Speech Impairment / Loss

The impact that speech impairment or loss can have on a person can be profound. When impairment of speech occurs, a person’s ability to communicate with the world around him does not come easily, and the person and those around him may become frustrated. Some conditions can be so severe that basic communication is extremely difficult. There are many reasons for speech impairments.

The two most common speech problems are aphasia and dysarthria.

Phonological Disorder

Phonological disorder is a type of speech disorder known as an articulation disorder.

Children with phonological disorder do not use some or all of the speech sounds expected for their age group.

This disorder is more common in boys. About 3% of preschool children and 2% of children ages 6 - 7 have the disorder.

The cause of phonological disorder in children is often unknown. Close relatives may have had speech and language problems. Other risk factors may include poverty and coming from a large family.

Phonological disorders may also be caused by:

  • Problems or changes in the structure or shape of the muscles and bones that are used to make speech sounds. These changes may include cleft palate and problems with the teeth.
  • Damage to parts of the brain or the nerves that control how the muscles and other structures work to create speech (such as from cerebral palsy).

Milder forms of this disorder may disappear on their own by around age 6.

Speech therapy may be helpful for more severe symptoms or speech problems that do not get better. Therapy may help the child create the sound, for example by showing where to place the tongue or how to form the lips when making a sound.



Aphasia is impaired expression or comprehension of written or spoken language. It is always due to injury to the brain such as a stroke, head trauma, brain tumors or infections. This term is used for adults who already had communication skills, not children or people who have never developed communication skills. Aphasia can be a temporary or a permanent condition.

Treatments can include orientation reminders, a calm environment and other people speaking in a normal tone / volume and using communication aids. The speech pathologist works in conjunction with doctors, nurses, neuropsychologists, etc., to give the patient an evaluation and treatment plan for his specific condition, which may include drills and exercises to improve specific language skills, group therapy for practicing conversations or exercises to strengthen speech muscles, reports the American Speech-Language-Hearing Association.


Dysarthria is best described as difficult or poorly articulated speech. If the person sustains a brain injury, sometimes the muscles of the mouth, face and respiratory system are weakened, stop moving or move slowly. A brain injury can include stroke, trauma, tumors, Parkinson’s disease and multiple sclerosis as well as others.

Symptoms of dysarthria include the following.
  • slurred speech
  • speaking softly or barely able to whisper
  • slow rate of speech
  • rapid rate of speech with a mumbling quality
  • limited tongue, lip and jaw movement
  • abnormal intonation (rhythm) when speaking
  • changes in vocal quality (“nasal” speech or sounding stuffy)
  • hoarseness
  • breathiness
  • drooling or poor control of saliva
  • chewing and swallowing difficulty

Dysarthria treatment will depend on the type, cause and severity of the symptoms and should be evaluated by a speech pathologist. The speech pathologist may use treatments such as improving breath support; increasing mouth, tongue and lip movement for more clear speech; muscle strengthening exercises; and slowing down speech, reports the American Speech-Language-Hearing Association.

If you develop any of the above symptoms, contact your doctor or local speech pathologist right away.