speech impediment overcoming

Monica Marzinske, CCC-SLP

Speech-language therapy.

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Speaking clearly: Help for people with speech and language disorders

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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.

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Home / Blog

Speech Impediment Guide: Definition, Causes, and Resources

December 8, 2020 

Tables of Contents

What Is a Speech Impediment?

Types of speech disorders, speech impediment causes, how to fix a speech impediment, making a difference in speech disorders.

Communication is a cornerstone of human relationships. When an individual struggles to verbalize information, thoughts, and feelings, it can cause major barriers in personal, learning, and business interactions.

Speech impediments, or speech disorders, can lead to feelings of insecurity and frustration. They can also cause worry for family members and friends who don’t know how to help their loved ones express themselves.

Fortunately, there are a number of ways that speech disorders can be treated, and in many cases, cured. Health professionals in fields including speech-language pathology and audiology can work with patients to overcome communication disorders, and individuals and families can learn techniques to help.

Commonly referred to as a speech disorder, a speech impediment is a condition that impacts an individual’s ability to speak fluently, correctly, or with clear resonance or tone. Individuals with speech disorders have problems creating understandable sounds or forming words, leading to communication difficulties.

Some 7.7% of U.S. children — or 1 in 12 youths between the ages of 3 and 17 — have speech, voice, language, or swallowing disorders, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). About 70 million people worldwide, including some 3 million Americans, experience stuttering difficulties, according to the Stuttering Foundation.

Common signs of a speech disorder

There are several symptoms and indicators that can point to a speech disorder.

• Unintelligible speech — A speech disorder may be present when others have difficulty understanding a person’s verbalizations.
• Omitted sounds — This symptom can include the omission of part of a word, such as saying “bo” instead of “boat,” and may include omission of consonants or syllables.
• Added sounds — This can involve adding extra sounds in a word, such as “buhlack” instead of “black,” or repeating sounds like “b-b-b-ball.”
• Substituted sounds — When sounds are substituted or distorted, such as saying “wabbit” instead of “rabbit,” it may indicate a speech disorder.
• Use of gestures — When individuals use gestures to communicate instead of words, a speech impediment may be the cause.
• Inappropriate pitch — This symptom is characterized by speaking with a strange pitch or volume.

In children, signs might also include a lack of babbling or making limited sounds. Symptoms may also include the incorrect use of specific sounds in words, according to the American Speech-Language-Hearing Association (ASHA). This may include the sounds p, m, b, w, and h among children aged 1-2, and k, f, g, d, n, and t for children aged 2-3.

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Categories of Speech Impediments

Speech impediments can range from speech sound disorders (articulation and phonological disorders) to voice disorders. Speech sound disorders may be organic — resulting from a motor or sensory cause — or may be functional with no known cause. Voice disorders deal with physical problems that limit speech. The main categories of speech impediments include the following:

Fluency disorders occur when a patient has trouble with speech timing or rhythms. This can lead to hesitations, repetitions, or prolonged sounds. Fluency disorders include stuttering (repetition of sounds) or   (rapid or irregular rate of speech).

Resonance disorders are related to voice quality that is impacted by the shape of the nose, throat, and/or mouth. Examples of resonance disorders include hyponasality and cul-de-sac resonance.

Articulation disorders occur when a patient has difficulty producing speech sounds. These disorders may stem from physical or anatomical limitations such as muscular, neuromuscular, or skeletal support. Examples of articulation speech impairments include sound omissions, substitutions, and distortions.

Phonological disorders result in the misuse of certain speech sounds to form words. Conditions include fronting, stopping, and the omission of final consonants.

Voice disorders are the result of problems in the larynx that harm the quality or use of an individual’s voice. This can impact pitch, resonance, and loudness.

Impact of Speech Disorders

Some speech disorders have little impact on socialization and daily activities, but other conditions can make some tasks difficult for individuals. Following are a few of the impacts of speech impediments.

• Poor communication — Children may be unable to participate in certain learning activities, such as answering questions or reading out loud, due to communication difficulties. Adults may avoid work or social activities such as giving speeches or attending parties.
• Mental health and confidence — Speech disorders may cause children or adults to feel different from peers, leading to a lack of self-confidence and, potentially, self-isolation.

Resources on Speech Disorders

The following resources may help those who are seeking more information about speech impediments.

Health Information : Information and statistics on common voice and speech disorders from the NIDCD

Speech Disorders : Information on childhood speech disorders from Cincinnati Children’s Hospital Medical Center

Speech, Language, and Swallowing : Resources about speech and language development from the ASHA

Children and adults can suffer from a variety of speech impairments that may have mild to severe impacts on their ability to communicate. The following 10 conditions are examples of specific types of speech disorders and voice disorders.

1. Stuttering

This condition is one of the most common speech disorders. Stuttering is the repetition of syllables or words, interruptions in speech, or prolonged use of a sound.

This organic speech disorder is a result of damage to the neural pathways that connect the brain to speech-producing muscles. This results in a person knowing what they want to say, but being unable to speak the words.

This consists of the lost ability to speak, understand, or write languages. It is common in stroke, brain tumor, or traumatic brain injury patients.

4. Dysarthria

This condition is an organic speech sound disorder that involves difficulty expressing certain noises. This may involve slurring, or poor pronunciation, and rhythm differences related to nerve or brain disorders.

The condition of lisping is the replacing of sounds in words, including “th” for “s.” Lisping is a functional speech impediment.

6. Hyponasality

This condition is a resonance disorder related to limited sound coming through the nose, causing a “stopped up” quality to speech.

7. Cul-de-sac resonance

This speech disorder is the result of blockage in the mouth, throat, or nose that results in quiet or muffled speech.

8. Orofacial myofunctional disorders

These conditions involve abnormal patterns of mouth and face movement. Conditions include tongue thrusting (fronting), where individuals push out their tongue while eating or talking.

9. Spasmodic Dysphonia

This condition is a voice disorder in which spasms in the vocal cords produce speech that is hoarse, strained, or jittery.

10. Other voice disorders

These conditions can include having a voice that sounds breathy, hoarse, or scratchy. Some disorders deal with vocal folds closing when they should open (paradoxical vocal fold movement) or the presence of polyps or nodules in the vocal folds.

Speech Disorders vs. Language Disorders

Speech disorders deal with difficulty in creating sounds due to articulation, fluency, phonology, and voice problems. These problems are typically related to physical, motor, sensory, neurological, or mental health issues.

Language disorders, on the other hand, occur when individuals have difficulty communicating the meaning of what they want to express. Common in children, these disorders may result in low vocabulary and difficulty saying complex sentences. Such a disorder may reflect difficulty in comprehending school lessons or adopting new words, or it may be related to a learning disability such as dyslexia. Language disorders can also involve receptive language difficulties, where individuals have trouble understanding the messages that others are trying to convey.  

Resources on Types of Speech Disorders

The following resources may provide additional information on the types of speech impediments.

Common Speech Disorders: A guide to the most common speech impediments from GreatSpeech

Speech impairment in adults: Descriptions of common adult speech issues from MedlinePlus

Stuttering Facts: Information on stuttering indications and causes from the Stuttering Foundation

Speech disorders may be caused by a variety of factors related to physical features, neurological ailments, or mental health conditions. In children, they may be related to developmental issues or unknown causes and may go away naturally over time.

Physical and neurological issues. Speech impediment causes related to physical characteristics may include:

• Brain damage
• Nervous system damage
• Respiratory system damage
• Hearing difficulties
• Cancerous or noncancerous growths
• Muscle and bone problems such as dental issues or cleft palate

Mental health issues. Some speech disorders are related to clinical conditions such as:

• Autism spectrum disorder
• Down syndrome or other genetic syndromes
• Cerebral palsy or other neurological disorders
• Multiple sclerosis

Some speech impairments may also have to do with family history, such as when parents or siblings have experienced language or speech difficulties. Other causes may include premature birth, pregnancy complications, or delivery difficulties. Voice overuse and chronic coughs can also cause speech issues.

The most common way that speech disorders are treated involves seeking professional help. If patients and families feel that symptoms warrant therapy, health professionals can help determine how to fix a speech impediment. Early treatment is best to curb speech disorders, but impairments can also be treated later in life.

Professionals in the speech therapy field include speech-language pathologists (SLPs) . These practitioners assess, diagnose, and treat communication disorders including speech, language, social, cognitive, and swallowing disorders in both adults and children. They may have an SLP assistant to help with diagnostic and therapy activities.

Speech-language pathologists may also share a practice with audiologists and audiology assistants. Audiologists help identify and treat hearing, balance, and other auditory disorders.

How Are Speech Disorders Diagnosed?

Typically, a pediatrician, social worker, teacher, or other concerned party will recognize the symptoms of a speech disorder in children. These individuals, who frequently deal with speech and language conditions and are more familiar with symptoms, will recommend that parents have their child evaluated. Adults who struggle with speech problems may seek direct guidance from a physician or speech evaluation specialist.

When evaluating a patient for a potential speech impediment, a physician will:

• Conduct hearing and vision tests
• Evaluate patient records
• Observe patient symptoms

A speech-language pathologist will conduct an initial screening that might include:

• An evaluation of speech sounds in words and sentences
• An evaluation of oral motor function
• An orofacial examination
• An assessment of language comprehension

The initial screening might result in no action if speech symptoms are determined to be developmentally appropriate. If a disorder is suspected, the initial screening might result in a referral for a comprehensive speech sound assessment, comprehensive language assessment, audiology evaluation, or other medical services.

Initial assessments and more in-depth screenings might occur in a private speech therapy practice, rehabilitation center, school, childcare program, or early intervention center. For older adults, skilled nursing centers and nursing homes may assess patients for speech, hearing, and language disorders.

How Are Speech Impediments Treated?

Once an evaluation determines precisely what type of speech sound disorder is present, patients can begin treatment. Speech-language pathologists use a combination of therapy, exercise, and assistive devices to treat speech disorders.

Speech therapy might focus on motor production (articulation) or linguistic (phonological or language-based) elements of speech, according to ASHA. There are various types of speech therapy available to patients.

Contextual Utilization  — This therapeutic approach teaches methods for producing sounds consistently in different syllable-based contexts, such as phonemic or phonetic contexts. These methods are helpful for patients who produce sounds inconsistently.

Phonological Contrast — This approach focuses on improving speech through emphasis of phonemic contrasts that serve to differentiate words. Examples might include minimal opposition words (pot vs. spot) or maximal oppositions (mall vs. call). These therapy methods can help patients who use phonological error patterns.

Distinctive Feature — In this category of therapy, SLPs focus on elements that are missing in speech, such as articulation or nasality. This helps patients who substitute sounds by teaching them to distinguish target sounds from substituted sounds.

Core Vocabulary — This therapeutic approach involves practicing whole words that are commonly used in a specific patient’s communications. It is effective for patients with inconsistent sound production.

Metaphon — In this type of therapy, patients are taught to identify phonological language structures. The technique focuses on contrasting sound elements, such as loud vs. quiet, and helps patients with unintelligible speech issues.

Oral-Motor — This approach uses non-speech exercises to supplement sound therapies. This helps patients gain oral-motor strength and control to improve articulation.

Other methods professionals may use to help fix speech impediments include relaxation, breathing, muscle strengthening, and voice exercises. They may also recommend assistive devices, which may include:

• Radio transmission systems
• Personal amplifiers
• Picture boards
• Touch screens
• Text displays
• Speech-generating devices
• Hearing aids
• Cochlear implants

Resources for Professionals on How to Fix a Speech Impediment

The following resources provide information for speech therapists and other health professionals.

Assistive Devices: Information on hearing and speech aids from the NIDCD

Information for Audiologists: Publications, news, and practice aids for audiologists from ASHA

Information for Speech-Language Pathologists: Publications, news, and practice aids for SLPs from ASHA

Speech Disorder Tips for Families

For parents who are concerned that their child might have a speech disorder — or who want to prevent the development of a disorder — there are a number of activities that can help. The following are tasks that parents can engage in on a regular basis to develop literacy and speech skills.

• Introducing new vocabulary words
• Reading picture and story books with various sounds and patterns
• Talking to children about objects and events
• Answering children’s questions during routine activities
• Encouraging drawing and scribbling
• Pointing to words while reading books
• Pointing out words and sentences in objects and signs

Parents can take the following steps to make sure that potential speech impediments are identified early on.

• Discussing concerns with physicians
• Asking for hearing, vision, and speech screenings from doctors
• Requesting special education assessments from school officials
• Requesting a referral to a speech-language pathologist, audiologist, or other specialist

When a child is engaged in speech therapy, speech-language pathologists will typically establish collaborative relationships with families, sharing information and encouraging parents to participate in therapy decisions and practices.

SLPs will work with patients and their families to set goals for therapy outcomes. In addition to therapy sessions, they may develop activities and exercises for families to work on at home. It is important that caregivers are encouraging and patient with children during therapy.  

Resources for Parents on How to Fix a Speech Impediment

The following resources provide additional information on treatment options for speech disorders.

Speech, Language, and Swallowing Disorders Groups: Listing of self-help groups from ASHA

ProFind: Search tool for finding certified SLPs and audiologists from ASHA

Baby’s Hearing and Communication Development Checklist: Listing of milestones that children should meet by certain ages from the NIDCD

If identified during childhood, speech disorders can be corrected efficiently, giving children greater communication opportunities. If left untreated, speech impediments can cause a variety of problems in adulthood, and may be more difficult to diagnose and treat.

Parents, teachers, doctors, speech and language professionals, and other concerned parties all have unique responsibilities in recognizing and treating speech disorders. Through professional therapy, family engagement, positive encouragement and a strong support network, individuals with speech impediments can overcome their challenges and develop essential communication skills.

Additional Sources

American Speech-Language-Hearing Association, Speech Sound Disorders

Identify the Signs, Signs of Speech and Language Disorders

Intermountain Healthcare, Phonological Disorders

MedlinePlus, Speech disorders – children

National Institutes of Health, National Institutes on Deafness and Other Communication Disorders, “Quick Statistics About Voice, Speech, Language”

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Common Speech Impediments: Causes, Symptoms, Treatment, And Support

Speech impediments include a variety of both language and speech disorders, some of which can be addressed through  online speech therapy  with speech-language pathologists. They can arise because of heredity and genetics, developmental delays, or even damage to Broca’s area—the part of the brain that’s involved in language skills and speech skills. They may also be linked to other conditions like autism spectrum disorder, cerebral palsy, dyslexia, or even hearing loss. It depends on the type and the cause, but most speech impediments and speech impairments can be treated through speech therapy.

That said, recognizing when a speech impediment may be present can help you get yourself or your child the treatment and support they may need for improved academic and/or social functioning and self-confidence.

Common symptoms of a speech impediment

There are many different types of speech impediments a person can have, so the symptoms can vary. That said, those listed below are common symptoms that could be initial indicators that you or your child may be experiencing speech problems or challenges:

• Elongating words
• Quiet or muffled speech
• Blinking frequently
• Distorted sounds while talking
• Frequent changes in pitch
• Poor voice quality
• Visible frustration when trying to communicate
• Overall difficulty communicating and expressing thoughts and ideas
• Inability to repeat words
• Inability to pronounce words the same way twice
• A phobia of speaking in public
• Speaking slowly and carefully
• Speech delay
• Frequent pauses when talking
• Limited vocabulary over several years, delayed language development

Some speech and language disorders are consistent with underlying mental health conditions such as autism. You can visit licensed health professionals or speech therapists to receive an accurate diagnosis and find out how to treat a speech impediment or language disorder, and its underlying cause, if applicable.

Key categories of speech impediments

Speech impediments or communication disorders can take many forms, from speech sound disorders to voice-related disorders. While speech sound disorders mostly result from sensory or motor causes, voice-related disorders deal with physical problems regarding speech. Read on for a list of some of the most common categories of speech impediments.

Voice disorders

Voice disorders  primarily arise due to issues regarding the health and structure of the larynx or the voice box. They can impact pitch, resonance, volume, and voice quality. Symptoms of a voice disorder may include having a hoarse, quivering, strained, choppy, or weak and whispery voice, which can make it difficult to produce speech sounds.

The root cause of these disorders can be either organic, like alterations to respiratory, laryngeal, or vocal tract mechanisms, or functional, like improper use of the voice. Some risk factors that may contribute to vocal health challenges include allergies, psychological stress, age, excessive alcohol or drug use, screaming, scarring from neck surgery, or even gastroesophageal reflux disease (GERD). Examples of voice disorders include laryngitis, vocal cord paralysis/weakness, polyps or nodes present on the vocal cords, leukoplakia, or muscle tension dysphonia.

Fluency disorders

A person may be diagnosed with a fluency disorder if they have trouble with speech timing and rhythm which makes it difficult to create a normal speech pattern. These disorders are characterized by interruptions in the typical flow of speaking, including abnormal repetitions, hesitation, and prolongations. Their cause is unknown, but it may be genetic. Symptoms can also be exacerbated by stress and anxiety. Stuttering is the most common example of fluency disorders. 

Symptoms of a fluency disorder may include dragging out syllables, speaking breathlessly, repetition of words, speaking slowly, and being tense while speaking. Secondary symptoms may include fidgeting, mumbling, saying “um” or “uh” often, not using certain problematic words, rearranging words in sentences, and anxiety around speaking. Treatment options vary depending on the specific disorder. With stuttering, for example, slowing down, practicing, using speech monitors, attending speech therapy, and receiving cognitive behavioral therapy (CBT) are all potential treatment options.

Articulation disorders and phonological disorders

Articulation and phonological disorders are two types of speech disorders classified as speech sound disorders that may impact communication. An articulation disorder includes speech that commonly exhibits errors such as substitution, omission, distortion, and/or addition (SODA). Although the actual causes of articulation disorders aren’t well understood, contributing factors may include brain injuries, a cleft palate/cleft lip, or nerve damage. Phonological disorders typically involve producing sounds correctly but using them in the wrong place and are more predictable than articulation errors. There may also be a genetic factor that contributes to both disorders and other families may be impacted as well. A licensed speech-language pathologist (SLP) can determine if an individual may have an articulation disorder or a phonological disorder. Ongoing speech therapy is typically the recommended treatment method.

Speech impediments versus language impairments

A speech impediment is typically characterized by difficulty creating sound due to factors like fluency disorders or other voice problems. These disorders may arise from underlying mental health issues, neurological problems, or physical factors or conditions impacting speech muscles.

Language impairments, on the other hand, are more about difficulty processing, reading, and writing and can be connected to an issue processing receptive language. They’re common in children, especially when they first start school. Language impairments relate to meaning, whereas speech impediments relate to sound. It’s also very common for a language impairment disorder to present alongside a learning disability like dyslexia.

Examples of speech impediments

Below is a brief overview of a few of the most common speech disorders and speech impediments, along with symptoms and potential treatment options.

Apraxia of speech is a speech sound disorder that affects the pathways of the brain. It’s characterized by a person having difficulty expressing their thoughts accurately and consistently. It involves the brain being able to form the words and knowing exactly what to say, but the person then being unable to properly execute the required speech movements to deliver accurate sounds. In mild cases, a person will only have small limitations in their ability to form speech sounds. In severe cases, alternate communication methods may need to be used.

An SLP is the type of provider who can diagnose apraxia. To diagnose speech disorders, including both childhood apraxia (sometimes called verbal apraxia) and acquired apraxia, they may ask the individual to perform simple speech tasks like repeating a particular word several times or repeating a list of words that increase in length. Apraxia generally needs to be monitored by both parents and an SLP over time for an accurate diagnosis to be possible.

There are various treatment options for apraxia, the most common being one-on-one meetings with a speech pathologist. They’ll likely help you or your child build helpful strategies and skills to help strengthen problem areas and communicate more clearly. Some other treatment methods include improving speech intelligibility or using alternate forms of communication, like electronic speech or manual signs and gestures.

The National Institute on Deafness and Other Communication Disorders describes aphasia as a communication disorder that results in a person’s inability to speak, write, and/or understand language. Like other communication disorders, it may occur because of damage to the portions of the brain that are involved in language, which is common in those who have experienced a stroke. It may also come on gradually in those who have a tumor or a progressive neurological disease like Alzheimer’s. Symptoms may include saying or writing sentences that don’t make sense, a reduction in a person’s ability to understand a conversation, and substituting certain sounds and words for others.

Since this disorder is usually caused by damage to parts of the brain, it will typically first be recognized in an MRI or CT scan that can confirm the presence of a brain injury. The extent and type of aphasia can generally only be determined by observing the affected part of the brain and determining how extensively it has been damaged, which is often done with the help of an SLP.

Treatment options for aphasia can be restorative (aimed at restoring impaired function) or compensatory (aimed at compensating for deficits).

Dysarthria 

Dysarthria is usually caused by brain damage or facial paralysis that affects the muscles of the jaw, tongue, or throat, which may result in deficits in a person’s speech. It may also be caused by other conditions like Lou Gehrig’s disease, Parkinson’s, or a stroke. It’s considered a nervous system disorder, subclassified as a motor speech disorder. It’s commonly seen in those who already have other speech disorders, such as aphasia or apraxia. Symptoms of dysarthria include slurred speech, speaking too slowly, speaking too quickly, speaking very softly, being unable to move one’s lips or jaw, and having monotonous speech.

Dysarthria can be diagnosed by an expert in speech-language pathology through an exam and tests like MRI, CT, electromyography, or the Denver articulation screening examination. Treatment depends upon the severity and rate of progression of the disorder. Some potential examples include tactics like slowing down while talking, doing exercises to help strengthen jaw muscles, moving the lips and tongue more, and learning strategies for speaking more loudly. Hand gestures and speech machines may also help. 

The importance of treatment

It is important to treat speech disorders; the consequences of an untreated speech or language impediment can vary widely depending on the type, symptoms, and severity, as well as the age and life situation of the individual. In general, it’s usually helpful to seek professional advice on treating speech disorders as soon as you notice or suspect an impediment present in yours or your child’s speech. Especially for moderate to severe cases, some potential effects of leaving these common speech disorders untreated can include:

• Poor academic performance/dropping out of school
• Decrease in quality of life
• Social anxiety and an inability to connect with people
• Damaged relationships
• Social isolation
• Hospitalization

Seeking professional support

Meeting with an SLP is usually the recommended first step for someone who believes they or their child may have a speech impediment. If you have a teenager with dyslexia, there are  resources for dyslexic teens  that can give supportive information about the condition. Healthcare providers may also provide helpful insights and ask about your family members’ history when it comes to speech and language-related issues as they can be hereditary. While these professionals can help with the physical aspects of a variety of speech and language impediments, you or your child may also benefit from emotional support in relation to the mental health effects of having an impediment. A therapist may be able to provide this type of guidance. If your child is experiencing a speech impediment, a counselor may be able to work with them to process their feelings of frustration and learn healthy coping mechanisms for stress. They can help you manage the same feelings if you receive a speech or language impediment diagnosis, or may be able to support you in your journey of parenting a child with a speech or language impediment diagnosis.

In addition to support at home, teenagers with a diagnosed speech impairment or impediment can receive special education services at school. The Centers for Disease Control notes that under the Individuals with Disabilities Act (IDEA) and Section 504, schools must provide support and accommodations for students with speech disorders. For some children, support groups can provide outlets for social connections and advice for coping. 

Meeting with a therapist in person is an option if there are providers in your area. That said, many people find it less intimidating or more comfortable to meet with a therapist virtually. For example, a teen who is experiencing a speech or language impediment may feel better interacting with a counselor through the online chat feature that virtual therapy platforms like TeenCounseling provide. It may allow them to express themselves more clearly than they could face-to-face or over the phone. Parents who need support in caring for a child with a speech or language impediment may find the availability and convenience of meeting with a therapist through an online therapy service like BetterHelp to be most beneficial. Research suggests that online and in-person therapy offer similar benefits for a variety of conditions, so you can choose the format that’s best for you.

Counselor reviews

See below for reviews of TeenCounseling therapists written by parents who sought help for their children through this service. 

“Kathleen has been good for my daughter to talk to. I am thankful for her to give my daughter someone else's perspective other than her parents. Thank you.”

“I love Ms. Jones. She doesn’t over-talk or judge you. She gives really good advice and if you're confused she knows how to break it down or explain whatever it is so you can understand. If you need to talk about anything, she’s always an open ear and responds quickly. Not only does she give you points from others' perspectives but she steps into yours so she can understand why certain things are the way they are. In my first session, I was nervous and I think she could tell. She’ll crack a joke every now and then to make me feel more comfortable. She’s just such a bundle of joy and a good counselor to have.”

Speech and language impediments can vary widely in terms of types, causes, symptoms, and severity. These are diagnosed by professionals in the field of speech and language pathology or by a medical doctor. A therapist can provide emotional support for those who are having difficulty coping with their own or their child’s diagnosis or other related challenges. 

What are the 3 speech impediments?

Speech impediments can manifest in a variety of ways. Three of the most common are listed below: 

• Voice disorders affect the tone, pitch, quality, and volume of a person’s voice. A person with a voice disorder may have difficulty speaking or being heard clearly by others. Voice disorders can be either functional or organic. Functional disorders occur due to improper use of the parts of the throat that produce speech, such as overuse of the voice leading to vocal fatigue. Organic voice disorders result from physical anatomical changes, such as nodules on the vocal cords. 
• Fluency disorders affect the rate, rhythm, and cadence of speech. Those with fluency disorders may speak in a disjointed, choppy, or prolonged fashion, making them difficult for others to understand clearly. While many types of fluency disorders exist, stuttering is likely the best-known. Speech often requires precise timing to convey a message accurately, which fluency disorders can disrupt. 
• Speech sound disorders are a broad category of disorders that interferes with a person’s ability to produce sounds and words correctly. Speech sound disorders can present very differently from person to person. Sometimes word sounds are omitted or added where not appropriate, and sometimes word sounds are distorted or substituted completely. A typical example of a speech sound disorder is the substitution of “r” for “w” in words like “rabbit” (becoming “wabbit”). Many children experience that substitution, but it does not become a disorder until the child does not outgrow it. 

Other types of disorders can cause problems with expressive communication or tongue-tie those experiencing them, such as developmental language disorder. Language disorders also cause concerns related to expressive communication, but the concerns are due to a lack of understanding of one or more components of language, not an inability to produce or use word sounds. 

What do you call a speech impediment?

Speech impediments are typically referred to as speech disorders . Speech refers to the ability to form speech sounds using the vocal cords, mouth, lips, and tongue. Speech also requires that a rhythm and cadence be maintained. Speech disorders indicate a problem producing intelligible speech; word sounds may be omitted or misplaced, the rhythm of the speech may be difficult to follow, or a person’s voice might be strangely pitched or too soft to hear clearly. 

It is important not to confuse speech disorders with language disorders . Language disorders arise due to difficulty understanding what words mean, how word sounds fit together, or how to use spoken language to communicate. Language problems may affect how a person speaks, but the root cause of the concern is linked to their understanding of language, not their ability to produce intelligible speech. 

How do I know if I have a speech impediment?

If you’re experiencing a sudden onset of impaired speech with no apparent cause, seek medical attention immediately. Strokes, traumatic brain injuries, and other serious medical conditions can cause sudden changes in speaking ability. Gradual changes in speaking ability may also indicate an underlying medical problem. If you’re concerned that your speaking ability has been gradually deteriorating, consider making an appointment with a healthcare provider in the near future. 

Most people with a speech disorder are diagnosed in childhood. Parents often identify speech-related concerns in early childhood based on their child’s speech patterns. The child’s pediatrician may also refer the child to a speech-language pathologist, a professional specializing in evaluating and treating speech disorders. If problems persist until the child is in school, teachers and other school officials might initiate a referral for an evaluation if they believe speech concerns are present. Children often receive speech and language therapy that resolves or improves their speech problems. 

Speech disorders also appear in adulthood, often due to injury or illness. It is also possible, although rare, for speech problems to be misdiagnosed or missed outright during a person’s childhood. In that case, the speech disorder may have been present since childhood and symptoms persisted into adulthood.

If you’re finding it difficult to communicate verbally with others, have an easily identifiable speech problem (like stuttering), or receive feedback that others have trouble understanding you, consider making an appointment with your doctor for an evaluation and referral to the appropriate healthcare providers. 

What are 5 causes of speech impairment?

Speech and language disorders can result from conditions that interfere with the development of perceptual, structural, motor, cognitive, or socioemotional functions. The cause of many speech disorders is unknown, but research has indicated several underlying factors that may be responsible: 

• Pre-existing genetic conditions, like Down’s syndrome or Fragile X syndrome. Evidence suggests that genes may play a role even if genetic abnormalities do not result in a diagnosable genetic condition. 
• Physical abnormalities, such as damage or improper development of the respiratory system, facial muscles, or cranial nerves. 
• Hearing problems, which can delay a child’s acquisition of speech. 
• Neurodevelopmental disorders, such as autism spectrum disorder, may interfere with speech development. There is also evidence to suggest that those with attention-deficit hyperactivity disorder may have a more challenging time acquiring speech skills. 
• Neurological conditions such as cerebral palsy. 

Mental health concerns can also cause problems communicating with others. For example, an underlying anxiety disorder may lead to selective mutism , wherein a child speaks only under certain circumstances. 

Is speech impediment a disability?

A speech-language disorder is considered a “ communication disability ” under the Americans with Disabilities Act (ADA). The ADA requires government and businesses to establish “effective communication” with people who have communication disabilities. Effective communication can be established in several ways. For those with a speech disorder, accommodation may be as simple as ensuring the person can get hold of writing materials if they need to express themselves quickly. In some cases, organizations may use a transliterator, or person trained to recognize unclear speech and repeat it clearly. 

Because speech disorders are known to lead to academic struggles in K-12 and higher education settings, they are categorized as a disability under the Individuals with Disabilities Education Improvement Act (IDEIA) . The IDEIA sets guidelines for all schools in the United States, public or not public, guaranteeing each child a right to accommodations and interventions for their speech disorder. 

Can I fix my speech impediment?

Whether or not a speech disorder can be completely eliminated depends heavily on individual factors. The cause of the disorder, its severity, and the type of speech dysfunction all play a role in determining whether a particular disorder can be completely resolved. While it is not possible to guarantee that a speech disorder can be “cured,” nearly all disorders are treatable, and improvement is likely possible. 

Can you treat a speech impediment?

Yes, many speech disorders are highly treatable. Most people receive treatment as children when most speech disorders become apparent. For children, speech-language pathologists will identify the specific speech disorder, search for an underlying cause, and design an intervention that targets that child’s speech problem. For example, a child who struggles with articulation errors and producing word sounds consistently may benefit from a contextual utilization approach . Contextual utilization leverages the fact that one sound is easier or more difficult to pronounce depending on which other sounds surround it. 

Speech disorders that emerge in adulthood may be more challenging to treat due to underlying factors, such as brain injury. Suppose an adult experiences a traumatic brain injury that affects their speaking ability. In that case, a speech-language pathologist may help them find alternative communication methods, such as using a computer. They may also help them directly restore some of their speaking ability by leading them through exercises that improve nerve function and muscle control.  

Is a speech impediment mental?

Speech disorders can be caused by various factors, many of which have nothing to do with the brain. However, there is a relationship between psychiatric mental health concerns and difficulty with spoken communication . Although researchers are still unsure of the exact cause, studies have identified a significant link between speech disorders and mental health disorders like schizophrenia, bipolar disorder, and major depression. 

Neurodevelopmental disorders, such as autism spectrum disorder and attention-deficit hyperactivity disorder, are also associated with an increased risk of developing a speech disorder. Although the link between neurodevelopmental disorders and speech disorders is not fully understood, evidence suggests that treating the speech disorder is still possible. 

Finally, speech disorders can also be caused by illness or injury in the brain, such as cancer, an infection, or traumatic brain injury. Although these are not considered mental or developmental disorders, they may affect brain function and mental acuity. Speaking is a complex process, and there are many ways it can be affected. 

Is autism a speech impediment?

Autism spectrum disorder is not a speech disorder, but it is heavily associated with communication problems. Those on the autism spectrum often use repetitive or rigid language and may not follow communication norms. They may repeat phrases continuously, use a modified tone of voice, or introduce information that has little to do with the conversation at hand. 

Those on the autism spectrum are often able to form word sounds properly. The communication deficits of autism spectrum disorder are more closely related to language disorders than speech disorders. Speech disorders are associated with difficulty producing or using word sounds correctly, whereas language disorders are associated with a lack of understanding of one or more language components.

Autism spectrum disorder is also characterized by difficulties using pragmatic communication, or communication that is appropriate to a specific social situation. Although not a disorder of speech, a limited ability to recognize the socioemotional content of speech can significantly impact interpersonal communication and social interactions. 

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What Is Apraxia of Speech?

A Challenging Language Disorder

Apraxia of speech is a language impairment that occurs due to brain damage. The underlying causes of apraxia of speech are usually different for children than for adults. Speech apraxia is difficult to cope with, and speech therapy can help improve communication.

Diagnosis of the underlying cause is crucial, both to help direct treatment for speech difficulties and to treat and prevent further neurological problems.

Illustration by Zoe Hansen for Verywell Health

Apraxia of Speech Symptoms 

Speech apraxia leads to significant difficulties in communicating. This condition usually causes persistent symptoms and typically doesn't change.

People with apraxia of speech are cognitively and physically able to produce words and sentences. Language comprehension should not be affected by apraxia of speech, and words are not slurred in apraxia of speech.

Features of apraxia of speech include the following:

• Distortion of sounds : The sounds of words and phrases are often wrong in speech apraxia. For example, the vowels or consonants might be drawn out for too long.
• Inconsistency in pronouncing words and sounds : The mispronunciation of words with speech apraxia is not necessarily consistent. For example, you could have difficulty with the first part of a word, and the next time you say that word, you might have difficulty with the middle or the end.
• Struggling for words : If you have apraxia of speech, you will work hard to say the words you want to say.
• Errors in speech : You might use the wrong words and phrases if you have apraxia of speech, despite knowing what you mean to say.

Other cognitive or physical problems can often occur with speech apraxia, depending on the underlying cause.

Apraxia vs. Other Speech and Language Disorders

Apraxia of speech is a type of language disorder. Aphasia is the most common language impairment, and dysarthria is a speech impairment caused by difficulty with motor speech function. Apraxia is distinct from these disorders, although they may share some similarities. Common speech disorders include:

• Receptive aphasia : Usually referred to as Wernicke’s aphasia, this type of language impairment is characterized by fluid speech that usually doesn’t make sense, often with word substitutions. Language comprehension is typically impaired with Wernicke’s aphasia.
• Impaired fluency : Often described as Broca’s aphasia , this is a language problem that causes people to have choppy speech without a normal rhythm. Usually, speech comprehension is not substantially affected by Broca’s aphasia.
• Conduction aphasia : In conduction aphasia, the problem is the ability to repeat a short sentence. Expression and comprehension of speech are spared.
• Dysarthria : This condition is characterized by slurred speech or difficulty making certain sounds. Usually, people with dysarthria without aphasia can understand language and may know which words they want to say but have difficulty pronouncing them.

Speech apraxia is caused by damage to regions in the brain that mediate communication between language regions in the brain and between the left and right hemispheres of the brain.

This can occur with developmental conditions, such as autism, or it may result from harm to the brain, such as from head trauma.

Conditions associated with apraxia of speech include:

• Autism spectrum disorder
• Cerebral palsy
• Head trauma
• Brain tumors
• Brain surgery

These conditions are not always associated with apraxia of speech. But they can sometimes cause damage or dysfunction to regions of the brain that allow communication between the right and left hemispheres—and then they could be associated with speech apraxia.

Speech apraxia is diagnosed based on a clinical evaluation, usually by a physician or a speech therapist . A detailed examination of speech and cognitive abilities is necessary to define apraxia of speech and to rule out other disorders that can cause similar speech and language patterns, such as dysarthria and aphasia.

Speech patterns noted in apraxia of speech include the following:

• Phonemic error frequency : This involves assessment of the frequency of mistakes while pronouncing words.
• Distortion error frequency : This is a count of how often sounds are altered during speech.
• Word syllable duration : This involves assessment of the extra time in saying a word, usually due to struggling.

The Apraxia of Speech Rating Scale (ASRS) is one of the ways that speech apraxia can be defined. Healthcare providers can use this scale to communicate with each other and follow the improvement of apraxia of speech with therapy. The ASRS includes 16 components, such as repetition of sounds or inaccurate sounds, that are rated on a scale from zero to four.

If you’ve been diagnosed with speech apraxia or any communication problem, healthcare providers will work to determine the underlying cause. Issues such as childhood neurodevelopmental problems, stroke, brain tumors, or damage from a head injury need to be identified and treated.

Diagnostic testing may include:

• Brain imaging tests : These tests can help identify common causes of apraxia of speech, such as a stroke or head trauma.
• Cognitive testing : These tests may be used as part of the assessment for autism, dementia, or psychiatric conditions, which may be related to speech challenges.
• Blood tests : Medical problems such as infections, electrolyte disturbances , or organ failure may cause communication difficulties.

In addition to diagnosing speech apraxia, your healthcare providers will also work to determine whether you have other neurological deficits that could be caused by the underlying issue causing your speech apraxia. These can include learning difficulties, behavioral problems, or body weakness.

Apraxia of speech is treated with speech therapy . This type of therapy will follow patterns of treatment that are well-established for improving speech and will also provide an individualized treatment plan.

Therapy may need to be ongoing, and the frequency and specific exercises used during your therapy can be adjusted as you improve. For example, if your speech improves substantially, you might be able to work with your speech therapist less frequently, or you may be able to do some speech exercises at home, as directed by your therapist.

It’s not possible to predict with absolute certainty whether a person will recover from apraxia of speech and how much they might improve. However, there are some diagnostic clues that can help in anticipating the extent of recovery. 

If you or a loved one has apraxia of speech, it can help to know that the ability to participate in speech therapy can lead to better outcomes. If your cognitive function is not affected or is only mildly impaired, this can help you take an active role in your therapy.

Research About Prognosis and Treatment

Stronger connectivity between certain areas of the right and left hemispheres of the brain is associated with better recovery.

For example, one research study showed that early connectivity of the inferior frontal gyrus (an area that processes speech and language) within two weeks after a stroke may be a strong predictor of recovery of apraxia of speech.  

And at six months, lower severity of speech apraxia was associated with stronger connectivity of the anterior insula (which supports subjective feelings) on the right and left hemispheres and the ventral premotor cortex (which is involved in grasping and manipulating objects) of the right and left hemispheres.

This type of connectivity can be identified with metabolic brain testing, which is time-consuming and often impractical. However, this research can help scientists learn about ways to improve treatment for people with apraxia of speech.

Living with a language impairment can be difficult. Communication challenges interfere with relationships and day-to-day life. This can require extra effort from family, friends, and everybody else who interacts with a person who has apraxia of speech.

Patience is essential to managing this communication difficulty. It is important to work with your speech therapist in order to identify ways to communicate as you work to recover. This can include using pictures, gestures, and other ways of expressing your needs.

Apraxia of speech is a type of language impairment that is caused by damage to the brain, either during fetal development, childhood, or adulthood. This condition can occur along with other neurological deficits that are associated with damage to the brain.

There are many different causes, and a diagnosis of the cause is essential for a comprehensive treatment of speech apraxia, as well as any associated physical and cognitive deficits. Speech therapy is the treatment for the speech impairment seen in this condition.

National Institute on Deafness and Other Communication Disorders. Apraxia of speech .

Vogindroukas I, Stankova M, Chelas EN, Proedrou A. Language and speech characteristics in autism . Neuropsychiatr Dis Treat . 2022;18:2367-2377. doi:10.2147/NDT.S331987

Haley KL, Jacks A. Three-dimensional speech profiles in stroke aphasia and apraxia of speech . Am J Speech Lang Pathol. 2023:1-10. doi:10.1044/2022_AJSLP-22-00170

Hybbinette H, Östberg P, Schalling E, et al. Longitudinal changes in functional connectivity in speech motor networks in apraxia of speech after stroke . Front Neurol. 2022;13:1013652. doi:10.3389/fneur.2022.1013652

Duffy JR, Martin PR, Clark HM, et al. The apraxia of speech rating scale: reliability, validity, and utility . Am J Speech Lang Pathol. 2023;32(2):469-491. doi:10.1044/2022_AJSLP-22-00148

Zhao J, Li Y, Zhang X, et al. Alteration of network connectivity in stroke patients with apraxia of speech after tDCS: a randomized controlled study . Front Neurol. 2022;13:969786. doi:10.3389/fneur.2022.969786

By Heidi Moawad, MD Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.

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The Fluency Ladder: A Path to Overcoming Speech Impediments

Speech therapy plays a vital role in the lives of individuals dealing with speech impediments like stuttering, stammering, selective mutism, or cluttering. These impediments can significantly affect one’s ability to communicate effectively in various situations, from daily conversations with family and friends to public speaking. In this comprehensive blog, we will delve into the concept of the Fluency Ladder and how it can be a valuable tool in helping individuals with speech impediments climb the ladder towards improved fluency.

Understanding Speech Comfort Zones

All individuals, whether they have speech impediments or not, have their own speech comfort zones. These zones represent different levels of comfort when it comes to communication. For someone with a speech impediment, often referred to as a Person Who Stutters (PWS), these zones can vary greatly. Let’s break down speech comfort zones, from the easiest to the most challenging:

• Talking alone
• Talking to pets
• Talking to family and friends
• Talking to acquaintances
• Talking to strangers
• Talking to authorities
• Talking in groups of varied sizes and compositions
• Talking on the phone
• Formal public speaking

The Fluency Ladder

The Fluency Ladder is a structured approach to improving fluency and confidence in different speech comfort zones. It serves as a guide, helping individuals gradually expose themselves to more challenging communication situations. The ultimate goal is to move from the easiest zones to the most difficult ones, one step at a time.

Here’s an example of a generic Fluency Ladder:

• Public Speaking
• Job Interview
• Phone (Virtual/Online)
• Strangers/Authorities
• Social Gatherings
• Restaurants/Stores/Workplace
• Home/Family/Friends

It’s crucial to emphasize that each person’s comfort zones are unique, making it essential to create a personalized Fluency Ladder. To create your personalized ladder, list your easiest zones at the bottom and gradually expose yourself to the next most challenging zone, working your way up.

Becoming Fluent in Easier Zones First

The most effective way to achieve fluency in all zones is to become fully fluent in the easiest one and then progressively move to the next easiest. Ideally, individuals should work on achieving full fluency in one zone at a time. While some PWS may live and work in isolation, most face a variety of communication situations.

Jumping Around the Fluency Ladder

In some cases, life may force individuals to jump around their Fluency Ladder, moving from easy to hard to medium to very hard zones, and so on. However, when possible, it’s best to aim for fluency from the easiest to the most difficult zones. Those who find themselves in challenging situations can rely on a Pressure or Emergency Speech Plan (ESP). This plan encourages PWS to speak less, use short increments of 1-5 words, link all words and syllables together, and pause briefly between word-increments.

The Importance of the Fluency Ladder

The Fluency Ladder serves as a constant reminder of where individuals are in their journey to fluency and fearlessness. It helps identify risks and guides the steps needed to eliminate pressured speech zones. With effort and determination, many PWS have successfully climbed their Fluency Ladder to reach their goals.

Taking Action: SAM Meetings and Toastmaster’s Clubs

A great place to start the journey towards fluency is by attending SAM Meetings (the world’s only speech club tailored to the needs of PWS and PWSS). The World Stop Stuttering Association is partnered with SAM and it’s the world’s ONLY Community of EX-stutterers and people who stutter. WSSA offers a unique, proven program, using The Neuroscience Method , which has enabled hundreds to stop stuttering and learn to love to speak, thus elevating their lives. SAM meetings offer the opportunity to hear inspiring talks by ex-stutterers, seek answers to questions, share progress updates, and make connections with others on a similar journey. In time, individuals can even give their own SAM Talk, summarizing their speech journey.

For those who feel comfortable at SAM Meetings, joining a Toastmaster’s Club nearby can be the next step. Toastmaster’s Clubs provide a supportive environment for learning to communicate confidently with total strangers who have no prior knowledge of your speech impediment.

The Fluency Ladder is a valuable tool for individuals dealing with speech impediments like stuttering, stammering, selective mutism, and cluttering. By systematically working through their unique comfort zones, PWS can gradually build their fluency and confidence in various communication situations. The journey may resemble learning to run a marathon, with small, consistent steps leading to success. And remember, SAM Meetings and Toastmaster’s Clubs are excellent resources on this journey to improved speech fluency and fearlessness. With dedication and support, PWS can overcome their speech impediments and achieve effective communication in all areas of life. It’s essential to continue to work towards improved fluency, and with each step, individuals can climb their own Fluency Ladder and reach new heights in their speech therapy journey.

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Types of Speech Impediments

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

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Articulation Errors

Ankyloglossia, treating speech disorders.

A speech impediment, also known as a speech disorder , is a condition that can affect a person’s ability to form sounds and words, making their speech difficult to understand.

Speech disorders generally become evident in early childhood, as children start speaking and learning language. While many children initially have trouble with certain sounds and words, most are able to speak easily by the time they are five years old. However, some speech disorders persist. Approximately 5% of children aged three to 17 in the United States experience speech disorders.

There are many different types of speech impediments, including:

• Articulation errors

This article explores the causes, symptoms, and treatment of the different types of speech disorders.

Speech impediments that break the flow of speech are known as disfluencies. Stuttering is the most common form of disfluency, however there are other types as well.

Symptoms and Characteristics of Disfluencies

These are some of the characteristics of disfluencies:

• Repeating certain phrases, words, or sounds after the age of 4 (For example: “O…orange,” “I like…like orange juice,” “I want…I want orange juice”)
• Adding in extra sounds or words into sentences (For example: “We…uh…went to buy…um…orange juice”)
• Elongating words (For example: Saying “orange joooose” instead of "orange juice")
• Replacing words (For example: “What…Where is the orange juice?”)
• Hesitating while speaking (For example: A long pause while thinking)
• Pausing mid-speech (For example: Stopping abruptly mid-speech, due to lack of airflow, causing no sounds to come out, leading to a tense pause)

In addition, someone with disfluencies may also experience the following symptoms while speaking:

• Vocal tension and strain
• Head jerking
• Eye blinking
• Lip trembling

Causes of Disfluencies

People with disfluencies tend to have neurological differences in areas of the brain that control language processing and coordinate speech, which may be caused by:

• Genetic factors
• Trauma or infection to the brain
• Environmental stressors that cause anxiety or emotional distress
• Neurodevelopmental conditions like attention-deficit hyperactivity disorder (ADHD)

Articulation disorders occur when a person has trouble placing their tongue in the correct position to form certain speech sounds. Lisping is the most common type of articulation disorder.

Symptoms and Characteristics of Articulation Errors

These are some of the characteristics of articulation disorders:

• Substituting one sound for another . People typically have trouble with ‘r’ and ‘l’ sounds. (For example: Being unable to say “rabbit” and saying “wabbit” instead)
• Lisping , which refers specifically to difficulty with ‘s’ and ‘z’ sounds. (For example: Saying “thugar” instead of “sugar” or producing a whistling sound while trying to pronounce these letters)
• Omitting sounds (For example: Saying “coo” instead of “school”)
• Adding sounds (For example: Saying “pinanio” instead of “piano”)
• Making other speech errors that can make it difficult to decipher what the person is saying. For instance, only family members may be able to understand what they’re trying to say.

Causes of Articulation Errors

Articulation errors may be caused by:

• Genetic factors, as it can run in families
• Hearing loss , as mishearing sounds can affect the person’s ability to reproduce the sound
• Changes in the bones or muscles that are needed for speech, including a cleft palate (a hole in the roof of the mouth) and tooth problems
• Damage to the nerves or parts of the brain that coordinate speech, caused by conditions such as cerebral palsy , for instance

Ankyloglossia, also known as tongue-tie, is a condition where the person’s tongue is attached to the bottom of their mouth. This can restrict the tongue’s movement and make it hard for the person to move their tongue.

Symptoms and Characteristics of Ankyloglossia

Ankyloglossia is characterized by difficulty pronouncing ‘d,’ ‘n,’ ‘s,’ ‘t,’ ‘th,’ and ‘z’ sounds that require the person’s tongue to touch the roof of their mouth or their upper teeth, as their tongue may not be able to reach there.

Apart from speech impediments, people with ankyloglossia may also experience other symptoms as a result of their tongue-tie. These symptoms include:

• Difficulty breastfeeding in newborns
• Trouble swallowing
• Limited ability to move the tongue from side to side or stick it out
• Difficulty with activities like playing wind instruments, licking ice cream, or kissing
• Mouth breathing

Causes of Ankyloglossia

Ankyloglossia is a congenital condition, which means it is present from birth. A tissue known as the lingual frenulum attaches the tongue to the base of the mouth. People with ankyloglossia have a shorter lingual frenulum, or it is attached further along their tongue than most people’s.

Dysarthria is a condition where people slur their words because they cannot control the muscles that are required for speech, due to brain, nerve, or organ damage.

Symptoms and Characteristics of Dysarthria

Dysarthria is characterized by:

• Slurred, choppy, or robotic speech
• Rapid, slow, or soft speech
• Breathy, hoarse, or nasal voice

Additionally, someone with dysarthria may also have other symptoms such as difficulty swallowing and inability to move their tongue, lips, or jaw easily.

Causes of Dysarthria

Dysarthria is caused by paralysis or weakness of the speech muscles. The causes of the weakness can vary depending on the type of dysarthria the person has:

• Central dysarthria is caused by brain damage. It may be the result of neuromuscular diseases, such as cerebral palsy, Huntington’s disease, multiple sclerosis, muscular dystrophy, Huntington’s disease, Parkinson’s disease, or Lou Gehrig’s disease. Central dysarthria may also be caused by injuries or illnesses that damage the brain, such as dementia, stroke, brain tumor, or traumatic brain injury .
• Peripheral dysarthria is caused by damage to the organs involved in speech. It may be caused by congenital structural problems, trauma to the mouth or face, or surgery to the tongue, mouth, head, neck, or voice box.

Apraxia, also known as dyspraxia, verbal apraxia, or apraxia of speech, is a neurological condition that can cause a person to have trouble moving the muscles they need to create sounds or words. The person’s brain knows what they want to say, but is unable to plan and sequence the words accordingly.

Symptoms and Characteristics of Apraxia

These are some of the characteristics of apraxia:

• Distorting sounds: The person may have trouble pronouncing certain sounds, particularly vowels, because they may be unable to move their tongue or jaw in the manner required to produce the right sound. Longer or more complex words may be especially harder to manage.
• Being inconsistent in their speech: For instance, the person may be able to pronounce a word correctly once, but may not be able to repeat it. Or, they may pronounce it correctly today and differently on another day.
• Grasping for words: The person may appear to be searching for the right word or sound, or attempt the pronunciation several times before getting it right.
• Making errors with the rhythm or tone of speech: The person may struggle with using tone and inflection to communicate meaning. For instance, they may not stress any of the words in a sentence, have trouble going from one syllable in a word to another, or pause at an inappropriate part of a sentence.

Causes of Apraxia

Apraxia occurs when nerve pathways in the brain are interrupted, which can make it difficult for the brain to send messages to the organs involved in speaking. The causes of these neurological disturbances can vary depending on the type of apraxia the person has:

• Childhood apraxia of speech (CAS): This condition is present from birth and is often hereditary. A person may be more likely to have it if a biological relative has a learning disability or communication disorder.
• Acquired apraxia of speech (AOS): This condition can occur in adults, due to brain damage as a result of a tumor, head injury , stroke, or other illness that affects the parts of the brain involved in speech.

If you have a speech impediment, or suspect your child might have one, it can be helpful to visit your healthcare provider. Your primary care physician can refer you to a speech-language pathologist, who can evaluate speech, diagnose speech disorders, and recommend treatment options.

The diagnostic process may involve a physical examination as well as psychological, neurological, or hearing tests, in order to confirm the diagnosis and rule out other causes.

Treatment for speech disorders often involves speech therapy, which can help you learn how to move your muscles and position your tongue correctly in order to create specific sounds. It can be quite effective in improving your speech.

Children often grow out of milder speech disorders; however, special education and speech therapy can help with more serious ones.

For ankyloglossia, or tongue-tie, a minor surgery known as a frenectomy can help detach the tongue from the bottom of the mouth.

A Word From Verywell

A speech impediment can make it difficult to pronounce certain sounds, speak clearly, or communicate fluently. 

Living with a speech disorder can be frustrating because people may cut you off while you’re speaking, try to finish your sentences, or treat you differently. It can be helpful to talk to your healthcare providers about how to cope with these situations.

You may also benefit from joining a support group, where you can connect with others living with speech disorders.

National Library of Medicine. Speech disorders . Medline Plus.

Centers for Disease Control and Prevention. Language and speech disorders .

Cincinnati Children's Hospital. Stuttering .

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, and language .

Cleveland Clinic. Speech impediment .

Lee H, Sim H, Lee E, Choi D. Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms . J Commun Disord . 2017;65:54-64. doi:10.1016/j.jcomdis.2016.12.001

Nemours Foundation. Speech problems .

Penn Medicine. Speech and language disorders .

Cleveland Clinic. Tongue-tie .

University of Rochester Medical Center. Ankyloglossia .

Cleveland Clinic. Dysarthria .

National Institute on Deafness and Other Communication Disorders. Apraxia of speech .

Cleveland Clinic. Childhood apraxia of speech .

Stanford Children’s Hospital. Speech sound disorders in children .

Abbastabar H, Alizadeh A, Darparesh M, Mohseni S, Roozbeh N. Spatial distribution and the prevalence of speech disorders in the provinces of Iran . J Med Life . 2015;8(Spec Iss 2):99-104.

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

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Stuttering is a speech condition that disrupts the normal flow of speech. Fluency means having an easy and smooth flow and rhythm when speaking. With stuttering, the interruptions in flow happen often and cause problems for the speaker. Other names for stuttering are stammering and childhood-onset fluency disorder.

People who stutter know what they want to say, but they have a hard time saying it. For example, they may repeat or stretch out a word, a syllable, or a consonant or vowel sound. Or they may pause during speech because they've reached a word or sound that's hard to get out.

Stuttering is common among young children as a usual part of learning to speak. Some young children may stutter when their speech and language abilities aren't developed enough to keep up with what they want to say. Most children outgrow this type of stuttering, called developmental stuttering.

But sometimes stuttering is a long-term condition that remains into adulthood. This type of stuttering can affect self-esteem and communicating with other people.

Children and adults who stutter may be helped by treatments such as speech therapy, electronic devices to improve speech fluency or a form of mental health therapy called cognitive behavioral therapy.

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Stuttering symptoms may include:

• Having a hard time starting a word, phrase or sentence.
• Stretching out a word or sounds within a word.
• Repeating a sound, syllable or word.
• Brief silence for certain syllables or words, or pausing before or within a word.
• Adding extra words such as "um" if expecting to have problems moving to the next word.
• A lot of tension, tightness or movement of the face or upper body when saying a word.
• Anxiety about talking.
• Not being able to communicate well with others.

These actions may happen when stuttering:

• Rapid eye blinks.
• Trembling of the lips or jaw.
• Unusual face movements, sometimes called facial tics.
• Head nodding.
• Tightening of fists.

Stuttering may be worse when the person is excited, tired or under stress, or when feeling self-conscious, hurried or pressured. Situations such as speaking in front of a group or talking on the phone can be especially hard for people who stutter.

But most people who stutter can speak without stuttering when they talk to themselves and when they sing or speak along with someone else.

When to see a doctor or speech-language pathologist

It's common for children between the ages of 2 and 5 years to go through periods when they may stutter. For most children, this is part of learning to speak, and it gets better on its own. But stuttering that continues may need treatment to improve speech fluency.

Call your healthcare professional for a referral to a specialist in speech and language called a speech-language pathologist. Or you can contact the speech-language pathologist directly for an appointment. Ask for help if stuttering:

• Lasts more than six months.
• Happens along with other speech or language problems.
• Happens more often or continues as the child grows older.
• Includes muscle tightening or physically struggling when trying to speak.
• Affects the ability to effectively communicate at school or work or in social situations.
• Causes anxiety or emotional problems, such as fear of or not taking part in situations that require speaking.
• Begins as an adult.

Researchers continue to study the underlying causes of developmental stuttering. A combination of factors may be involved.

Developmental stuttering

Stuttering that happens in children while they're learning to speak is called developmental stuttering. Possible causes of developmental stuttering include:

• Problems with speech motor control. Some evidence shows that problems in speech motor control, such as timing, sensory and motor coordination, may be involved.
• Genetics. Stuttering tends to run in families. It appears that stuttering can happen from changes in genes passed down from parents to children.

Stuttering that happens from other causes

Speech fluency can be disrupted from causes other than developmental stuttering.

• Neurogenic stuttering. A stroke, traumatic brain injury or other brain disorders can cause speech that is slow or has pauses or repeated sounds.
• Emotional distress. Speech fluency can be disrupted during times of emotional distress. Speakers who usually do not stutter may experience problems with fluency when they are nervous or feel pressured. These situations also may cause speakers who stutter to have greater problems with fluency.
• Psychogenic stuttering. Speech difficulties that appear after an emotional trauma are uncommon and not the same as developmental stuttering.

Risk factors

Males are much more likely to stutter than females are. Things that raise the risk of stuttering include:

• Having a childhood developmental condition. Children who have developmental conditions, such as attention-deficit/hyperactivity disorder, autism or developmental delays, may be more likely to stutter. This is true for children with other speech problems too.
• Having relatives who stutter. Stuttering tends to run in families.
• Stress. Stress in the family and other types of stress or pressure can worsen existing stuttering.

Complications

Stuttering can lead to:

• Problems communicating with others.
• Not speaking or staying away from situations that require speaking.
• Not taking part in social, school or work activities and opportunities for success.
• Being bullied or teased.
• Low self-esteem.
• Stuttering. American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/stuttering/. Accessed Feb. 2, 2024.
• Fluency disorders. American Speech-Language-Hearing Association. https://www.asha.org/practice-portal/clinical-topics/fluency-disorders/. Accessed Feb. 2, 2024.
• Childhood-onset fluency disorder (stuttering). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. 5th ed. American Psychiatric Association; 2022. https://dsm.psychiatryonline.org. Accessed Feb. 2, 2024.
• Stuttering. National Institute on Deafness and Other Communication Disorders. https://www.nidcd.nih.gov/health/stuttering. Accessed Feb. 2, 2024.
• Sander RW, et al. Stuttering: Understanding and treating a common disability. American Family Physician. 2019;100:556.
• Laiho A, et al. Stuttering interventions for children, adolescents and adults: A systematic review as part of the clinical guidelines. Journal of Communication Disorders. 2022; doi:10.1016/j.jcomdis.2022.106242.
• 6 tips for speaking with someone who stutters. The Stuttering Foundation. https://www.stutteringhelp.org/6-tips-speaking-someone-who-stutters-0. Accessed Feb. 2, 2024.
• 7 tips for talking with your child. The Stuttering Foundation. https://www.stutteringhelp.org/7-tips-talking-your-child-0. Accessed Feb. 2, 2024.
• Clark HM (expert opinion). Mayo Clinic. Feb. 11, 2024.

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Overcoming speech impediments

In this edition of Wellness Wednesdays, we look at six health issues that most commonly contribute to speech impediments among seniors, and tips for overcoming challenges associated with speech impediments and communication disorders.

What are speech impediments?

Speech impediments are a type of communication disorder where normal speech is disrupted. They can affect anyone, however, seniors are especially prone to ailments that can negatively impact their speaking abilities.

6 health issues commonly linked to communication disorders in seniors:

• Aphasia- Aphasia is a disorder that impairs one’s ability to use and understand language. The leading cause of aphasia is stroke, and one in four people who have a stroke will develop aphasia according to the National Stroke Association . Aphasia may cause you or your loved one difficulty in speaking and/or understanding speech, and difficulty with reading and writing.
• Hearing Loss- Seniors who have difficulty hearing often report communication problems resulting from not only their inability to hear what another individual is saying, but also because of difficulty thinking or concentrating. This can lead to signs of inattentiveness, distraction and boredom, all of which make communication more difficult for a senior.
• Multiple Sclerosis (MS)- Multiple sclerosis can cause difficulty with both speech and understanding. Prevalent among people with MS is problems with swallowing, which can cause difficulty when trying to speak. A person with MS may not even notice his or her own speech problems, as they are quite often noticed by others first. Cognitive problems associated with MS can impede an individual’s understanding as well, which can hinder their ability to communicate.
• Amyotrophic Lateral Sclerosis (ALS)- ALS is a progressive, disabling disease that can sometimes cause difficulty swallowing and speaking. As the disease progresses, communication can often become more difficult.
• Parkinson’s Disease- In those suffering from Parkinson’s disease, damage to a region of the brain called the basal ganglia often causes speech problems. Typical symptoms include voice change, problems with articulation, and reduced fluency.
• Alzheimer’s Disease and Other Types of Dementia- Alzheimer’s disease and other kinds of dementias can hinder communication and understanding when areas of the brain responsible for speech and comprehension are affected. Difficulty when it comes to remembering details, which is a commonly associated symptom of Alzheimer’s, can also make it more difficult to communicate effectively.

Tips for overcoming challenges associated with speech impediments/communication disorders:

If you or your loved one has a speech impediment or suffers from a communication disorder, you/they should consider:

• Using props to make conversation easier
• Drawing or writing things down on paper when possible
• Taking your/their time when trying to communicate
• Creating a communication book that includes words, pictures and symbols that are helpful in communicating your/their thoughts
• Using the internet to connect to people via email or chat
• Working with a speech language pathologist to mitigate your/their speech problems
• Using hearing aids if your/their speech problems are associated with hearing loss
• Educating family members and friends on active listening to help them better understand you/your loved one
• Maintaining eye contact
• Using shorter and simpler words and sentences to decrease your/their likelihood of stumbling on your/their words
• Repeating yourself/themselves when necessary
• Expressing yourself/themselves through actions and emotions rather than words
• Learning sign language

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5 Keys To Overcoming Speech and Language Disorders

My goal here is to give you 5 of the most important things you can do to help your child overcome his speech and/or language disorder.

• Actually getting speech and language therapy . This might sound obvious however many parents follow the advice “wait and see”. Parents are often told by well meaning friends and professionals, such as pediatricians, that the child might grow out of it.  So instead of getting help they wait and see only to find out they should not have waited. This is very frustrating since another factor that affects progress is the child’s age. In most cases the sooner the better when it comes to therapy. Due to how the brain develops it is easier to learn language and communication skills before the age of 5. It is also easier to break a bad habit (articulation error) when it begins rather than wait until it becomes more ingrained.While your child should continue to learn to pronounce and use more complex words throughout his life he should be easily understood by all listeners, including strangers, by the time he is three.There are earlier speech and language milestones ; however, this one is very significant and any child who misses it should be evaluated. The only person qualified to evaluate your child’s speech and language needs is a board certified speech language pathologist . If you are concerned with your child’s speech and language development, that is who you need to speak with.
• The amount of speech and language therapy received. The frequency of therapy has a direct correlation with the amount of progress made. This is one case when “the more the better” is true. A NOMS (National Outcomes Measurement System) study found that children who learned to speak clearly in therapy received about twice as much speech therapy as children who remained unable to speak clearly.To make the most progress in the least amount of time your child needs to get as much speech/language therapy as he can tolerate and no less than twice a week.
• Whether individual or group speech language therapy is provided. Speech therapy, especially for articulation should be provided on an individual basis. Individual therapy, in my experience, is always more effective when it comes to articulation disorders. This is also backed up by the NOMS data.Group speech therapy decreases the amount of time spent with each child on their specific articulation needs. The reason for this is because each child’s articulation errors are always different. The way that they learn is also different.While there are times for group therapy, articulation isn’t one of them. Group language therapy does have its benefits. It is essential for helping children with pragmatic language deficits.
• The Skill Of The Therapist And The Quality Of The Speech Language Therapy. Not only does bad therapy waste time it can make the problem worse. Your child’s speech language pathologist needs to be highly skilled in the area your child is having the most difficulty and she also needs to have a good rapport with your child. If either component is missing there will be problems.In the worst cases children working with the wrong therapists become very fearful and resistant to therapy. When that happens it takes the right therapist a lot of extra time to really get started on therapy.This is a problem I have seen many times over the years. If your child has become resistant to therapy he can still be treated effectively by the right therapist; however, it will take her some time to gain his trust and get him to respond to therapy.
• Parent Involvement. Some of the most important factors that help children progress include parent carry over, participation and motivation. The more interest, devotion and excitement you show, the better your child’s attitude will be towards therapy. As a result the more progress your child will make. Whether it is doing homework, viewing therapy appointments as priorities, or talking to your child about what they are learning, it makes a huge difference. This is one of the many reasons children benefit so much from therapy outside of school regardless of how skilled their school therapist is. It’s easier for parents to be much more involved in a private setting. And the more involved the parents are the better.If your therapist isn’t giving you homework, ask for it. If you’re having trouble getting your child to do the work at home, tell your therapist and ask for tips. You need to approach speech and language therapy as a team. Be open, honest and involved. Your child’s progress depends on it.

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Experts share ways to help overcome a speech impediment

HOUSTON, Texas (KTRK) -- As it turns out, a speech impediment is a common problem, and there are ways parents can help their kids overcome it.

Poet Amanda Gorman, who was invited to read her own poem during President Joe Biden's inauguration, admits she suffered from a speech impediment. She used the song "Aaron Burr, Sir" from the musical "Hamilton" to help overcome it. The song is packed with R's and fast-paced rhymes. She kept repeating until she tackled her R's.

It's something speech language pathologist Kaitlyn Cazalas says that kids and adults can do to improve their speech and quality of life.

President Biden said he overcame a stutter as a child by breaking up speeches with slashes after every few words, which forced him to slow down when read aloud.

"There are a lot of children and even adults that we've noticed that still struggle with some of those speech sound errors," Cazalas said.

When it comes to learning and meeting virtually, Cazalas said she found that children with speech impediments really need more of a hands-on learning environment and a face-to-face approach.

According to the American Speech Language Hearing Association, more than 3 million Americans stutter. Approximately 5-10% of all children will stutter at some point in their lives, but most will typically outgrow it within a few months or years. Early intervention can help children overcome stuttering.

For 1 in 4 of these children, the problem will persist into adulthood and can become a lifelong communication disorder.

Listening to music and repeating the words can help with speech disorders, experts say.

"We know that music stimulates multiple areas of the brain, including the speech and language centers, and the areas that are responsible for motor movement and coordination," Cazalas said. "These are skills that we practice all the time."

Another method experts recommend is to make a list of trigger words with your child, and encourage them to skip those words if it's helpful.

Practice writing poems that are packed with the sounds or letters that they struggle with and have them read aloud.

"In the home setting, they can implement a bunch of different strategies," Cazalas said. "Just like Amanda Gorman, they can practice in songs. Maybe they have practiced some of those sounds at home and the child just continues to struggle. Maybe they are just not able to get that correct tongue placement. That would definitely be the time to seek a professional such as a speech language pathologist."

Speech therapy costs between $48 and $200 for an hour-long session, but if therapy is deemed medically necessary, it may be covered by most insurance plans.

Follow Brhe Berry on Facebook , Twitter and Instagram .

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How to Get Rid of a Speech Disorder

Last Updated: December 4, 2023 Approved

This article was co-authored by Devin Fisher, CCC-SLP . Devin Fisher is a Speech-Language Pathologist based in Las Vegas, Nevada. Devin specializes in speech and language therapy for individuals with aphasia, swallowing, voice, articulation, phonological social-pragmatic, motor speech, and fluency disorders. Furthermore, Devin treats cognitive-communication impairment, language delay, and Parkinson's Disease. He holds a BS and MS in Speech-Language Pathology from Fontbonne University. Devin also runs a related website and blog that offers speech-language therapy resources and information for clinicians and clients. There are 13 references cited in this article, which can be found at the bottom of the page. wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, several readers have written to tell us that this article was helpful to them, earning it our reader-approved status. This article has been viewed 331,266 times.

Many people feel insecure about their speech impediments, whether they're dealing with a lisp or an inability to articulate words. Although it may not seem like it—particularly if you have been dealing with this problem for years—you may be able to get rid of or improve your speech impediment with a few speech-training practices and some major confidence-boosters. And don't forget to seek out the professional opinion of a speech and language therapist/pathologist for more information.

Helping Yourself with a Speech Disorder

• One modern approach is to use technology. There are apps that can run on smartphones and tablets that listen to what you say and then give you feedback. For example, on Android there is the free app "Talking English." You can also find similar apps in the Apple App Store.

Stephanie Jeret

Cues and picture boards can help those with aphasia find words and express thoughts. For aphasia or trouble finding words, cues like the first sound can help jog your memory. Picture boards are great too, especially if speaking is very difficult. These tools allow people to communicate their needs and thoughts through other means.

Using Your Body to Improve Speech

• Shoulders relaxed
• Back straight
• Feet steady

• Sit comfortably and with an erect posture. Breathe in deeply through your nose. You should use your hand to feel your stomach expanding like a balloon being inflated. Hold the breath and then release it slowly, feeling your stomach deflating beneath your hand. Repeat this exercise before you have to speak publicly to relieve stress.

Getting Professional Help

• Speech therapy is helpful for correcting your impediment. The therapist will point out the part of speech where you're having problems, and will work with you to correct it. Private speech therapy sessions do not come cheap, although most insurance policies will fund services needed to treat speech disorders.
• There's no substitute for learning and practice when it comes to the proper and effective use of language. Take every opportunity to speak, to practice and brush up on the correct pronunciation and enunciation provided to you by a professional.

• Every time the dentist adjusts your braces (or even dentures), you need to train yourself to talk and to eat properly. It may be quite painful at first, but remember not to go too far, lest you end up with a mouth injury.
• Most braces are used for orthodontic purposes, although some braces can be used as decorations. Braces are rather expensive, and you may need to take out a dental plan or cash in on dental insurance to pay for them.
• Kids and teenagers don't like to wear braces because they're often teased as “metal mouths” or “railroad faces.” The fact is that braces are still the best way to correct a lisp caused by misaligned teeth.

Assessing Your Speech Disorder

• Cleft lips and palates were a major cause of speech impediments until surgery became affordable. Now, children born with clefts can have reconstructive surgery and a multidisciplinary team of providers that help with feeding and speech and language development. [14] X Research source
• Malocclusion is when the teeth do not have the proper normal bite. Malocclusions are usually corrected through braces, although orthodontic surgery is necessary in some cases. Individuals with this condition may talk with a lisp, make a whistle sound when certain words are spoken, or mumble.
• Neurological disorders caused by accidents or brain and nerve tumors can cause a speech disorder called dysprosody. Dysprosody involves difficulty in expressing the tonal and emotional qualities of speech such as inflection and emphasis.

Expert Q&A

• Welcome good speech. Look forward to it, and accept and celebrate even little improvements. Thanks Helpful 0 Not Helpful 0
• Try to slow down and pronounce each word properly, as this can also help when trying to overcome a speech problem. Thanks Helpful 0 Not Helpful 0

• See a Speech Pathologist who maintains their Certification of Clinical Competence from the American Speech and Hearing Association. These professionals are able to evaluate, diagnose and treat speech impairments. Nothing replaces sound medical advice from a specialist. Thanks Helpful 11 Not Helpful 14

You Might Also Like

• ↑ https://www.uts.edu.au/sites/default/files/2018-10/Camperdown%20Program%20Treatment%20Guide%20June%202018.pdf
• ↑ Devin Fisher, CCC-SLP. Speech Language Pathologist. Expert Interview. 15 January 2021.
• ↑ https://www.stutteringhelp.org/sites/default/files/Migrate/Book_0012_tenth_ed.pdf
• ↑ http://www.coli.uni-saarland.de/~steiner/publications/ISSP2014.pdf
• ↑ https://sps.columbia.edu/news/five-ways-improve-your-body-language-during-speech
• ↑ https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress/
• ↑ http://kidshealth.org/teen/diseases_conditions/sight/speech_disorders.html#
• ↑ https://www.nidcd.nih.gov/health/stuttering
• ↑ https://medlineplus.gov/ency/article/001058.htm
• ↑ http://www.asha.org/public/speech/disorders/CleftLip/
• ↑ https://www.cdc.gov/ncbddd/developmentaldisabilities/language-disorders.html
• ↑ https://www.stanfordchildrens.org/en/topic/default?id=stuttering-90-P02290
• ↑ https://raisingchildren.net.au/preschoolers/development/language-development/stuttering

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How to Overcome a Speech Impediment — or Thrive in Spite of It

July 4, 2023

Many people — including some wildly successful ones — live with a speech impediment. In our comprehensive guide, we’ll answer the following questions:

• What is a speech impediment?
• What causes speech impediments?
• What are some common speech impediments?
• What challenges are associated with living with a speech impediment?
• What are some tips for living with a speech impediment?
• What famous people have a speech impediment?
• How are speech impediments treated?

Let’s get started!

What Is a Speech Impediment?

So, what is a speech impediment, exactly? It’s a difficulty in speaking that can affect a person’s ability to communicate effectively. These can range from mild to severe, and they can affect a person’s ability to pronounce certain sounds, speak fluently, or use their voice in a clear and resonant way. Below, we’ll review some of the most common types.

Causes of Speech Impediments

Speech impediments can be caused by a variety of factors. We’ll take a look at some of the most common causes.

• Genetics:  Some are inherited. For example, stuttering is more common in families with a history of stuttering.
• Brain injury:  A brain injury can damage the areas of the brain that control speech, leading to a speech impediment. This can happen as a result of a stroke, head injury, or other neurological condition.
• Hearing loss:  If a person can’t hear sounds clearly, they might have difficulty learning to produce those sounds correctly. This can lead to articulation disorders.
• Developmental delay:  Some children with developmental delays might also have speech impediments. This is because they might not have had the same opportunities to learn speech as other children.
• Neurological disorders:  Some neurological disorders, such as autism and cerebral palsy, can cause speech impediments. These disorders can affect the way the brain controls movement, which can make it difficult to produce speech sounds correctly.
• Physical problems:  Some physical problems, such as a cleft palate or tongue-tie, also can make speech more difficult. These problems can make it difficult to produce certain sounds or to move the lips, tongue, or jaw properly.

In some cases, the cause is unknown. This is often the case with mild speech impediments that resolve on their own over time.

Common Speech Impediments

There are many types of speech impediments, and the symptoms can vary depending on the individual. But, let’s take a look at some of the most common speech impediments.

• Stuttering:  This is the most common type. People who stutter have difficulty producing sounds smoothly and fluently. They may repeat sounds or syllables, or they may pause or hesitate in their speech. Get some tips on how to avoid stuttering.
• Articulation disorders:  These are problems with the production of speech sounds. People with articulation disorders may have difficulty pronouncing certain sounds, or they may substitute one sound for another. For example, a child with an articulation disorder might say “wabbit” instead of “rabbit.”
• Voice disorders:  These are problems with the voice that can make it difficult to speak clearly or loudly. There are a variety of common factors that cause voice disorders, including vocal abuse, misuse, or injury. For example, a person with a voice disorder might have a hoarse voice or might be unable to project their voice.
• Dysarthria:  This type is a motor speech disorder that affects the muscles used for speech. People with dysarthria might have difficulty moving their lips, tongue, or jaw. And, this can make it difficult to speak clearly. For example, a person with dysarthria might slur their speech or have difficulty pronouncing certain sounds.
• Cleft lip and palate:  These are birth defects that can affect a person’s ability to speak clearly. People with cleft lip and palate may have difficulty producing certain sounds, or their speech might be muffled or nasal.
• Cluttering : This is considered a type of fluency disorder and it’s often confused with or mistaken for stuttering. One of the key differences is that people who stutter know what they want to say, whereas people who clutter are usually still figuring out what they want to say.

Living With a Speech Impediment

Living with a speech impediment can be challenging. People who do often face social stigma, discrimination, and difficulty communicating with others. They might also experience anxiety and low self-esteem.

But it’s important to remember that people with speech impediments are still capable of communicating effectively. In fact, some people choose not to get treatment and feel empowered through their speaking differences. For people who do choose to explore speech therapy, they can learn to manage their speech impediment and communicate confidently.

Challenges of Living With a Speech Impediment

Let’s take a closer look at some of the challenges that people with speech impediments might face.

• Societal stigma:  They might be stigmatized by others. They might be made fun of, teased, or excluded from social groups. This can lead to feelings of isolation and loneliness.
• Discrimination:  People with speech impediments might also face discrimination in the workplace or in school. They might be denied jobs or opportunities because of the way they speak.
• Communication difficulties:  They might have difficulty communicating with others. They might be misunderstood or unable to express themselves clearly. This can lead to frustration and anxiety.
• Low self-esteem:  People with speech impediments might feel ashamed of the way they speak and avoid social situations. This can make it difficult to form relationships and build a sense of self-worth.

Despite these challenges, people with speech differences live happy and fulfilling lives. Below, we’ll go over some of the ways they can manage or treat their symptoms for people who want to do so.

Tips for Living With a Speech Impediment

Here are some ways you can manage life when you have a speech impediment.

• Be patient:  It takes time and effort to work on speaking differences. Don’t get discouraged if you don’t see results immediately. Just keep practicing and working hard, and you’ll get ever closer to reaching your goals.
• Build your confidence:  It’s important to build your confidence and believe in yourself. Remember that you’re not alone, and there are many people who understand what you’re going through.
• Seek support:  There are many support groups and online communities where you can connect with others who have speech impediments. These groups can provide you with support, advice, and a sense of community.
• Seek treatment:  We’ll cover this more in depth below.

Living with a speech impediment can be challenging, but it’s not impossible. With the right help and support, you can overcome your speech differences if that’s a goal of yours.

Famous People Who Have a Speech Impediment

Speaking of fulfilling lives, here are just a few successful and famous people with speech impediments.

James Earl Jones

James Earl Jones is an actor who’s famous for his voice; he even provided the voice of Darth Vader in the Star Wars movies. Jones has a stutter, and he has said that his stutter was so severe as a child that he almost stopped speaking altogether. However, he eventually overcame his stutter with the help of speech therapy.

Tiger Woods

The professional golfer has a stutter that he has struggled with since childhood. He says that stress can trigger his stutter and that he sometimes has to take deep breaths to control it. However, he has never let his stutter stop him from achieving success in his career.

Daniel Radcliffe

The actor who played Harry Potter in the “Harry Potter” movies has a mild form of dyspraxia, which is a motor speech disorder. This means that he sometimes has difficulty pronouncing certain sounds. However, his dyspraxia hasn’t prevented him from becoming a successful actor.

Barbara Walters

The legendary TV journalist had a speech impediment called rhotacism, which is a difficulty pronouncing the “R” sound. This sometimes made her speech sound lisped. However, Walters didn’t let her speech differences stop her from becoming one of the most successful journalists in the world.

Winston Churchill

The British prime minister who led his country through World War II had a stutter. He often used humor to cope with his stutter. Also, he once said that his stutter made him a better speaker because it forced him to slow down and think about what he was saying.

These are just a few examples of famous people who have speech impediments. There are many other people who have achieved success despite their speech differences.

Treating Speech Impediments

If you or someone you know has a speech impediment, it’s important to see a speech language pathologist (SLP) . An SLP can diagnose the type of speech impediment and develop a treatment plan.

Speech therapy can help people improve their speech and communication skills. It can help people learn to pronounce sounds correctly, speak more fluently, and use their voice in a clear and resonant way. Speech therapy also can help people develop strategies for effective communication in social situations.

These days, speech therapy with artificial intelligence is an option that many find accessible and effective.

The amount of time it takes to overcome a speech impediment varies depending on the individual and their speaking differences. However, most people who receive speech therapy make significant progress.

Wrapping Up

Speaking differences like stuttering don’t have to stand in your way. Find encouragement from those who tackled this challenge and overcame it — or managed it well enough to thrive in spite of it.

At the end of the day, what’s most important is that you feel confident when you speak and having a speech impediment doesn’t have to change that.

Note: This post was created in partnership with artificial intelligence.

Start practicing with Yoodli.

Getting better at speaking is getting easier. Record or upload a speech and let our AI Speech Coach analyze your speaking and give you feedback.

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Joe Biden speaks with ABC News tonight. How many TV interviews has the president given?

President Joe Biden will sit down with George Stephanopoulos of ABC News on Friday for a televised interview while his campaign remains in damage-control mode following last week’s botched presidential debate .

This will be the president’s second interview with the ABC News anchor, adding to his short list of televised interviews since taking office. Biden currently holds the record for the fewest press conferences and media interviews held by presidents in over 40 years.

Sign up for Your Vote: Text USA TODAY reporters and the elections team by joining our SMS service.

News of the interview came just days after Biden struggled on stage at the first presidential debate with former President Donald Trump, often stumbling over his words and giving confusing responses. The 81-year-old has been open about his history of struggling with a speech impediment as a child and largely overcoming it into adulthood.

The upcoming interview may be Biden’s redemption for his performance last week. Here’s a look at the president’s infrequent TV appearances before Friday’s interview.

More: When is Joe Biden's ABC interview? How to watch president's sitdown with George Stephanopoulos

Biden’s most recent televised appearance was with CNN’s Erin Burnett, who spoke with him about job growth, the Israel-Hamas war and the protests on college campuses that followed.

Biden spoke with media personality and radio host Howard Stern in a filmed interview on SiriusXM, saying he’d be “happy to debate” Trump, indicating for the first time he’d be open to doing so during the 2024 election season.

During the interview, Biden addressed his struggles with stuttering.

“You realize how humiliating it is,” he said. “It taught me to understand what other people are going through.”

In April, Biden was criticized by the New York Times for his lack of access to the media, and the president joked about it in his speech at the White House Correspondent’s Association’s annual dinner.

“Of course, the New York Times issued a statement blasting me for ‘actively and effectively avoiding independent journalists,’” Biden said.

“I do interviews with strong independent journalists who millions of people actually listen to—like Howard Stern.”

MSNBC host Jonathan Capehart interviewed Biden after his Super Tuesday wins and the State of the Union address.

Capehart questioned Biden about calling an undocumented immigrant an “illegal” during his address, saying that he regrets using it and it was a misstep.

February 2024

Biden made an appearance on Late Night with Seth Meyers in front of a live studio audience a week before Super Tuesday.

The talk show host and comedian quickly jumped to the topic of the case of his classified documents and age.

Meyers: “Some classified documents recently leaked, and this isn’t a gotcha show, but I do want to ask about it. It says you are currently 81 years old.”

Biden: “Who the hell told you that? Yeah, that’s classified! That’s classified!”

Meyers: “All jokes aside, according to recent polling, this is a real concern for American voters. How do you address that concern, going forward, as you come up to the 2024 election?”

Biden: “Well, a couple things. Number one, you got to take a look at the other guy. He’s about as old as I am, but he can’t even remember his wife’s name. Number one. Number two, it’s about how old your ideas are.”

October 2023

CBS News anchor and correspondent Scott Pelley interviewed Biden on 60 Minutes, mainly talking about the Oct. 7 Hamas attacks on Israel.

Biden sat down with MSNBC’s Nicole Wallace to discuss the Supreme Court’s ruling to overturn affirmative action precedent.

After Wallace concluded her questions and thanked Biden, the president got up while the camera was still filming and exited off-screen.

. @POTUS out 👋 pic.twitter.com/tUN4ekb6L4 — MSNBC (@MSNBC) June 29, 2023

September 2023

Former CNN White House correspondent John Harwood conducted a September 2023 interview with the president where he discussed hyper-partisanship and the Supreme Court. According to ProPublica , who Harwood worked with to film and produce the interview, Biden did not receive any questions or topics ahead of time.

September 2022

Pelley interviewed Biden for 60 Minutes for the first time in 2022 and addressed concerns about Biden’s age.

Pelley : “How would you say your mental focus is?”

Biden: “Oh, it’s focused. I’d say it’s-- I think it’s-- I-- I haven’t-- look, I have trouble even mentioning, even saying to myself, my own head, the number of years. I no more think of myself as being as old as I am than fly. I mean, it’s just not-- I haven’t-- observed anything in terms of-- there’s not things I don’t do now that I did before, whether it’s physical, or mental, or anything else.”

The president’s jumbled response quickly overtook parts of the internet and is often used to mock Biden and his speech impediment.

Biden discussed gun violence and the then-prospect of Roe V. Wade being overturned with talk show host Jimmy Kimmel for his first late-night appearance as president.

The interview came as his approval rating hit an all-time low for his administration, and tensions were high as Russia continued its invasion of Ukraine.

August 2021

Stephanopoulos interviewed Biden in 2021 for the first time and questioned the president about the largely criticized military operation to pull American troops from Afghanistan.

Former ESPN Sage Steele conducted a pre-taped interview with Biden on the sports industry’s bounce back from the COVID-19 pandemic one year after the major outbreak.

Steele said in April that her interview with the president was “scripted” by ESPN.

February 2021

Biden gave his first on-camera interview of his presidency with NBC Nightly News with Norah O’Donnell.

The then-78-year-old talked about his hopes for his first 100 days in office, including recovering from the COVID-19 pandemic.

— Sam Woodward is the Minnesota elections reporting fellow for USA Today. You can reach her at [email protected] , on X @woodyreports, or on Threads @samjowoody

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Why Did Moses Have a Speech Disability?

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Moses is the quintessential prophet in the Jewish tradition. Moses’s job, like the task of all other prophets, is to convey the word of God to the people. He fulfills this role, the Torah tells us, in exemplary fashion: “Never again did there arise in Israel a prophet like Moses” (Deut. 34:10). Moses is not just the paradigm for all prophets that follow, he is the best in the business. But if Moses is supposed to serve as the first and foremost prophet—that is, to be the expert at telling people what God wants from them—why would God choose a mouthpiece who has a speech disability?

Moses wonders about this himself when faced with his first task as a prophet, which is to beseech Pharaoh to release the Israelites from bondage: “How then should Pharaoh heed me—who gets tongue-tied!” (Exod. 6:12). Moses has already pointed this issue out a few chapters earlier, protesting that he has “never been a man of words” and is “slow of speech and slow of tongue” (4:10). And in verse 6:30 he again repeats that he is tongue-tied and wonders how he can get Pharaoh to listen to him.

As surprising as it is for God to choose a prophet who has difficulty speaking, God’s response to Moses after the third time he points out his disability is perhaps even more surprising: God promises Moses, “See, I place you in the role of God to Pharaoh, with your brother Aaron as your prophet” (Exod. 7:1). What does it mean for Moses to be in the role of God? And why is this God’s response to Moses’s concerns?

Most classical commentators believe that “in the role of God” refers to some position of power that Moses will hold in Pharaoh’s eyes—for instance, that he will be seen as a judge, according to Rashi, or even as a kind of god or other heavenly being, per Ibn Ezra. I would like to offer an alternative read, however, and suggest that God mentions “the role of God” not because Pharaoh is going to be impressed by Moses, but rather in order to reassure Moses by offering a useful analogy. “The role of God” here, in the context of the verse taken as a whole, is the role of someone who needs assistance with speaking. Just as God is a being who speaks through a prophetic agent, so too will Moses have his own mouthpiece, his brother Aaron. God is thus simply explaining to Moses that just like God can’t and doesn’t speak directly to most people, so too Moses does not have to do all the speaking himself.

God not only reassures Moses that he will have support, but also admits to Moses that God’s own role is one that requires assistance, too . God’s response to Moses is thus a demonstration of true empathy. Consider the difference between a child asking for help and the parent saying “Sure, you can have help,” as opposed to a parent saying “Sure, everyone needs help sometimes—I know I do!” God understands what Moses needs because God needs the same things. In fact, God seems to suggest that, astonishingly, to require assistance is part of what it means to be in the role of God!

This radical theological idea also fits with an earlier exchange between God and Moses. The first time Moses mentions his worries, God responds: “‘Who gives humans speech? Who makes them dumb or deaf, seeing or blind? Is it not I, God?’” (4:11). Again, we might wonder: How is this statement meant to assuage Moses’s concerns? God may have made Moses the way he is, but how does that help Moses feel better about being asked to step into a role that will publicly highlight his speech disability? There is even something potentially disturbing about this verse, in its gesturing at a theology in which people should simply “accept their lot” and not complain or ask for help, as well as its use of categories that do not reflect the experiences of people with disabilities themselves. (The category “dumb” is typically considered to be offensive as well as inaccurate.)

Again, however, I would like to offer an alternate reading of this verse. We know that God reveals God’s glory by making humans who are physically different from one another, as the Mishnah states: “When a human stamps several coins with one seal, they are all similar to each other. But the supreme Ruler of Rulers, the Holy One, Blessed be God, stamped all people with the seal of the first human, and not one of them is similar to another. Therefore, each and every person is obligated to say: The world was created for me” (Mishnah Sanhedrin 4:5). And we also know that God made humans betzelem elohim, in the image of God. Perhaps, then, God is reminding Moses of that: all humans are created by God, humans are physically diverse, and therefore all humans in all their differences are created in God’s image.

Being created in God’s image, then, does not mean that humans are endowed with some kind of divine perfection, but rather that humans are granted both abilities and disabilities, and that this mirrors something essential about the divine as well. It may seem strange to consider God as having a disability, perhaps even a kind of speech impediment. Yet this is also a potentially powerful way to conceptualize a God who gave the Torah through a revelation that was incomplete and in need of human interpretation. To be godly, then, as well as to be human, is to have both power and limitations, to be both abled and disabled. In that case, a prophet with a speech impediment is not a person with a flaw to be overcome, but rather the truest representation of the divine voice.

The publication and distribution of the JTS Commentary are made possible by a generous grant from Rita Dee ( z”l ) and Harold Hassenfeld ( z”l ).    

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Chancellor Rachel Reeves is taking immediate action to fix the foundations of our economy

In her first speech as Chancellor, Rachel Reeves laid out plans to rebuild Britain and make every part of the country better off.

Good morning.

Last week, the British people voted for change.

And over the last 72 hours I have begun the work necessary to deliver on that mandate.

Our manifesto was clear:

Sustained economic growth is the only route to the improved prosperity that country needs and the living standards of working people.

Where previous governments have been unwilling to take the difficult decisions to deliver growth…

… or have waited too long to act…

… I will not hesitate.

Growth [political content removed]. It is now our national mission.

There is no time to waste.

This morning I want to outline the first steps [political content removed] taken to fix the foundations of our economy.

So we can rebuild Britain and make every part of our country better off.

But first, let me address the inheritance.

I have repeatedly warned that whoever won the general election would inherit the worst set of circumstances since the Second World War.

What I have seen in the past 72 hours has only confirmed that.

Our economy has been held back by decisions deferred and decisions ducked.

Political self-interest put ahead of the national interest.

A government that put party first, country second.

We face the legacy of fourteen years of chaos and economic irresponsibility.  

That is why over the weekend I instructed Treasury officials to provide an assessment of the state of our spending inheritance so that I can understand the scale of the challenge. And I will present this to Parliament before the summer recess. 

This will be separate from a Budget that will be held later this year – and I will confirm the date of that Budget, alongside a forecast from the Office for Budget Responsibility, in due course.

All governments face difficult choices – and I will not shrink from those choices.

Those choices are made harder, however, by the absence of the economic growth necessary to not only balance the books but also to improve living standards.

New Treasury analysis that I requested over the weekend shows that, had the UK economy grown at the average rate of other OECD economies this last 13 years, our economy would have been over £140 billion larger.

This could have brought in an additional £58 billion in tax revenues in the last year alone. That’s money that could have revitalised our schools, our hospitals, and other public services.

Growth requires difficult choices – choices that previous governments have shied away from.

And it now falls to [political content removed] fix the foundations.

We have promised a new approach to growth – one fit for a changed world.

That approach will rest on three pillars – stability, investment, and reform.

Let me turn first to stability.

In the run-up to the general election, I set out the crucial first steps in our economic plans:

To deliver economic stability, so we can grow our economy and keep taxes, inflation and mortgages as low as possible.

And that commitment stands.

I emphasised this commitment in a meeting with the Governor of the Bank of England on Friday, and I will do the same when I meet the chair of the Office for Budget Responsibility this week.

These institutions are guarantors of our economic stability and I will not be playing games at their expense.

Over the weekend I made clear to Treasury officials that the manifesto commitments that we were elected on will be kept to and they will be delivered on.

That includes robust fiscal rules.

And it includes our commitments to no increases in National Insurance, and the basic, higher, or additional rates of Income Tax, or VAT.

Now I know there are some who will argue that the time for caution is past.

[Political content removed].

That a large majority in Parliament means we have the licence to row back on the principles of sound money and economic responsibility.

I know that many of you aren’t used to hearing this after recent years. But I believe that the promises that a party is elected on should be delivered on in government and we will do so.

We do not take lightly the trust of voters who have been burned too often by incompetence, irresponsibility, and recklessness.

And to investors and businesses who have spent fourteen years doubting whether Britain is a safe place to invest, then let me tell you:

After fourteen years, Britain has a stable government. A government that respects business, wants to partner with business, and is open for business.

In an uncertain world, Britain is a place to do business.

Let me turn to how we will unlock private investment that we so desperately need.

[Political content removed] …plans to launch a new National Wealth Fund, with a remit to invest – and so to catalyse private sector investment – in new and growing industries.

And in March, the former governor of the Bank of England, Mark Carney, agreed to lead a Taskforce on the establishment of a new National Wealth Fund.

I can tell you today that I have received the report from that Taskforce, and I will be announcing the next steps in short order.

Alongside investment must come reform.

Because the question is not whether we want growth, but how strong is our resolve – how prepared are we to make hard choices and face down the vested interests;

How willing, even, to risk short-term political pain to fix Britain’s foundations.

The story of the last fourteen years has been a refusal to confront the tough and responsible decisions that are demanded.

This government will be different.

And there is no time to waste.

Nowhere is decisive reform needed more urgently than in the case of our planning system.

Planning reform has become a byword for political timidity in the face of vested interests and a graveyard of economic ambition.

Our antiquated planning system leaves too many important projects getting tied up in years and years of red tape before shovels ever get into the ground.

We promised to put planning reform at the centre of our political argument – and we did.

We said we would grasp the nettle of planning reform – and we are doing so.

Today I can tell you that work is underway.

Over the weekend, I met with the Prime Minister and the Deputy Prime Minister to agree the urgent action needed to fix our planning system.

Today, alongside the Deputy Prime Minister, I am taking immediate action to deliver this [political content removed] government’s mission to kickstart economic growth;

And to take the urgent steps necessary to build the infrastructure that we need, including one and a half million homes over the next five years.

The system needs a new signal. This is that signal.

First, we will reform the National Planning Policy Framework, consulting on a new growth-focused approach to the planning system before the end of the month, including restoring mandatory housing targets.

And, as of today, we are ending the absurd ban on new onshore wind in England. We will also go further and consult on bringing onshore wind back into the Nationally Significant Infrastructure Projects regime, meaning decisions on large developments will be taken nationally not locally.

Second, we will give priority to energy projects in the system to ensure they make swift progress…

… and we will build on the spatial plan for Energy by expanding this to other infrastructure sectors.  

Third, we will create a new taskforce to accelerate stalled housing sites in our country…

…beginning with Liverpool Central Docks, Worcester Parkway, Northstowe and Langley Sutton Coldfield, representing more than 14,000 homes.

Fourth, we will also support local authorities with 300 additional planning officers across the country.

Fifth, if we are to put growth at the centre of our planning system, that means changes not only to the system itself, but to the way that ministers use our powers for direct intervention.

The Deputy Prime Minister has said that when she intervenes in the economic planning system, the benefit of development will be a central consideration and that she will not hesitate to review an application where the potential gain for the regional and national economies warrant it.

… and I welcome her decision to recover two planning appeals already, for data centres in Buckinghamshire and in Hertfordshire.

To facilitate this new approach, the Deputy Prime Minister will also write to local mayors and the Office for Investment to ensure that any investment opportunity with important planning considerations that comes across their desks is brought to her attention and also to mine.

The Deputy Prime Minister will also write to Local Planning Authorities alongside the National Planning Policy Framework consultation, making clear what will now be expected of them…

…including universal coverage of local plans, and reviews of greenbelt boundaries. These will prioritise Brownfield and grey belt land for development to meet housing targets where needed.

And our golden rules will make sure the development this frees up will allow us to deliver thousands of the affordable homes too, including more for social rent.

Sixth, as well as unlocking new housing, we will also reform the planning system to deliver the infrastructure that our country needs.

Together, [political content removed] we will ask the Secretaries of State for Transport and Energy Security and Net Zero to prioritise decisions on infrastructure projects that have been sitting unresolved for far too long.

And finally, we will set out new policy intentions for critical infrastructure in the coming months, ahead of updating relevant National Policy Statements within the year.

I know that there will be opposition to this.

I’m not naïve to that;

And we must acknowledge that trade offs always exist: any development may have environmental consequences, place pressure on services, and rouse voices of local opposition.

But we will not succumb to a status quo which responds to the existence of trade-offs by always saying no, and relegates the national interest below other priorities.

We will make those tough decisions, to realise that mandate. 

Be in no doubt – we are going to get Britain building again.

We are going to get Britain’s economy growing again.

We will end the prevarication and make the necessary choices to fix the foundations:

We will introduce a modern industrial strategy, to create good work and drive investment in all of our communities.

We will reform our skills system, for a changing world of work.

We will tackle economic inactivity and get people back to work.

We will take on the hard work of reforming our public services, to make them fit for the future.

We will work closely with our national, regional and local leaders to power growth in every part of Britain.

And we will turn our attention to the pensions system, to drive investment in homegrown businesses and deliver greater returns to pension savers.

I know the voters’ trust cannot be repaid through slogans or gimmicks – only through action, only through delivery.

The Treasury I lead is proceeding on that basis.

I was appointed to this post less than 72 hours ago.

Upon my arrival, I told Treasury staff that the work starts straight away.

That work has begun.

I have commissioned and received economic analysis from HMT officials on the lost growth of the past 14 years, which I have set out today.

I have instructed Treasury officials to prepare an assessment of the state of our spending inheritance, to be presented to Parliament before the summer recess.

I have started working with the Prime Minister, to make the necessary preparations for the establishment of a Growth Mission Board, and that board will meet before summer recess, focused squarely on reviving our country’s economic growth and prosperity

I have established a new Growth Delivery Unit here, at the heart of  the Treasury.

I have received the recommendations of the National Wealth Fund Taskforce, and will shortly be announcing next steps.

There is much more to do.

More tough decisions to be taken.

You have put your trust in us.

And we will repay that trust.

The work towards a decade of national renewal has begun.

And we are just getting started.

Thank you very much.

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Who Is Casey Affleck's Girlfriend? All About Caylee Cowan

Casey Affleck and his girlfriend, actress Caylee Cowan, began dating in 2021

Casey Affleck is head over heels for his girlfriend, Caylee Cowan.

The Manchester by the Sea star and the Holiday Twist actress first met in January 2021. While sparks flew immediately, the Oscar winner revealed on Instagram that it took a few months before he "got smart" and committed to their relationship, noting he was glad that "it wasn't too late."

In honor of knowing each other for a year, Affleck shared a photo of himself with Cowan in Budapest and captioned it, " We have gone through a lot of ups and downs this year, but how I feel about you has only gone in one direction. ... While it beats, you have a place in my heart."

Later that August, Cowan posted her own heartfelt words to celebrate his birthday. "To know you is to love you and to love you and be loved by you in return is a blessing comparable to nothing else on Earth," she wrote on Instagram .

So who is Casey Affleck's girlfriend? Here's everything to know about Caylee Cowan and her relationship with the Light of My Life actor.

She's an actress

Cowan got her start in community theater in California and Arizona, she told Voyage LA . Growing up, she worked on productions of Three Sisters , The Glass Menagerie and others before she began auditioning for movies. She made her feature film debut in 2019's Sunrise in Heaven , a romantic drama set in the 1960s, shot in 11 days.

In the years since, she's landed a number of roles, including opposite Nicolas Cage in Willy's Wonderland . Afterward, she shined as the titular anti-heroine of Frank and Penelope , in which she played an exotic dancer-turned-outlaw. She's currently working on the horror film The Possession at Gladstone Manor and promoting the drama Double Exposure .

In addition to acting, Cowan tried her hand at producing with 2019's The Peace Between , which followed the stories of three European refugees. The process left her craving more opportunities to get behind the camera.

"I love making movies, and I want to get more into producing," she told Flaunt .

Speaking about the documentary, which she got involved in through a group of female filmmakers who brought her onto the project, she added, "I think it's a really beautiful tale about humanity—it's real stories."

She moved around a lot during her childhood

Cowan was born and raised in Los Angeles, where she currently lives. Throughout her childhood, though, she moved around, spending stretches of time in Arizona as well. "Growing up, I went to 11 different schools," the actress told Voyage LA.

While Cowan dreamed of becoming an actress, her family couldn't afford "to support those kinds of dreams," she explained, adding that she was the child of a single mother who held down three jobs to help the family get by.

Cowan also had a difficult time at school, where she struggled with dyslexia and a speech impediment up until her teens when she managed to "overcome those setbacks."

Affleck and Cowan went Instagram official in November 2021

Eleven months after they met, Affleck made the pair's relationship official on Instagram with a since-deleted post featuring them at a Red Cross blood drive.

In the caption, Affleck referred to Cowan as " my love " and shared that while she's squeamish when it comes to needles and blood, the actress still wanted to donate.

"Though she believably feigned nonchalance all the way to the donation location, once on the table with her sleeve rolled up, she was overheard quietly asking a staff member, 'Is there a chance I might die?' " Affleck revealed, assuring people that donating blood "is not only SAFE but PAINLESS and QUICK."

"I love you so much," Cowan replied in the comments.

Their Instagram debut came soon after the couple were first spotted kissing and embracing in public in L.A., according to photos published by Page Six .

They aren't shy about expressing their love for each other

Since going official with their romance, the actors have gushed about each other on social media and red carpets alike.

"Being in love is just — makes your whole world just colored and beautiful," Cowan told PEOPLE at the premiere of her movie Spinning Gold , calling her relationship " the best thing ."

Marking the couple's first anniversary of meeting, the Oscar winner called her "a deep and tender woman." He continued, "My girl, you make me a better man every day. You could push me and you could drag me and you could carry me, but instead you just walk with me and talk with me and make me laugh."

At the same time, Cowan referred to Affleck as "the other half of my heart," addressing him on their milestone as her "home." She added, "You make me feel safe in this world. The shelter of your embrace gets me through the toughest days."

The pair also frequently comment on each others' social media posts, voicing their shared affection. "How you see me makes me a better man. How you love me makes me love better. I am yours," Affleck wrote in the comments alongside Cowan's birthday tribute to him in 2022.

They've made several red carpet appearances together

Affleck and Cowan have gotten glammed up on a number of red carpet occasions, from movie premieres to film festivals and award show celebrations.

They made their first major appearance together at the Cannes Film Festival in May 2022, where they attended a screening of Three Thousand Years of Longing . Cowan stole the spotlight in a flowing red dress with a plunging neckline, while Affleck looked dapper in a classic black tux.

That year, they also attended the 79th Venice Film Festival in September, which Cowan documented on her Instagram , sharing sweet shots of them on the red carpet. "Thank you for getting me through it. I love you," Affleck wrote in the comments.

Two months later, the pair arrived at the annual amfAR Gala in L.A., where they hit the red carpet with their arms around each other and even shared a kiss. Since then, they've attended charity events side-by-side, as well as Oscar parties and Paris Fashion Week.

They enjoy traveling the world

The jet-setting pair have been on several trips together over their three-year romance, ranging from Mexico to Paris and beyond.

The first trip Affleck and Cowan publicly documented was to Budapest in January 2022. Two months later, they relaxed in a hammock in Tulum, Mexico, while celebrating Cowan's 24th birthday.

In May 2022, they spent some time by the water in Portofino, Italy, where she and Affleck holed up in a luxury hotel during the Riviera International Film Festival.

Affleck and Cowan have also traveled to New York City, the Amalfi Coast and other destinations, capturing their travels with film photos and candid snaps on Instagram.

Affleck is her favorite actor

Cowan deeply admires her beau as both a partner and an actor — so much so that she ranked him "the most underrated brilliant actor alive today."

When asked by Vulkan which actor, dead or alive, she'd most like to work with, she shouted out her boyfriend. "Casey Affleck because I love him and I think he's the most underrated brilliant actor alive today," she said. "Of course, I'm a bit bias."

While spending time with Affleck on set in Boston as he filmed The Instigators, she realized that she would still be head over heels for him even if he weren't an actor.

"He was in a fireman's outfit, and I was just like, 'Uh oh,' " she told PEOPLE. "If this man had any other career, I'd [still] be like, 'Mm, that's the one.' "

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