Speech Impairments

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).

Voice Problems

The third type of speech impairment, a voice problem, is not very common in students, but if a child's voice is unusual given the age and sex of the individual (e.g., too husky for a young girl or two high for an older teenage boy), immediate attention from a professional should be arranged. Two qualities of voice are important. Pitch is the perceived high or low quality of voice. Loudness is the other main aspect of voice.

Age is a critical variable for all three types of speech impairments (Bernthal & Bankson, 2004). Correct production does not develop at the same time for all speech sounds (Small, 2005). Thus, articulation behavior that is developmentally normal at one age is not acceptable at another.  By age 8½, most children have mastered the last sound (z, as in was) at 90 percent accuracy. In the case of stuttering, age is also important; it is normal for very young children (between the ages of 3 and 5) to be dysfluent—their speech includes many hesitations and repetitions—as they master oral communication and language. Young children (below age 6) often exhibit high rates of dysfluencies and may even fit a definition of stuttering. Dysfluencies are likely to occur in exciting, stressful, or uncommon situations (Conture, 2001; Gregory et al., 2003). However, more than half of those preschoolers who stutter recover by the age of seven (Ratner, 2005). And in the case of voice, pitch changes during puberty, particularly for boys. Of course, this pitch change is a normal part of development and disappears as the boy's body grows and voice pitch becomes stabilized. It is important that adults not become alarmed or pay too much attention to speech errors during the normal developmental period.