Language impairment; Impairment of speech; Inability to speak; Aphasia; Dysarthria; Slurred speech; Dysphonia voice disorders
Speech and language impairment may be any of several problems that make it difficult to communicate.
The following are common speech and language disorders.
Aphasia is loss of the ability to understand or express spoken or written language. It commonly occurs after strokes or traumatic brain injuries. It can also occur in people with brain tumors or degenerative diseases that affect the language areas of the brain. This term does not apply to children who have never developed communication skills. There are many different types of aphasia.
In some cases of aphasia, the problem eventually corrects itself, but in others, it doesn't get better.
With dysarthria, the person has problems expressing certain sounds or words. They have poorly pronounced speech (such as slurring) and the rhythm or speed of speech is changed. Usually, a nerve or brain disorder has made it difficult to control the tongue, lips, larynx, or vocal cords, which make speech.
Dysarthria, which is difficulty pronouncing words, is sometimes confused with aphasia, which is difficulty producing language. They have different causes.
People with dysarthria may also have problems swallowing.
Anything that changes the shape of the vocal cords or the way they work will cause a voice disturbance. Lump-like growths such as nodules, polyps, cysts, papillomas, granulomas, and cancers can be to blame. These changes cause the voice to sound different from the way it normally sounds.
Some of these disorders develop gradually, but anyone can develop a speech and language impairment suddenly, usually in a trauma.
For dysarthria, ways to help improve communication include speaking slowly and using hand gestures. Family and friends need to provide plenty of time for those with the disorder to express themselves. Typing on an electronic device or using pen and paper can also help with communication.
For aphasia, family members may need to provide frequent orientation reminders, such as the day of the week. Disorientation and confusion often occur with aphasia.Using nonverbal ways of communicating may also help.
It's important to maintain a relaxed, calm environment and keep external stimuli to a minimum.
Mental health counseling may help with depression or frustration that many people with speech impairment have.
Contact the provider if:
Unless the problems have developed after an emergency event, the provider will take a medical history and perform a physical exam. The medical history may require the assistance of family or friends.
The provider will likely ask about the speech impairment. Questions may include when the problem developed, whether there was an injury, and what medicines the person takes.
Diagnostic tests that may be performed include the following:
If the tests find other medical problems, other specialist doctors will need to be consulted.
For help with the speech problem, a speech and language therapist or social worker will likely need to be consulted.
Halpern H, Goldfarb R. Language and Motor Speech Disorders in Adults. 3rd ed. Burlington, MA: Jones and Bartlett Learning. 2013.
Kirshner HS. Aphasia and aphasic syndromes. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 13.
Kirshner HS. Dysarthria and apraxia of speech. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 14.
Last reviewed on: 5/30/2016
Reviewed by: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.