Speech Disorders

Disorders of Speech and Language


Described below are the most common types of speech/language disorders/impairments that are evaluated and treated in a school setting.

  • Articulation is the process by which sounds, syllables, and words are formed when your tongue, jaw, teeth, lips and palate alter the air stream coming from the vocal folds.
    • A child has an articulation problem when he or she produces speech sounds incorrectly. 
    • Cause: Articulation problems may be caused from a physical problem, hearing loss, or may be related to other problems in the mouth, such as dental problems.  However, most articulation problems occur in the absence of any obvious physical disability.  The cause of these articulation problems may be faulty learning of speech sounds. 
    • Assessment includes:
      • Sound production
      • Stimulability
      • Intelligibility
      • Structure and function of the oral mechanism
      • Rate
      • Effect on communication / education
  • Language is about understanding spoken words and using words to communicate ideas to others.  Language is used in just about every situation in life and is vital for learning. 
    • Language disorders involve (1) the form of the language (phonology, morphology, syntax), (2) the content of language (semantics), and/or (3) the function of language in social communication (pragmatics) in any combination.  Children with language disorders may experience difficulty with one or many aspects of language.
    • Cause:  While the cause of many speech-language impairments is not known, experts believe that they are caused by conditions that affect brain development either before, during, or after birth, such as muscular disorders, hearing problems or developmental delays.  Language disorders may be developmental or acquired. A genetic factor is sometimes considered a contributing cause in some cases.  Sometimes, children are not exposed to enough language to learn the rules.  Sometimes the child has no need to talk because parents respond to pointing and gestures instead of speech, but most language disabilities occur without an identifiable cause.
    • Assessment includes:
      • Receptive language - understanding the meaning of language.
      • Expressive language - the ability to express words using language.  Some children can form words easily but have severe difficulties with finding the words they need and organizing them to make what they want to say make sense.
      • Pragmatic language - using language for different purposes (promising, requesting), changing language for listener needs (peer vs. teacher), following the rules of conversation (turn taking, introducing topics of conversation, and staying on the topic), and non-verbal (body) language.
      • Effect on communication / education
  • Fluency can be thought of simply as a speaker's effortless flow of speech.
    • Stuttering/Dysfluency is the condition in which the flow of speech is broken by abnormal blocks (no sound), repetitions (st-st-stuttering), or prolongations (ssssstuttering) of sounds and syllables. There may also be unusual facial and body movements associated with the effort to speak.
    • Cause: We still do not know for a fact what causes stuttering.  It may have different causes in different people, or it may only occur when a combination of factors comes together.  Possible influences include incoordination of the speech muscles; rate of language development; the way parents and others talk to the child; and other forms of communication and life stress.
    • Assessment includes:
      • Frequency of prolongations, repetitions, blocks
      • Secondary characteristics - physical behaviors, avoidance, frustration
      • Rate of speech
      • Effect on communication / education
  • Voice is the sound produced by the larynx, commonly referred to as the voice box.  Air passes from the lungs through the larynx when you exhale.  Generally there is no sound made by this simple act of breathing.  By closing the vocal folds, the air passes between them, vibrating the folds and producing voice.
    • A voice disorder is defined as abnormal vocal pitch, loudness, quality or resonance of voice.  Abnormal refers to when the voice calls attention to itself rather than to what the speaker is saying.  It is also a problem if the speaker experiences pain or discomfort when speaking or singing.  The voice can be chronically hoarse, harsh, breathy, or of poor quality.  The voice could be too loud or too soft. The pitch could be inappropriate for the child's age or sex.  The voice could be hyponasal or hypernasal.
    • Cause: There are a variety of causes of voice problems.  Misuse or overuse of the voice, such as talking too loudly or using a pitch level that is too high or too low can result in a voice problem.  Some voice disorders occur due to medical issues such as cancer, reflux, growth on the cords, infection, etc.  People can sustain an injury that causes damage to the larynx and/or vocal folds.  Some voice disorders are related to problems between the nerves and muscles within the larynx.  Other voice disorder causes are unknown.
    • Assessment includes:
      • Pitch
      • Intensity - loudness
      • Quality - hoarseness, roughness, breathiness, tension, tremor, strain
      • Resonance - nasality
      • Effect on communication / education
    • The child with a voice problem must always be seen by an ear, nose and throat doctor for diagnosis before being treated by an speech/language pathologist (SLP), because some voice problems can not be treated by an SLP.

v    In order to qualify for any speech/language services, the speech/language impairment must have an impact on the student's educational performance.

v     Please follow the special education process for referral for services.

v     For services for children ages birth-3, contact the Frederick County Developmental Center, 301-694-1611.

v     For services for children over 3 but not yet enrolled in public school, contact Frederick County Public Schools Child Find, 301-644-5292.