Speech Impairments

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The receiver of communication must understand the sounds of the words spoken to understand the full message. If speech sounds are incorrectly produced, one sound might be confused with another, either changing the meaning of the message or yielding no meaning. When speech is abnormal, it is unintelligible, is unpleasant, or interferes with communication (Bemthal & Bankson, 2004; Hall, Oyer, & Haas, 2001). Speech impairments include three major types of problems: difficulties with articulation, fluency, and voice. Problems with any one of these speech impairments are distracting to the listener and can negatively affect or interrupt the communication process.

Articulation Problems

The most common speech impairment, articulation problems, exists when the process of producing speech sounds is flawed, and the resulting speech sounds are incorrect. Some individuals have no physiological reason for their articulation difficulties. Others correctly articulate a sound when it occurs in one position in words but not in other positions. They may be able to pronounce a sound consistently without errors when it occurs at the beginning of a word but cannot do so when the sound occurs in the middle or at the end of a word. The tble below describes the four kinds of articulation errors, but as you read about them, remember that articulation is related to the speaker's age, culture, and environment. For example, a young child's errors may be developmentally correct, whereas the same speech product made by an older child may well reflect an articulation problem. The difference could also be due to regional speech patterns, foreign language accents, or cultural speech preferences, but none of these speech differences reflects a speech impairment. Regional differences in speech—dialects—do not need attention from an SLP.

 Four Kinds of Articulation Errors

Fluency Problems

When the rate and flow pattern of a person's speech is of concern, it is most likely that the individual is experiencing a fluency problem. Fluency problems, or dysfluencies, usually involve hesitations or repetitions of parts of words that interrupt the flow of speech (Conture, 2001). Stuttering is one type of fluency problem where sounds or parts of words are repeated. Some young children (ages 3 to 5) demonstrate dysfluencies in the course of normal speech development, and these are not usually indicative of a fluency problem in need of therapy. With older individuals, the repetition of words or phrases (e.g., "The the boy boy went to the a a show") is typically not a sign of stuttering, but frequently repeating sounds or parts of words (e.g., "The b-b-boy wha-wha-ent to the sha-sha-show.") is a signal of this speech impairment (Ratner, 2005).