Speech Disorders

When you were a child just learning to talk, you may have lisped or stuttered; in fact, your relatives probably considered it cute. If you're a teen who is still stuttering, though, you may not feel like it's so endearing. You're not alone. More than 3 million Americans have the speech disorder known as stuttering (or stammering, as it's known in the United Kingdom ). It's one of several conditions affecting a person's ability to speak clearly.

Some Common Speech Disorders
Stuttering is a problem that interferes with fluent speech. A person who stutters may repeat the first part of a word (as in sssssing) or hold a single sound for a long time (as in caaaaaaake). Some people who stutter have trouble getting sounds out altogether. Stuttering is complex, and it can affect speech in many different ways.

Cluttering is another problem that makes a person's speech difficult to understand. Like stuttering, cluttering affects the fluency, or flow, of a person's speech. Someone who clutters may speak in bursts or pause in unexpected places. The rhythm of cluttered speech may sound jerky, rather than smooth, and the speaker often seems unaware of the problem.

Articulation disorders encompass a wide range of errors people can make when talking. Substituting a "w" for an "r" ("wabbit" for "rabbit"), omitting sounds ("cool" for "school"), or adding sounds to words ("pinanio" for "piano") are examples of articulation errors. Lisping refers to specific substitution involving the letters "s" and "z." A person who lisps replaces those sounds with "th."

Apraxia (dyspraxia), also known as oral-motor speech disorder, is a problem with motor coordination or motor planning. A person with this speech problem has difficulty moving the muscles and structures necessary to form speech sounds into words.

What Causes Speech Problems?
It's easy to take the ability to speak for granted, but producing fluent speech without errors (speech that flows smoothly and is easily understood) is actually a highly complicated process. When we speak, we must coordinate many muscles from various body parts and systems, including the larynx, which contains the vocal cords; the teeth, lips, tongue, and mouth; and the respiratory system. Normal speech may seem effortless, but it requires precise timing, nerve, and muscle control. The ability to understand language and produce speech is coordinated by the brain. So a person with brain damage from an accident, stroke, or birth defect may have speech and language problems. Apraxia is thought to be due to a brain impairment that may or may not show up on brain magnetic resonance imaging (MRI) tests.

Some people with speech problems, particularly articulation disorders, may have hearing problems. Even mild hearing loss may have an impact on how a person reproduces the sounds they hear. Certain birth defects, such as a cleft palate , can interfere with a person's ability to produce speech. When a person has a cleft palate there is a hole in the roof of the mouth, which affects the movement of air through the oral and nasal passages. There also may be problems with other structures needed for speech, including the lips, teeth, and jaw.

Genetics may also play a role in some speech problems. For example, stuttering seems to run in some families. But in most cases, no one knows the exact cause of a person's speech problems

How Are Speech Problems Treated?
The good news is, treatments such as speech therapy can help people of any age overcome some speech problems.

If you are concerned about your speech, it's important to let your doctor know. If hearing tests and physical exams don't reveal any problems, some doctors arrange a consultation with a speech-language pathologist (pronounced: puh- tha -luh-jist).

A speech-language pathologist is trained to observe people as they speak and to identify their speech problems. Speech-language pathologists look for the type of problem (such as a lack of fluency, articulation, or motor skills) a person has. For example, if you stutter, the pathologist will examine how and when you do so. Speech-language pathologists may evaluate their clients' speech either by recording them on audio or videotape or by listening during conversation. A few clinics that specialize in fluency disorders may use computerized analysis. By gathering as much information as possible about the way a person speaks, the pathologist can develop a treatment plan that meets each individual's needs. The plan will depend on things like age and the type of speech disorder a person has.

If you're being treated for a speech disorder, part of your treatment plan may include seeing a speech therapist , a person who is trained to treat speech disorders. How often you have to see the speech therapist will vary - you'll probably start out seeing him or her more frequently at first, then your visits may decrease over time. Most treatment plans include breathing techniques, relaxation strategies that are designed to help you relax your muscles when you speak, posture control, and a type of voice exercise called oral-motor exercises . You'll probably have to do these exercises each day on your own to help make your treatment plan as successful as possible.

Dealing With Speech Problems
Only people with speech problems know how frustrating it can be. People who stutter, for example, often complain that others try to finish their sentences or fill in words for them. Some feel like people treat them as if they're stupid, especially when a listener says things like "slow down" or "take it easy." (Most people who stutter are just as intelligent as people who don't.) People who stutter report that listeners often avoid eye contact and refuse to wait patiently for them to finish speaking. If you have a speech problem, let others know how you like to be treated when speaking.

Some people look to their speech therapists for advice and resources on issues of stuttering. Speech therapists can often connect you with others in similar situations, such as support groups in your area for teens who stutter.

If you're a teen with a speech problem, achieving and maintaining control of your speech may be a lifelong process. Although speech therapy can help, you are sure to have ups and downs in your efforts to communicate. But the truth is that the way you speak is only one part of who you are. Don't be embarrassed to make yourself heard!