speech and language therapy. The person with aphasia relearns and practices language skills and learns to use other ways to communicate. Family members often participate in the process, helping the person communicate.

Products & Services

A Book: Mayo Clinic Family Health Book, 5th Edition
Newsletter: Mayo Clinic Health Letter — Digital Edition

Aphasia is a symptom of some other condition, such as a stroke or a brain tumor.

A person with aphasia may:

Speak in short or incomplete sentences
Speak in sentences that don't make sense
Substitute one word for another or one sound for another
Speak unrecognizable words
Have difficulty finding words
Not understand other people's conversation
Not understand what they read
Write sentences that don't make sense

Patterns of aphasia

People with aphasia may have different strengths and weaknesses in their speech patterns. Sometimes these patterns are labeled as different types of aphasia, including:

Broca's aphasia
Wernicke aphasia
Transcortical aphasia
Conduction aphasia
Mixed aphasia
Global aphasia

These patterns describe how well the person can understand what others say. They also describe how easy it is for the person to speak or to correctly repeat what someone else says.

Aphasia may develop slowly over time. When that happens, the aphasia may be labeled with one of these names:

Logopenic aphasia
Semantic aphasia
Agrammatism

Many people with aphasia have patterns of speech difficulty that don't match these types. It may help to consider that each person with aphasia has unique symptoms, strengths and weaknesses rather than trying to label a particular type of aphasia.

Because aphasia is often a sign of a serious problem, such as a stroke, seek emergency medical care if you or a loved one suddenly develop:

Difficulty speaking
Trouble understanding speech
Difficulty with word recall
Problems with reading or writing

From Mayo Clinic to your inbox

The most common cause of aphasia is brain damage resulting from a stroke — the blockage or rupture of a blood vessel in the brain. Loss of blood to the brain leads to brain cell death or damage in areas that control language.

Brain damage caused by a severe head injury, a tumor, an infection or a degenerative process also can cause aphasia. In these cases, the aphasia usually occurs with other types of cognitive problems, such as memory problems or confusion.

Primary progressive aphasia is the term used for language difficulty that develops gradually. This is due to the gradual degeneration of brain cells located in the language networks. Sometimes this type of aphasia will progress to a more generalized dementia.

Sometimes temporary episodes of aphasia can occur. These can be due to migraines, seizures or a transient ischemic attack (TIA). A transient ischemic attack (TIA) occurs when blood flow is temporarily blocked to an area of the brain. People who've had a are at an increased risk of having a stroke in the near future.

Aphasia can create numerous quality-of-life problems because communication is so much a part of your life. Communication difficulty may affect your:

Relationships
Day-to-day function

Difficulty expressing wants and needs can result in embarrassment, frustration, isolation and depression. Other problems may occur together, such as more difficulty moving around and problems with memory and thinking.

Jun 11, 2022

Clark DG. Approach to the patient with aphasia. https://www.uptodate.com/contents/search. Accessed May 24, 2022.
Aphasia. Merck Manual Professional Edition. http://www.merckmanuals.com/professional/neurologic_disorders/function_and_dysfunction_of_the_cerebral_lobes/aphasia.html#v1034169. Accessed May 24, 2022.
Clark DG. Aphasia: Prognosis and treatment. https://www.uptodate.com/contents/search. Accessed May 24, 2022.
Aphasia. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/aphasia/. Accessed May 24, 2022.
Aphasia. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/Pages/aphasia.aspx. Accessed May 24, 2022.
Crosson B, et al. Neuroplasticity and aphasia treatments: New approaches for an old problem. Journal of Neurology, Neurosurgery and Psychiatry. 2019; doi:10.1136/jnnp-2018-319649.
Elsner B, et al. Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. Cochrane Database of Systematic Reviews. 2019; doi:10.1002/14651858.CD009760.pub4.
Botha H, et al. Classification and clinicoradiologic features of primary progressive aphasia (PPA) and apraxia of speech. Cortex. 2015. doi:10.1016/j.cortex.2015.05.013.
Kasselimis DS, et al. The unbridged gap between clinical diagnosis and contemporary research on aphasia: A short discussion on the validity and clinical utility of taxonomic categories. Brain and Language. 2017; doi:10.1016/j.bandl.2016.10.005.
Clark H (expert opinion). Mayo Clinic. May 30, 2022.
Diseases & Conditions
Aphasia symptoms & causes

News from Mayo Clinic

Associated Procedures

CON-XXXXXXXX

Your gift holds great power – donate today!

Make your tax-deductible gift and be a part of the cutting-edge research and care that's changing medicine.

Monica Marzinske, CCC-SLP

Speech-language therapy.

Behavioral Health
Children's Health (Pediatrics)
Exercise and Fitness
Heart Health
Men's Health
Neurosurgery
Obstetrics and Gynecology
Orthopedic Health
Weight-loss (Bariatric) Surgery
Women's Health

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.

Middle-aged person looking to side with a thoughtful gaze

Speech Sound Disorders

Center for childhood communication, what are speech sound disorders .

As children learn to speak, they make words easier to say by deleting or changing sounds. As they grow older, children say more speech sounds. This makes their words easier to understand. If your child has a speech sound disorder, they cannot say sounds and words like other children their age.

Three types of speech sound disorders include:

Articulation disorder: difficulty saying certain speech sounds. You may notice your child drops, adds, distorts or substitutes sounds in words.
Phonological process disorder: where your child uses patterns of errors. The mistakes may be common in young children learning speech skills. When the errors continue past a certain age, it may be a disorder.
Disorders that involve a combination of articulation and phonological process disorders.

Some sound changes may be part of your child’s accent or family dialect, and not a true speech disorder.

Causes of speech sound disorders

Speech sound disorders can be caused in a few ways:

Developmental (your child was born with the disorder)
Motor or neurological ( childhood apraxia of speech )
Structural ( cleft lip and palate )
Sensory or perceptual conditions (like hearing loss )

Symptoms of speech sound disorders

Signs of a speech sound disorder can include:

Substituting sounds in words (saying “wain” instead of “rain”)
Distorting sounds in words (saying “thoap” instead of “soap”)
Adding sounds to words (saying “puhlay” instead of “play”)
Saying only one syllable in a word (saying “bay” instead of “baby”)
Simplifying a word by repeating a syllable (saying “baba” instead of “bottle”)
Leaving out a consonant sound (saying “at” or “ba” instead of “bat” or saying “tar” instead of “star”)
Saying words differently each time (saying “buh” for “go” the first time, then “agah” for “go” the second time)

Testing and diagnosis for speech sound disorders

One of our speech-language pathologists (SLP) may assess your child’s speech through formal testing, language samples, play-based activities, and observations of your child’s mouth structures and movements. Our SLP will determine if your child’s sound errors are expected for their age. If not, they may have a speech sound disorder. Treatment with a CHOP SLP can help your child with their speech development.

Treatment for speech sound disorders

Our SLP will create goals to support your child’s speech development. Goals may include recognizing speech sounds and learning how to say speech sounds and words. Each child is unique and may have different needs. The therapy approach will depend on the specific diagnosis and your child’s needs. Once your child says a sound in therapy on their own, it will take time for them to say it consistently. Our SLP will work patiently with your child toward their speech development goals.

Speech-language therapy sessions involve you, your child, their other caregiver(s) and a SLP. Sessions may be play-based or structured with tabletop activities. This will depend on your child’s needs and abilities. Sessions also include your child's interests and your family's culture. This leads to better engagement, relevance, learning and fun.

Early recognition and diagnosis of speech sound disorders can help your child overcome speech problems. With proper treatment and support, your child can learn how to communicate clearly.

Type 2 Diabetes
Heart Disease
Digestive Health
Multiple Sclerosis
Diet & Nutrition
Supplements
Health Insurance
Public Health
Patient Rights
Caregivers & Loved Ones
End of Life Concerns
Health News
Thyroid Test Analyzer
Doctor Discussion Guides
Hemoglobin A1c Test Analyzer
Lipid Test Analyzer
Complete Blood Count (CBC) Analyzer
What to Buy
Editorial Process
Meet Our Medical Expert Board

The Benefits of Speech Therapy

What to expect, frequently asked questions.

A speech-language pathologist (SLP) can help you with speech, language, and swallowing. They provide speech therapy to children and adults who may have speech or language disorders.

People with certain medical conditions may also benefit from speech therapy. Medical conditions that may cause speech or swallowing impairment include traumatic brain injury , stroke (brain damage due to a blood vessel blockage or bleed), and dementia (decline in memory and thinking functions).

This article looks at the various uses for speech therapy, what to expect during a session, and the techniques involved in this type of therapy.

Verywell / Theresa Chiechi

Speech therapy can help with a variety of conditions.

Speech Disorders

Speech therapy may help with speech disorders like:

Stuttering : Stuttering may involve repeating parts of words, prolonging words, or struggling to get out certain words. You may be more likely to have a stutter if you have a family history of stuttering.
Apraxia : This motor speech disorder makes it difficult to move the tongue and lips to make sounds required for speech. In some cases, people with apraxia cannot speak at all. Causes for this disorder include brain tumors, dementia, stroke, and any other condition that causes brain injury.
Voice : Voice disorders can be temporary or permanent and make it hard to speak. Chronic voice disorders include chronic cough, vocal fold paralysis, vocal polyps (growths on the vocal cords), and spasmodic dysphonia (vocal cord spasms).
Dysarthria : People with this speech disorder have muscle weakness that makes it difficult to talk. They may slur or mumble their words. Dysarthria can happen due to brain injury or chronic degenerative conditions like Parkinson’s disease or Huntington’s disease .

Language Disorders

A language disorder ( aphasia ) is a condition that makes it difficult for a person to read, write, speak, or understand speech or other modes of communication.

Someone with this type of disorder may struggle to:

Use incorrect words for things
Say complete sentences
Understand what other people say
Understand jokes
Read or spell

Brain tumors, traumatic brain injuries, and degenerative disorders that affect cognitive function can all cause aphasia.

Feeding and Swallowing Disorders

Feeding and swallowing disorders can occur in both children and adults. A feeding disorder involves trouble with eating, sucking, drinking from a cup, or chewing. The specific term for swallowing disorders is dysphagia . Children or adults with dysphagia have trouble swallowing food or drink.

Problems swallowing or feeding may or may not be related to a medical condition. Conditions that may cause a swallowing or feeding disorder include:

Cleft palate or cleft lip
Asthma and other breathing issues
Heart disease
Premature birth
Nervous system disorders
Reflux
Muscle weakness
Sensory issues
Autism
Behavior problems
Certain medications

Speech therapy begins with an evaluation to assess your difficulties and whether any structural issues contribute to your speech, language, feeding, or swallowing problems. An evaluation may involve a standardized test to help determine what you most need help with. Informal conversations may also help figure out your needs.

A speech-language pathologist will then work with you to help improve your ability to speak, converse, or swallow. This may involve:

Educating you on how to do certain things like articulating or pronouncing sounds
Teaching you language skills
Providing you with educational materials
Giving you exercises to help strengthen your muscles
Giving you exercises that help you breathe better
Participation in group therapy sessions

You should also expect to practice the skills and exercises you learn in speech therapy sessions at home. Your speech-language pathologist may provide you with workbooks, worksheets, or virtual apps for at-home practice.

Speech Therapy for Adults

Depending on the reason you’re seeking out speech therapy, a speech-language pathologist may:

Help you learn to move your muscles correctly to make sounds if you have apraxia or dysarthria
Teach you how to use your breath to speak louder if you have dysarthria
Help you learn to manage stuttering by teaching you to lower stress levels in certain situations
Help you strengthen your mouth muscles to make it easier to swallow and eat if you have a feeding or swallowing disorder due to a brain injury or disease

Speech Therapy for Children

A speech-language pathologist’s approach will depend on the child. When working with a child who has a feeding or swallowing disorder, they might focus on:

Strengthening the muscles of the mouth
Helping the child with chewing
Encouraging the child to try new food and drink
Changing food texture to make it easier to swallow food
Helping with sensory issues related to food

Other skills a speech-language pathologist may work on with a child include:

Language complexity : For example, they might teach words like "and" and "or" to connect ideas within sentences.
Conversation skills : This may include role-playing to help the child with socialization and improve their read of social cues.
Vocabulary : They may use games or storytelling to help build the child’s vocabulary.
Phonological awareness : This recognition of the sounds that make up words is an important skill for reading. The SLP may work on helping the child identify sounds and rhymes in words to build this skill.

Healthcare professionals will also test your child’s hearing to see if hearing loss may be contributing to language and speech issues.

If you or your child is getting speech therapy from a qualified speech-language pathologist, you might wonder how likely it is that you’ll see improvement in speech, language, or feeding.

Results will depend on the individual. It’s also essential to follow the exercises, tips, and strategies provided by the speech-language professional. Regular visits and keeping up with practice activities and exercises make it more likely to see an improvement in yourself or your child.

A speech-language pathologist works with children or adults who have speech, language, or feeding and swallowing disorders. Typically the first session will involve an evaluation to determine the areas that are causing you the most problems.

From there, they may teach you exercises and strategies to improve your speech, language, or ability to swallow and eat.

A Word From Verywell

Think you or your child would benefit from speech therapy? Get in touch with your primary healthcare provider and ask for a recommendation. You can also use the American Speech-Language-Hearing Association’s (ASHA) Find a Certified SLP Tool .

Not all children develop at the same rate, but if your child has issues understanding language, doesn’t use gestures, or doesn’t seem to be learning new words, you might consider having them evaluated by a speech therapist.

While this may depend on the individual and the cause of speech-related problems, research suggests that speech and language therapy can significantly improve speech and language issues.

One example of a typical speech therapy technique is articulation therapy. This technique teaches the person to make specific sounds, sometimes by showing them how to move their mouth or tongue.

A language delay is when a child has difficulty in speaking and understanding speech that is unusual for their age.

American Speech-Language-Hearing Association. Stuttering .

American Speech-Language-Hearing Association. Apraxia of speech in adults .

American Speech-Language-Hearing Association. Voice disorders .

American Speech-Language-Hearing Association. Dysarthria .

American Speech-Language-Hearing Association. Aphasia .

American Speech-Language-Hearing Association. Feeding and swallowing disorders in children .

Brainline. Speech therapy .

Understood for All. What is speech therapy .

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

Broomfield J, Dodd B. Is speech and language therapy effective for children with primary speech and language impairment? Report of a randomized control trial . Int J Lang Commun Disord . 2011;46(6):628-640. doi:10.1111/j.1460-6984.2011.00039.x

Nemours Children's Health. Speech-language therapy .

By Steph Coelho Steph Coelho is a freelance health and wellness writer and editor with nearly a decade of experience working on content related to health, wellness, mental health, chronic illness, fitness, sexual wellness, and health-related tech.She's written extensively about chronic conditions, telehealth, aging, CBD, and mental health. Her work has appeared in Insider, Healthline, WebMD, Greatist, Medical News Today, and more.

Congresswoman with brain disorder uses text-to-voice app to deliver House speech

R ep. Jennifer Wexton (D-VA) is utilizing a text-to-voice application in order to speak on the House floor as she navigates a degenerative brain condition she was recently diagnosed with.

Wexton was diagnosed with progressive supranuclear palsy which affects her ability to speak, hear, and move. When she testified before Congress on Monday, she used the assistive application to speak about legislation she introduced to rename a post office in her constituency.

“PSP makes it very difficult for me to speak, and I use an assistive app so that you and our colleagues can understand me,” Wexton said via the app. “I am proud to be here today speaking in support of my bill to rename the Purcellville, Virginia, post office in honor of my former constituent.”

During her remarks, she only briefly touched on her condition before centering the speech around the post office renaming. She is proposing the post office be renamed after fellow Virginian and former Secretary of State Madeleine Albright.

“[Albright] was a fearless trailblazer for women and a devoted public servant who touched the lives of so many whom she taught, mentored, and worked with — including me,” Wexton said.

Wexton was diagnosed with PSP last year after initially being misdiagnosed with Parkinson’s disease. She announced she would not seek reelection this year after representing Virginia's 10th Congressional District since 2019.

CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER

“I’m heartbroken to have to give up something I have loved after so many years of serving my community,” Wexton said in a statement . “But taking into consideration the prognosis for my health over the coming years, I have made the decision not to seek reelection once my term is complete and instead spend my valued time with Andrew, our boys, and my friends and loved ones.”

She is the first member of Congress to use this type of assistive technology. Sen. John Fetterman (D-PA) uses talk-to-text technology to help him with auditory processing problems, which make it difficult to understand different sounds, brought on by a stroke he suffered in 2022.

Congresswoman with brain disorder uses text-to-voice app to deliver House speech

Skip to main content
Keyboard shortcuts for audio player

A lawmaker with a brain disease used voice assist to back her bill on the House floor

Rachel Treisman

Virginia Rep. Jennifer Wexton used text-to-speech technology to advocate for her bill on the House floor Monday, following her diagnosis with the rare brain condition known as progressive supranuclear palsy. C-SPAN/Screenshot by NPR hide caption

Rep. Jennifer Wexton is being hailed as an inspiration after advocating for her bill on the House floor this week, even as she battles a rare brain disorder that has limited her ability to speak.

The Virginia Democrat took the podium on Monday to make the case for her bill, which would rename a post office in her county after regular customer — and late Secretary of State — Madeleine Albright.

Wexton delivered her nearly two-minute remarks using a text-to-speech application, technology she's increasingly relied on since she was diagnosed last year with a degenerative brain condition known as progressive supranuclear palsy (PSP).

An Arizona lawmaker announced she was getting an abortion. Here's what happened next

"PSP makes it very difficult for me to speak, and I use an assistive app so that you and our colleagues can understand me," Wexton told the House speaker by way of opening remarks.

Today, with the assistance of voice to text tech due to my PSP, I spoke on the House floor in favor of my bill to rename the Purcellville post office in honor of Madeleine Albright. Sec. Albright was a trailblazer & inspiration to countless women in public service, including me. pic.twitter.com/S5v203jBsu — Rep. Jennifer Wexton (@RepWexton) May 7, 2024

PSP is a rare brain disease that affects walking, balance, eye movements and swallowing, for which there is no cure, according to the Mayo Clinic .

Wexton, 55, announced her diagnosis in September, several months after being misdiagnosed with Parkinson's Disease. Acknowledging that "there is no 'getting better' with PSP," she said she would not seek reelection in 2024 — but pledged to keep serving the people of northern Virginia's 10th Congressional District until then.

"While my time in Congress will soon come to a close, I'm just as confident and committed as ever to keep up the work that got me into this fight in the first place for my remaining time in office – to help build the future we want for our children," said Wexton.

Shots - Health News

Scientists restore brain cells impaired by a rare genetic disorder.

Wexton is in her third term after first flipping her seat blue in 2018. A dozen Democrats and four Republicans are vying to replace her , with primary voting set to close in mid-June.

Wexton has remained involved as promised. In the days leading up to her speech, she traveled to Baltimore to discuss restoration of the Francis Scott Key Bridge with other Appropriations Committee leaders and used voice assistive technology to question Transportation Secretary Pete Buttigieg , as well as Acting Secretary of the U.S. Department of Housing and Urban Development Adrianne Todman at separate hearings, disclosing her PSP diagnosis in both.

"I describe it as Parkinson's on steroids and I don't recommend it," she said.

On Monday, Wexton spoke in favor of a bill she first introduced last spring, seeking to rename the post office in Purcellville — about 50 miles west of Washington, D.C. — after her former constituent.

Albright, who died in 2022 at age 84, "chose not to have her mail delivered to her rural western Loudoun County farm but instead became a fixture at the post office that will bear her name," Wexton said.

Virginia lawmakers consider proposal to legalize physician-assisted death

"Secretary Albright was a fearless trailblazer for women and a devoted public servant who touched the lives of so many whom she taught, mentored and worked with, including me," she added. "It is my honor to lead this legislation to celebrate her historic life and legacy here in Virginia's 10th Congressional district, where her farm is located and where she spent as much time as she was able."

Wexton noted that this would be the latest in a long list of accolades for the former secretary — including a 2012 Presidential Medal of Freedom — and called it an honor to help preserve her legacy in Virginia.

"Secretary Albright once said the greatest honor of her life was representing the United States of America, a sentiment I am sure we all share as members of the House of Representatives," Wexton said.

The House passed the bill the next day, by a vote of 371 to 28. The Albright family called it a "wonderful tribute to her memory" in a statement shared by Wexton's office.

Wexton has successfully introduced several bills to rename post offices in her district during her time in the House, after WWII veteran Norman Duncan and country music icon (and Winchester native) Patsy Cline .

She is not the first lawmaker to use assistive technology in Congress — Sen. John Fetterman, D-Penn., uses captioning technology due to auditory processing issues following his 2022 stroke. But it remains a rare sight, and has garnered attention and considerable praise in recent days.

As video of Wexton's remarks racked up thousands of views and hundreds of likes on X, formerly Twitter, other politicians and onlookers shared statements of support for the congresswoman.

Looking Back: Memorable Speeches Delivered From House Chamber

"Congresswoman Jennifer Wexton gets more inspiring each day," wrote Virginia State Delegate Rip Sullivan . "With remarkable courage and grace, she continues to dedicate herself to the 10th district. Her constituents are lucky to have her fighting for them."

Virginia State Delegate Kathy Tran wrote that "for individuals who use augmentative and alternative communication ( AAC ) Jennifer Wexton is showing them that they too can lead and serve at the highest levels."

Even Vice President Kamala Harris weighed in , calling Wexton "an inspiration to me and to millions of Americans across our nation."

"You are showing the world what true courage and determination look like," she wrote late Tuesday. "Keep fighting."

Wexton replied with a message of thanks, adding: "And I still have things to do!" — muscle emoji included.

brain disease
House of Represantatives
speech assistive technology
Jennifer Wexton

Congresswoman battling brain disorder delivers House speech using a text-to-voice app

Rep. Jennifer Wexton (D-Va.), whose ability to speak, hear and move has been affected by a degenerative brain condition, uses assistive technology to help her navigate life on the Hill.

Rep. Jennifer Wexton (D-Va.) stepped to the microphone on the House floor Monday to speak about one of her latest pieces of legislation, as she has done many times before during her five years in Congress.

But the voice that gave the speech wasn’t hers — it was from a text-to-voice application, an assistive device she uses to help her navigate a degenerative brain condition with which she was diagnosed last year.

Wexton’s disorder — progressive supranuclear palsy (PSP) — has largely affected her ability to speak, hear and move. With the help of the assistive app, the congresswoman on Monday spoke about legislation she introduced to rename a post office in Purcellville, Va., after former secretary of state Madeleine Albright, who lived in nearby Hillsboro, Va.

“PSP makes it very difficult for me to speak, and I use an assistive app so that you and our colleagues can understand me,” Wexton said in her remarks. “I am proud to be here today speaking in support of my bill to rename the Purcellville, Virginia, post office in honor of my former constituent.”

. @RepWexton - who has Progressive Supranuclear Palsy (PSP) - uses an assistive device to speak on the House floor. pic.twitter.com/ZoA5PAohKR — Howard Mortman (@HowardMortman) May 6, 2024

Wexton, 55, explained that Albright was a fixture at the Purcellville post office, which she visited often while living on her farm in rural western Loudoun County. The lawmaker said she wanted to ensure that Albright’s legacy “continues to live on in Virginia for generations to come.”

The Virginia Democrat, who first won election to the House in 2018, received the PSP diagnosis last summer after an initial misdiagnosis of Parkinson’s disease. PSP, a rare neurological condition, typically progresses rapidly and has no cure.

Wexton announced in September that she would not run for reelection for her seat in Virginia’s 10th District. Next month, a crowded field will battle for each party’s nomination for the general election, hoping to succeed Wexton in the seat she turned blue in 2018 with a win over Republican Barbara Comstock. Early voting is underway.

Wexton isn’t the first lawmaker to recently employ assistive technology in Congress. Sen. John Fetterman (D-Pa.) relies on real-time talk-to-text technology to help him with auditory processing issues after suffering a near-fatal stroke in 2022.

In her remarks Monday, Wexton only briefly touched on the topic of her condition, focusing her remarks instead on her effort to name the Purcellville post office after a woman who she said helped shape the political careers of many more.

Albright, Wexton said, “was a fearless trailblazer for women and a devoted public servant who touched the lives of so many whom she taught, mentored and worked with — including me.”