Most Common Etiologies
- Cerebral palsy
- Craniofacial disorders (e.g., cleft lip/palate)
- Functional articulation and/or phonological disorders
Potential Consequences/Impact of Speech Impairment Can Include
- Difficulty expressing need or routine information intelligibly
- Difficulty communicating intelligibly in order to function at level of independence expected for age
- Difficulty expressing feelings intelligibly; may be at risk for frustration or depression
- Difficulty engaging successfully in social and/or classroom situations that require intelligible speech
- Difficulty achieving adequate intelligible speech to reach educational potential
- At risk for personal injury due to difficulty communicating intelligibly about a dangerous situation or calling for help
Behaviors that should trigger an SLP referral
- By age 3 years cannot:
- be understood by family and/or caregivers
- correctly produce vowels and such sounds as p, b, m, w in words
- repeat when not understood without becoming frustrated
- By age 4 years cannot:
- be understood by individuals with whom they do not associate regularly
- be understood by family and/or caregivers
- correctly produce t, d, k, g, f
- be asked to repeat without becoming sensitive
- By age 5 years cannot:
- be understood in all situations by most listeners
- correctly produce most speech sounds
- be asked to repeat without exhibiting frustration
- Disturbance in neuromuscular control causes difficulty learning to produce sounds appropriately
- speech is usually slurred; difficulty controlling respiration for speech; abnormal loudness, rhythm, or vocal quality
- exhibits difficulty learning sounds to form words; may sound nasal, strangled and/or breathy
- exhibits frustration and/or avoidance of speech due to extreme difficulty forming sounds or difficulty being understood
- Disturbance in programming, positioning, and sequencing of muscular movements
- sound errors are prevalent but variable (i.e., "dog" could be produced "dog," "tog," "gog," "god" by same child)
- varies from rarely being able to produce sounds to ongoing speech that is rarely understood, or speech that is usually understood with frequent sound errors
- unaware of sound variations or exhibits varying degrees of frustration and/or anxiety regarding inability to "control speech"
- Disturbance in performing voluntary movements with mouth and vocal mechanism
- cannot produce movements for sound production or sounds are produced without voice (whispered speech)
- varies from inability to produce any words to extreme difficulty being understood
- exhibits frustration and/or avoidance of speech due to difficulties
- Deafness/severe hearing loss causes severe prosodic disturbances in intonation, duration, and rhythm in addition to sound errors
- produces no meaningful words or sounds understood only by family
- speaks loudly in high pitched voice with frequent distortion, omission, and substitution of sounds
- Autism, emotional disturbance, and/or mental retardation may cause very unusual prosodic variations
- intonation and/or rhythm of connected speech may sound abnormal
- volume may be consistently or intermittently too loud or too soft
- Deviation in structure of speech mechanism
- difficulty producing specific sounds and intelligible speech
- exhibits frustration and/or avoidance of speech
- speech has excessive nasality
- Difficulty in hearing and/or inability to differentiate between sounds inhibit child's ability to detect and correct error sounds; usually unaware of errors
- Intelligibility and sound production are compromised when nasal passages, nasopharynx, and larynx are bypassed due to tracheostomy/ventilator dependence
- Exhibits sudden decrease in speech intelligibility
- ranges from slurred, generally intelligible speech to total absence of speech, or totally unintelligible speech
- awareness ranges from extremely aware to totally unaware of sound errors
- Exhibits decline in ability to be understood by family, friends, and/or caregivers in the expression of basic needs, preferences, and feelings
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