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• What is speech impairment?              
  
• Associated strengths
• General information
• Impact on Employability Skills and Attributes
• Areas where ‘reasonable adjustments’ may be required
• General advice
• Resources/references

What is Speech Impairment?

There are a number of causes of difficulties with speech:

• a person may have problems articulating their thoughts through the spoken word (dysphasia);
• injury or medical conditions such as a stroke or cerebral palsy can lead to a lack of control of the muscles involved in producing speech;
• stuttering and stammering can cause fluency difficulties;
• those born profoundly deaf will have difficulty communicating through speaking as this is learnt primarily by hearing speech in early childhood.

When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder. Difficulties pronouncing sounds, or articulation disorders, and stuttering are examples of speech disorders.

When a person has trouble understanding other people ( receptive language), or sharing thoughts, ideas, and feelings completely ( expressive language), then he or she has a language disorder. A stroke can result in a speech and/or a language disorder.

There are different terms to describe different types of speech impairments including:

• phonological difficulties;
• articulation difficulties;
• verbal dyspraxia;
• dysarthria;
• semantic pragmatic disorder;
• Aspergers Syndrome;
• elective mutism.

Most people can overcome their difficulties with the right help, but 1 in 500 will have severe or long-term difficulties.


Associated strengths

An inability to express themselves adequately sometimes results in a person with a speech impairment being perceived as less able or intelligent than they actually are. Do not assume that because someone has difficulties with speech that they have any learning difficulties.


General information

Stuttering is a speech disorder in which sounds, syllables, or words are repeated or prolonged, disrupting the normal flow of speech. These speech disruptions may be accompanied by struggling behaviours, such as rapid eye blinks or tremors of the lips.
Stuttering is sometimes referred to as stammering

Repetitive or rigid language. Often, those with autism who can speak will say things that have no meaning or that seem out of context in conversations with others. For example, they may count from one to five repeatedly, or they may continuously repeat words they have heard, a condition called ‘echolalia’.  Some people with autism speak in a high-pitched or singsong voice or use robot-like speech. Others may use stock phrases to start a conversation. For example, someone may say “Hello, my name is Jack”, even when he talks with friends or family

Apraxia of speech, also known as verbal apraxia (see also ‘Dyspraxia’), is a speech disorder in which a person has trouble saying what he or she wants to say correctly and consistently. It is not due to weakness or paralysis of the speech muscles (the muscles of the face, tongue, and lips). The severity of apraxia of speech can range from mild to severe.

There are two main types of speech apraxia: acquired apraxia and developmental apraxia. Acquired apraxia of speech can affect a person at any age, although it most typically occurs in adults. It is caused by damage to the parts of the brain that are involved in speaking, and involves the loss or impairment of existing speech abilities. The disorder may result from a stroke, head injury, tumour, or other illness affecting the brain. Acquired apraxia of speech may occur together with muscle weakness affecting speech production (dysarthria) or language difficulties caused by damage to the nervous system (aphasia).

Articulation refers to movements of the articulators – tongue, soft palate, jaws, teeth, lips. Problems with any of these lead to an articulation disorder affecting intelligibility to varying degrees.  Articulation disorders encompass a wide range of errors people can make when talking e.g., substituting a "w" for an "r" ("wabbit" for "rabbit"), omitting sounds ("cool" for "school"), or adding sounds to words ("pinanio" for "piano") are examples of articulation errors.

Lisping refers to specific substitution involving the letters "s" and "z." A person who lisps replaces those sounds with "th."


Impact on Employability Skills and Attributes

Although most people depend on the speech in the following employability skills, this does not mean that people who have speech impairment cannot possess these skills; rather, they may need reasonable adjustments to practice to enable them to develop or evidence the skills. 

Students with speech impairments may experience limited ability or difficulties with the following:

• Speech

Click below for further information about reasonable adjustments that may be made for each of the employability skills/attributes shown:

• Speech and Oral Communication
  
• Speech and Teamwork

NB: The experience and characteristics of different impairments/conditions are highly variable between individuals. For this reason it is really important that you never make assumptions about what a person can or cannot do. Though someone may have significant difficulties, they may also have devised sophisticated means of compensating for these, so talk to the person concerned and make judgements only on an individual basis.


Areas where ‘reasonable adjustments may be required
 
Communication - Stuttering can make it difficult to communicate with other people and this can affect a person’s quality of life. Symptoms of stuttering can vary significantly throughout a person’s day. In general, speaking before a group or talking on the telephone may make a person’s stuttering more severe, while singing, reading, or speaking in unison may temporarily reduce stuttering.

People with either form of apraxia of speech may have a number of different speech characteristics, or symptoms. One of the most notable symptoms is difficulty putting sounds and syllables together in the correct order to form words. Longer or more complex words are usually harder to say than shorter or simpler words. Another common characteristic of apraxia of speech is the incorrect use of "prosody", that is, the varying rhythms, stresses, and inflections of speech that are used to help express meaning.

Consistency of speech - People with apraxia of speech also tend to make inconsistent mistakes when speaking. For example, they may say a difficult word correctly but then have trouble repeating it, or they may be able to say a particular sound one day and have trouble with the same sound the next day. People with apraxia of speech often appear to be groping for the right sound or word, and may try saying a word several times before they say it correctly.

Group work – Students may lack confidence in contributing to group discussions until they feel secure within the group and group members understand their preferences in terms of communicating.


General advice

• Be patient; allow the person time to complete what they wish to say.
• Some appreciate help to complete their sentences - check their preference.
• Some may wish to communicate via computer with a speech synthesiser.
• Those with receptive language difficulties may have trouble understanding questions or the demands of a task - be patient, allow plenty of time for information to be assimilated.
• Recognise the person’s potential - they have a speech problem not a low IQ!
• Students with such difficulties may find tutorials and other group work more challenging than other students and may need time to gain confidence. Tutors can help initially by asking questions that only require brief answers.
• Stress often exacerbates the problem. Give lots of encouragement and support.
• Listening to someone struggling with speech can often feel embarrassing. Keep calm and watch the person’s lips.
• Assessments based on verbal input or discussion may need to be modified.
• Check with the student whether or not they would like you to discuss with the other students the particular ways in which they can be helpful in group sessions. The student may wish to do this themselves, but this should be clarified beforehand.

Resources/references

Differences between ‘voice’, ‘speech’ and ‘language’   the National Institute on Deafness and other Communication Disorders:

Speech and Language development explained