Overview of Speech and Language Impairments

Article by:
Sarah Morales, BS
Children's Speech Care Center

Speech and language impairments include a variety of conditions that interfere with communication. Many of these disabilities are relatively rare or subtle in appearance, and the individual’s lack of any visible abnormalities may further disguise speech and language impairments. Before describing these disorders in more detail, I will define “speech” and “language” as speech-language pathologists (specialists in the diagnosis and treatment of speech and language disorders) define these terms. Language is a socially shared, rule-governed code used for communication. Speech is the audible, oral output of language. Language is not limited to oral expression however—it occurs in written form (or through use of gestures and alternative methods of communication for those who are low verbal or nonverbal) and within the brain in one’s thoughts.

Speech and language impairments may occur separately in a person, or the individual may demonstrate both types of impairments; to further complicate matters, this distinction is usually not easy to make. A speech impairment affects spoken language. Examples of this include stuttering (repeating syllables or words, prolonging sounds, or “blocking” on a word or sound), phonological or articulation disorders (inability to say sounds properly), speech in the hearing impaired (speech may be difficult to understand, nasal-sounding, unusual in pitch or rhythm), apraxia (facial grimaces or unusual movements may accompany speech, such as groping to produce sounds, syllables, and words; difficulty planning and sequencing movements for speech within the brain; speech may be unintelligible, or not understandable), etc. Voice disorders affect the sound of the voice itself (i.e. hoarseness, breathy voice, strained/tense voice). Such disorders are often caused by changes in the shape of the vocal cords (e.g., swelling of the vocal cords, growths on the vocal cords such as vocal nodules). A language impairment affects the understanding of language (receptive language disorder), the formulation of an utterance (saying what one intends to say--expressive language disorder), or both. Receptive and expressive abilities may be impaired together such as in a disorder called developmental language delay in toddlers and preschoolers or language learning disability in school-aged children. A child who is unable to talk (called a nonverbal child) may have good receptive language abilities. In contrast, a child who is able to express his/her thoughts well may have difficulty following directions. Reading/writing disabilities (e.g., dyslexia) are also types of language disorders. Persons with learning disabilities may also exhibit difficulties comprehending language or expressing themselves with language.

The disabilities discussed above are considered linguistic in nature, meaning that they are directly related to language and speech. Some disorders involve other difficulties or abnormalities while also affecting speech and language. For example, mental retardation impairs brain functioning in general, and thus the learning of speech and language will be delayed (e.g. Down Syndrome, possibly Fragile X syndrome, which is a genetically based disorder often involving an intellectual disability). Autism impairs learning, processing, communication and social functioning—such issues impact language and/or speech. Physical disabilities such as cerebral palsy or cleft palate can also affect speech and language. A stroke or head injury may affect areas of the brain responsible for generating and understanding speech and language.

In conclusion, the field of speech-language pathology is diverse and complex. Only a speech-language pathologist can accurately and thoroughly diagnose and treat speech and language impairments. These professionals are available in the public schools, hospitals, university clinics, or private practice clinics. Several websites also offer valuable information regarding speech-language pathologists’ duties (www.asha.org) and types of speech and language impairments (www.slpsite.com).