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Rhotacism: A complete guide to this speech impediment

Remember when you were a child and spoke by making your “R’s” sound like “W’s” and everything thought it was cute? That’s known as rhotacism and some people live with it even as adults. What is rhotacism, what is it like in other languages, and what are its symptoms? What does it look like as a speech impediment and what are some examples? What are its causes? How does it affect the brain ? Is it curable and how can it be fixed? This article will answer all your doubts about rhotacism. 

What is rhotacism?

Rhotacism is a speech impediment that is defined by the lack of ability, or difficulty in, pronouncing the sound R . Some speech pathologists, those who work with speech impediments may call this impediment de-rhotacization because the sounds don’t become rhotic, rather they lose their rhotic quality. It could also be called a residual R error.

It’s not such an uncommon phenomenon and actually also happens with the letter L , a phenomenon known as lambdacism . Sometimes people mistake these speech impediments for a lisp, of which they are not. Within the 2000-2001 school year, more than 700,000 students within the American public school system were categorized as having either a language impediment or a speech impediment. Ironically, all three speech impediments contain the troubled letter within them.

The word rhotacism comes from the New Latin rhotacism meaning peculiar or excessive use of [r]. The Latin word came from Ancient Greek word rhōtakismós which means to incorrectly use “rho” which is the equivalent of the Greek R. For language nerds, here’s a really great explanation of how the word came into being.

How does rhotacism work in different languages?

Rhotacism is, in theory , more common among people whose native language has a trilled R. For example, in Spanish the “rr” is a trilled R. Other languages with a trilled R include Bulgarian, Hungarian, Arabic, Finnish, Romanian, Indonesian, Russian , Italian, and most Swedish speakers. Some people might mock Asians, specifically Chinese, for not being able to pronounce the English word “broccoli” correctly- rather pronouncing it “browccoli”. This isn’t due to a rhotacism, however. It’s actually due to the fact that Mandarin (Chinese) words can have an “r” sound in the beginning of a word, but not in the middle or end of a word. This leads them to have issues in their phonotactics and creates an inability to pronounce the English “R” in the middle of words.

The leader of Hezbollah, Hasan Nasrallah, is a Lebanese leader and is mocked for his rhotacism when he says, “ Amwīka ” and “ Iswā’īl ” for the Arabic Amrīka (America), and Isrā’īl (Israel). He is a native Arabic speaker- a language which has the trilled R. Notice how he puts a W sound in those two words where the R sound usually is.

Symptoms of rhotacism

• Some people try to hide their impediment by avoiding words with R ’s in them.
• An overall inability to say R sounds
• Using trilled R’s or guttural R’s (such as the French R) when trying to pronounce the regular English R.

Rhotacism as a speech impediment

Using a strict classification, only about 5%-10% of the human population speaks in a completely normal way. Everyone else suffers from some type of speech disorder or another. For children of any language, the R sounds are usually the hardest to master and often end up being the last ones a child learns. That’s why baby talk if you think about it, doesn’t really use explicit or strong R sounds. In English, rhotacism often comes off as a W sound which is why “Roger Rabbit” sounds like “Woger Wabbit”. R is often more difficult because a child has to learn the different combination of the /r/ sounds, not just the letter itself, unlike other letters. For example, when it comes before and after vowel sounds. The combination of a vowel with the /r/ sound is called a phenome and in English, there are eight combinations of these:

–        The prevocalic R , such as “rain”

–        The RL , such as “girl”

–        The IRE, such as “tire”

–        The AR, such as “car”

–        The EAR , “such as “beer”

–        The OR , such as “seashore”

–        The ER , such as “butter”

–        The AIR , such as “software”

A speech impediment is a speech disorder , not a language disorder . Speech disorders are problems in being able to produce the sounds of speech whereas language disorders are problems with understanding and/or being able to use words. Language disorders, unlike speech disorders, have nothing to do with speech production.

Often what happens is that the person speaking isn’t tensing their tongue enough, or not moving their tongue correctly (up and backward depending on the dialect) which makes the W or “uh” sound come out. It may also be that the person is moving their lips instead of their tongue.

Examples of rhotacism

• Barry Kripke from the TV show The Big Bang Theory has both rhotacism and lambdacism- meaning he has issues pronouncing both his R ’s and his L ’s.
• The most famous of rhotacism would be Elmer Fudd from Looney Tunes . He pronounces the word “rabbit” [ˈɹ̠ʷæbɪ̈t] as “wabbit” [ˈwæbɪ̈t]
• In Monty Python’s Life of Brian , the 1979 film’s character Pilate suffers from rhotacism. In the film, people mock him for his inability to be understood easily.

Here’s a video with a woman who suffers from rhotacism. She explains how difficult it can be to have the speech impediment.

Causes of rhotacism

For many people, the causes of rhotacism are relatively unknown-, especially in adults. However, scientists theorize that the biggest cause is that the person grew up in an environment where they heard R ’s in a weird way, the shape of their mouths are different than normal, or their tongues and lips never learned how to produce the letter. In children, this could happen because the parents or adults around think the way the child talks (using baby talk) is cute and the child never actually learns how to produce it.

For one internet forum user, it has to do with how they learned the language , “I speak various languages, I pronounce the “R” normal in Dutch, French, and Spanish, but I have a rhotacism when speaking English. It’s the way I learnt it.”

For other people, speech issues are a secondary condition to an already existing, serious condition. Physically, it would be a cleft lip or a cleft palate. Neurologically, it could be a condition such as cerebral palsy. It may also be a tongue tie . Almost everyone has a stretch of skin that runs along the bottom of their tongue. If that skin is too tight and reaches the tip of the tongue, it can make pronouncing (and learning how to pronounce) R ’s and L ’s difficult. If the tongue tie isn’t fixed early on, it can be incredibly difficult to fix and learn how to pronounce later.

How the brain affects rhotacism

The brain affects rhotacism only for those who suffer from it not due to a physical impediment (such as a cleft palate). For some, this could happen because the brain doesn’t have the phonemic awareness and never actually learned what the letter R is supposed to sound like. This is common with kids whose parents spoke to them in “baby talk” and encouraged the child’s baby talk, too. This kind of behavior only strengthens a child’s inner concept that / R / is pronounced like “w” or “uh”.

Another reason could be that the brain connections simply don’t allow the lips or mouth to move in the way they need to in order to pronounce the R . This inability has little to do with physical incapabilities and more to do with mental ones. Some people with rhotacism have an issue with their oral-motor skills which means that there isn’t sufficient communication in the parts of the brain responsible for speech production.

Treatment for rhotacism

Is rhotacism curable.

It can have negative social effects- especially among younger children, such as bullying, which lowers self-esteem and can have a lasting effect. However, if the impediment is caught early enough on and is treated rather quickly, there is a good overall prognosis meaning it’s curable.

        However, some people never end up being able to properly pronounce that R and they end up substituting other sounds, such as the velar approximant (like w sounds) , the uvular approximant (also known as the “French R ”), and the uvular trill ( like the trilled R in Spanish).

How to fix rhotacism

Rhotacism is fixed by speech therapy . Before anything else, there needs to be an assessment from a Speech Language Pathologist (SLP) who will help decide if the problem can be fixed. If a child is involved, the SLP would predict if the child can outgrow the problem or not. After the diagnosis, a speech therapist will work with the person who suffers from the speech impediment by possibly having weekly visits with some homework and practice instructions. Therapy happens in spouts- a period of a few weeks and a break. There is a follow-up to see if there has been an improvement in pronunciation. In the U.S., children who are in school and have a speech disorder are placed in a special education program. Most school districts provide these children with speech therapy during school hours.

Another option, often used alongside speech therapy, is using a speech therapy hand-held tool that helps isolate the sound being pronounced badly and gives an image of the proper tongue placement to enable better pronunciation.

One study tested a handheld tactical tool (known as Speech Buddies) and the traditional speech therapy methods. The study found that students who used the hand-held tool (alongside speech therapy) improved 33% faster than those who used only the traditional speech therapy methods.

Have you or someone you know ever struggled with rhotacism? Let us know what you think in the comments below!

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R Sound Articulation: How Speech Therapy Helps with Rhotacism

The letter “r” is one of the most difficult consonant sounds for many people to articulate correctly. The inability to produce this sound is called rhotacism, and it is a common problem that affects both children and adults. Speech therapy can help individuals with rhotacism improve their ability to articulate this sound correctly.

In this article, you will learn more about...

• the definition of rhotacism is and what causes it,
• the benefits of speech therapy for someone with rhotacism, and
• the different treatment options available for someone with rhotacism.

Let’s dive in.

What is Rhotacism and What Causes It?

Rhotacism is a speech disorder wherein an individual has difficulty articulating the “r” sound. It is also known as r-deletion, r-substitution, or lallation (the substitution of “l” for “r”). One common difficulty is with the “hard r” sound, which refers to a specific pronunciation of the “r” sound, typically found in certain dialects or accents. It is characterized by a strong, emphasized “r” sound at the end of a word or syllable, such as in the word “car” or “hard.”

This speech disorder can be caused by a variety of factors, including:

1. Developmental Delays – Children who experience developmental delays often experience difficulties in speech production. This can be due to delays in the development of the muscles and coordination required for speech.

2. Neurological Disorders – Certain neurological conditions, such as dysarthria or apraxia, can affect the muscles used in speech and make it difficult to produce the “r” sound. These conditions affect the brain’s ability to control the muscles used for speech and can cause slurred or difficult-to-understand speech.

3. Physical Conditions – Tongue tie, cleft palate, and other impairments involving the mouth, tongue, or throat can affect the way the muscles move and make it difficult to form the “r” sound. Trauma or injury to the mouth, tongue, or throat can also cause rhotacism. This can happen if the individual experiences an accident, injury, or surgery that affects the muscles or nerves used for speech.

4. Lack of Exposure – Lack of exposure to the “r” sound during early years can lead to difficulty in pronouncing it later in life. This may happen if the individual grows up in a language or culture that does not use the “r” sound frequently.

5. Dialect or Accen t- In some dialects or accents, the “r” sound is pronounced differently. Individuals who speak these dialects or accents may find it difficult to produce the “r” sound in a different way, especially when they start learning new languages.

Working With a Speech Therapist to Treat Rhotacism

Speech therapy is an effective treatment for rhotacism. A Speech-Language Pathologist (SLP) can help improve the ability to produce the “r” sound correctly. The SLP will assess and develop a plan of treatment tailored to the individual’s needs. The therapy sessions may include a variety of exercises and techniques designed to help the individual identify and correct any errors in their speech.

Here are a few examples:

• Articulation Therapy involves working on the specific movements and positions of the mouth and tongue required to produce the “R” sound correctly. The therapist may use visual aids, such as mirrors or diagrams, to help the individual see the correct positioning of their mouth and tongue.
• Auditory Discrimination Training is another technique that may be used in speech therapy. This involves helping the individual differentiate between the “r” sound and other consonant sounds, such as “l” or “w”. The therapist may use listening exercises or games to help the individual develop their ability to identify and produce the correct sound.

Progressing in Treatment

As the individual progresses in treatment, the SLP may introduce activities that involve reading aloud or engaging in conversations. By doing so, the individual is able to practice their articulation of the “r” sound in a more natural setting. The SLP will also help them develop strategies for self-monitoring their speech and providing feedback when needed.

Benefits of Speech Therapy

For children with speech sound disorders, early intervention can prevent the disorder from impacting their social and academic development. For adults, speech therapy can improve their ability to communicate effectively in personal and professional settings.

Improved communication skills can also lead to increased confidence and self-esteem. Individuals who are able to articulate the “r” sound correctly may feel more comfortable speaking in front of others and participating in social activities.

Speech therapy for rhotacism can also help individuals with related speech disorders. For example, individuals with a lisp may also struggle with articulating the “R” sound correctly. By improving their ability to produce this sound, they may also improve their ability to speak more clearly and confidently overall.

In addition to the benefits for the individual, speech therapy for rhotacism can also have benefits for their family and friends. Clear communication is essential for building strong relationships, and improving communication skills can lead to stronger, more meaningful connections with others.

Rhotacism, in short…

Rhotacism is a common speech disorder that can have a large impact on communication skills. Speech pathologists can help by creating treatment plans that include drills, activities, and conversation practice to aid articulation of the “r” sound. With the support of an SLP and continued practice, individuals can make marked improvements in their ability to communicate. Speech therapy for rhotacism can lead to increased confidence and self-esteem, better communication skills, and stronger social connections.

Do you know anyone that has difficulty articulating the letter “r”? Schedule a consultation with one of our speech pathologists to know the best treatment plan that suits their needs.

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A Parent's Guide to R Sound Speech Therapy and How It Can Help Your Child

If your child has difficulty with the r-sound, they may need some help to learn how to pronounce it. This article covers the basics of R sound speech therapy and how it can help your child learn to speak more accurately.

It isn't too concerning if your child can't pronounce R as a preschooler. Rs are the most difficult letter to pronounce, and often kids won't fully develop the ability until the age of seven. However, if you are finding your attempts to teach your child to pronounce their Rs properly is causing conflict, it could interfere with family dynamics and your child's confidence.

The inability to pronounce Rs is a speech impediment called rhoticism. It is so common there is speech therapy specifically designed to help children pronounce their Rs. This is a complete guide to R speech therapy and how it can help your child learn to make the R sound stress-free.

Master 'R' Sounds with Ease!

What is Rhoticism?

Rhoticism is the most common speech disorder children experience. Inability to pronounce the R sound usually leads to a child pronouncing their Rs as Ws. This is because there are more variations of the letter R pronouncement than any other letter. Adding to the difficulty, it isn't easy to show a child how to position their mouth and tongue to make the sound correctly. For example, when showing a child to make the letter B, they can see the movement of your lips, making it easier for them to mimic you and make the sound.

When Should a Child Be Able to Say Their R's?

R is usually the last letter children learn to make. In most cases, a child begins to say forms of their Rs by about two and a half and has it perfected by the age of six. For some, however, development might not be perfected until as late as age seven . In most cases, rhoticism isn't addressed until a child approaches age seven or eight, but R sound speech therapy and coaching can start sooner.

Why Are There So Many Variations of R?

The R sound occurs most frequently when speaking English. It is challenging to master because it has so many variations in pronunciation. Where the R occurs in the word influences how the R should sound. Variations include:

• R as in run
• RL as in pearl
• IRE as in fire
• AR as in far
• EAR as in dear
• OR as in door
• ER as in sister
• AIR as in dare

With so many variations, you can see why it might be more challenging for a child to learn to master each sound with the rest of their letters.

How Can I Help My Child Say Rs?

Parents can also learn to assist their child with some fun exercises such as:

Connect Rs to Vowels

Many children find it easier to say their Rs with a vowel. R blends speech therapy such as making your way through the vowels, making it easier to understand how to pronounce R in different variations. First, pronouncing the vowel, either long or short, holding the sound, and then adding an R at the end helps your child hear how the letters sound together. For long A, you would begin with them saying aaaaaa and then adding the R to say aaaaaarrrrrr as in air. Then for the short, they would start saying ahhhhhhh and then add the R to say ahhhhrrrrr as in car.

Tongue Movement

As mentioned, one of the challenges with R's is the difficulty providing visual cues to show them how to pronounce the letter. Since you can't show them your tongue, you can try using your arm to show them by extending your arm out to the front and then pulling it up towards your body as you pronounce the R.

R Sound Activities

Always approach the exercises as something fun you can do together, so your child isn't self-conscious or nervous. For example, Rs are very much like growls. Have your child act out being certain animals like a cranky dog growling or a mighty lion roaring. Have them roll the R out as they mimic each animal. Pirates also make an R sound when they say "argh." You can dress up as pirates to practice the sounds. You can also watch their favorite cartoon and whenever a character makes an R sound have them shout it out or repeat it.

Use Rs Every Day

Find opportunities to pronounce Rs with your child, whether pointing out foods in the grocery store with Rs, items in a park, or even when your child hears you say an R.

Practicing R words speech therapy at home can be very helpful, but success is more likely with the help of a speech therapist.

What Causes Rhoticism?

Speech disorders like rhoticism are related to difficulty making sounds when speaking. In the case of rhoticism, it is related to not tensing their tongue enough or failing to move it correctly. Trying to master the up and backward movement when pronouncing R's can be tricky, which is why children often start by making a W sound instead. The child sees most letters pronounced with the lips, while Rs are pronounced with the tongue.

How Does R Speech Therapy Help?

R sound speech therapy can make a world of difference for your child. Your child's therapist provides a safe learning environment where they won't feel judged or pressured. Speech therapists take time to build a rapport with their patients to feel more comfortable during the process. Parents can often inadvertently cause a child to feel they are under attack or doing something wrong. Speech therapists alleviate that family stress providing neutral ground where a child can feel less vulnerable. Their goal is to assist your child in learning how to move their tongue to achieve the correct positions to pronounce their Rs correctly.

Each child is treated as an individual with an assessment to understand their challenges and then use different methods to find the approach that they respond to best. Therapists make articulation therapy fun using games and activities that children respond to well. Your child will improve over time, enjoying small successes each session until the Rs roll naturally off their tongue. Through practice, they learn how to make R sounds, add Rs to syllables, then words, phrases, and complete sentences with confidence !

We invite you to learn more about how Articulation Speech Therapy at Nobles Speech Therapy can help your child pronounce the R sound better and overcome other speech difficulties.

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(301) 615-2529

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Parent's Academy › Speech Disorders › Speech Sound Disorders › R Sound Articulation Therapy: A Guide for Parents

R Sound Articulation Therapy: A Guide for Parents

Natalie barnes.

Speech Therapist and Audiologist , Cape Town , South Africa

Jan 20, 2022 The R sound is a very unusual sound that has multiple variations. There are as many as 32 different sounding types of the R sound. Yikes!

This article focuses on the R consonant sound and how your child can use our app to practice saying it correctly. Download the app and start your at-home practice today.

As a speech therapist, I can tell you that though the R sound is commonly used in the English language, it is also one of the trickiest. In fact, the R sound is one of the last sounds to be mastered by children. And though it begins to emerge at 3-years-of-age, it often only matures at the ages of 6 or 7.

What is the /R/ Sound?

As already mentioned, the /r/ sound is one of the hardest sounds to master. Children usually master it by the ages of 6-7. Whether a child struggles with the pre-vocalic /r/ (where the R is produced at the beginning of a word) or the vocalic /r/ (when the R sound is produced after a vowel), many speech therapists agree that it can be one of the most challenging sounds to teach. With that being said, there are many tips we can use to help a child practice their /r/ sound.

The key to helping your child correctly say the /r/ sound is to look at three important oral structures used in speech: the lips, the tongue, and the throat.

When producing the /r/ sound, we want to make sure to have our lips more in a neutral position or more of a square shape. Some SLPs may also have a child smile.

We can produce the /r/ sound using two tongue positions: 

• the retroflex position , where the tip of the tongue is raised or curled at the roof of the mouth;
• the bunched position , where we move our tongue towards the back of our teeth while the tongue tip points a bit down.

The upper part of the throat right behind the tongue, also known as the pharynx, must constrict or tighten in order for the correct R sound to be produced. The vocal cords need to vibrate to produce the sound correctly.

Check out the following video:

After watching the video, open our app and practice the words that include the R consonant in them.

Let’s make the R-sound easy!

Take this quiz and get a report on your child’s milestones and a personalized learning plan to start progressing with Speech Blubs!

Teaching the R Consonant Sound to Your Child

Explain to your child that you are going to practice saying the R sound, like in the word “rabbit.”

Tell your child that when they say the R sound in “rabbit” you’d like to see their lips make an “O” shape . Make sure you show them how if they don’t understand.

Next, to get your child’s tongue in the correct placement position, tell them that their tongue needs to create a hump in the middle of their mouth like a little hill.

This is so that when they say the R sound in “rabbit,” they can pretend that there is a little rabbit hopping over the hill in their mouth to get outside. If there’s no hill, then there’s no correct R sound and the rabbit can’t get out.

Lastly, explain to your child that they need to tighten the back part of their throat so that they can push enough air up into their mouth and along their tongue in order to help the rabbit jump over the hill.

Once they can correctly say the R consonant sound in isolation, follow the articulation error hierarchy which you can read about in this article , or watch in this video.

Some Mo/r/e T/r/icks

Tell your child to make a “fish face” to help them achieve the correct “O” lip placement. This can become a game to see who can make the funniest face while moving their lips into the correct position.

If this doesn’t work, exaggerate sticking your lips out and telling them to copy you or use a mirror so they can see their own progress. Once they can do this you can refine the positioning of their lips into the correct “O” shape.

Visual cueing and modeling are powerful learning aids that can be used in where you say the correct R consonant sound while your child imitates what your lips are doing. Our app is a wonderful imitation tool, as it develops your child’s articulation skills and other desirable behaviors by promoting learning through watching video demonstrations given by real kids. Download the app for iOS or Android devices.

You can read more about video modeling and imitation by reading the following article: Mirror Neurons, Video Modeling, and Your Child’s Speech .

Physically showing your child where to place their tongue is very effective. Most children who experience difficulty with the R sound are unable to position their tongue correctly because it all happens behind the visual barrier of the front teeth. This can also make it quite frustrating for them.

Once you have reached the word level and are practicing words that start with the R consonant sound, touch the tip of your child’s tongue with your finger or a tongue depressor and tell them that you want them to lift that part up as far as they can without touching the roof of their mouth.

Once you have reached the word level and are practicing words that have the R consonant sound in other places, touch the middle of your child’s tongue with your finger or a tongue depressor and tell them that you want them to lift that part up to create an arch without touching the roof of their mouth.

Have your child gargle with water to help them learn how to tighten their throat muscles the way they would when correctly saying the R consonant sound.

You can also draw their attention to this kind of throat tightening by having them drink through a straw and explaining how the muscles work.

When your child says the R sound, place their hand on their neck to feel the vibration made by their vocal cords. If they have trouble creating this vibration, then place their hand on your throat to show them how it’s done. Pretend that the vibration is the “rabbit” hopping. If there’s no vibration, then the “rabbit” isn’t hopping and he can’t get out.

To assist with the voicing and correct articulation of the R consonant sound, tell your child to pretend that they are growling like an angry dog. You can also turn this into game by seeing who can come up with the scariest or funniest growl.

More tips and tricks

• Have your child try and think of their own words that contain the R consonant sound.
• Make up silly phrases or sentences and even imitate appropriate phrases and sentences that you see in more than 1000 bonus video stories anywhere within Speech Blubs 2 or elsewhere.
• Give your child an R consonant word and ask them to make up silly phrases or sentences – this is great language practice!
• Use a mirror within the app at all levels of the hierarchy so that your child can see what they are doing and learn the skill of self-monitoring.
• Put objects or toys that start with or contain a letter R in their name in a bag. Ask your child to draw one by one, and say the name of the object out loud to you.
• When you are outside playing, play a game where you have to name the objects that have the letter R. For example, Road, Bricks, Tree, Branch, Mary-go-round, Water, Stream, River, Car, Truck, Train . . . try to spot as many as you can!
• Play a game called “Rabbit Runs to . . .” Tell your child that they are a rabbit that has to run to a certain place in the house. Each time they reach the place you name, they have to answer the question: “Where did the rabbit run to?” “Rabbit Runs to the Rug.” “Rabbit Runs to the Refrigerator.” “Rabbit Runs to the Door.”
• Make a dictionary of R words. You can use the store free advertisements of products they send to your house. Cut out all the things they sell that have a letter R: broccoli, rice, bread . . . and paste them in a special book. You can write down the names of the objects, and look at them every day to name the objects.

How to Play Articulation Bingo?

• Use the button below to download our Articulation Bingo Board
• Print out the board and give it to your child or cut out the pictures and put them into a bag
• Let your child pick a word from the board/bag
• Find the word in Speech Blubs App and practice it, play with fun filters, and watch educational videos
• Your child is a winner when he practices three pictures in a row (across, down, or horizontally) or the entire board.

Use Speech Blubs app every day for at least 5-10 minutes to achieve the best results.

If you’re worried about your child’s ability to say the R consonant sound or have any other concerns about their pragmatics, comprehension, or talking, use our free screener within the app. Our speech and language pathologist-developed tool will even give you a personalized report with actionable advice with the results.

For more information about the app visit our FAQ section or write to us . Know that you have an ally in Speech Blubs and that our biggest success is seeing your child achieve their greatest potential.

If your child has difficulties with other sounds, here are the articles that can help you with speech therapy, speech exercises, and articulation activities ideas:

• Articulation Therapy: An All-in-One Guide for Parents
• B Sound Articulation Therapy
• H Sound Articulation Therapy
• JJ and CH Sounds Articulation Therapy
• L Sound Articulation Therapy
• Lisp Articulation Therapy
• M Sound Articulation Therapy
• N Sound Articulation Therapy
• NG Sound Articulation Therapy
• S Sound Articulation Therapy
• SH Sound Articulation Therapy
• T and D Sounds Articulation Therapy
• W Sound Articulation Therapy

Have a question for our Speech Therapists?

The author’s views are entirely his or her own and may not necessarily reflect the views of Blub Blub Inc. All content provided on this website is for informational purposes only and is not intended to be a substitute for independent professional medical judgement, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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Exploring the /R/ Sound in Articulation Disorders

What Everyone Needs to Know About Articulation Disorders: Exploring the Sound /R/

This week, we are taking a fresh and in-depth look at articulation disorders in children, including trying to decipher what is fact, fiction and frankly what you need to know about articulation disorders in relation to normal speech development milestones.  As we drill down into the nitty gritty of articulation disorders, today we are choosing to focus on pronouncing the sound of /R/.

Articulation Disorder: Mis-pronouncing the Letter /R/:

Believe it or not – there is a scientific and medical term associated with the phenomena of mispronunciation of the letter /r/. The term Rhotacism refers to inability of difficulty of pronouncing the sound of /r/. When this happens, the pronunciation of the /r/ sounds more like the letter /w/. Think Barbara Walters, or as Saturday Night Live liked to spoof, “Baba Wawa” or Elmer Fudd.   Of course, when your child is learning to talk, sometimes it’s cute to hear your child say “wabbit” instead of rabbit, or “twain” instead of train. However, if it’s not corrected, as your kids get older and cannot express themselves clearly, they run the risk of being teased by their classmates and even worse, being afraid to speak up at all.

How do you know when it’s time to step in and seek some sort of speech therapy? Generally, these four guidelines can help you:

• Is your child feeling frustrated when he is trying to speak?
• Is his speech difficult to understand?
• Is his speech a source of amusement or teasing from others?
• Is he older than the recommended age where articulation disorders generally tend to subside? (In this case, the /r/ sound should be mastered by the age of eight).

Research has shown that 7.5% of school age children have an articulation disorder and the letter /r/ has proven particularly difficult. Because /r/ comes before and after vowel sounds, a child would need to learn different combinations of the /r/ sound, not just the sound itself.  The combination of the /r/ with a vowel is called a phenome , and in speech there are eight phonetic combinations that include the letter /r/. These include:

• AR as in car
• AIR as in software
• EAR as in beer
• ER as in butter
• IRE as in tire
• OR as in seashore
• RL as in girl
• Prevocalic R as in rain

Treatment Options:

First you will need an assessment from a Speech Language Pathologist (SLP). A speech evaluation by an SLP will help decide if your child will outgrow the problem. A therapist screens all areas of a childs’ communication abilities and does an in-depth assessment of the particular disorder, in this case the letter /r/. A complete speech therapy evaluation must take into consideration all the possible combinations of the /r/sound.

After diagnosis, you should expect a speech therapist to work with you on therapy options. These options may include weekly visits, augmented with homework and practice instructions. Therapy would be conducted over a period of weeks, followed by a break. A follow-up visit would be required to review progress. Another possible treatment is using a speech therapy hand- held tactile tool, such as Speech Buddies , that would help isolate the sound and provide proper tongue placement for correct pronunciation. Often, the two therapies can be combined. A third option would be to search for online resources that you can conduct with your child. We have listed a few resources at the bottom of the page.

Industry standards have indicated that many children find success in approximately 14 hours. In a recent study published in the Fall 2013 issue of eHearsay: Electronic Journal of the Ohio Speech-Language Hearing Association , a clinical study tested traditional speech therapy methods against a hand-held tactile tool (Speech Buddies). The results showed that students who used the tools showed improvements 33% faster than those using traditional speech therapy methods.

Regardless of the therapy you choose for your child’s articulation disorder, in particular the sound /r/, the overall prognosis is good with early intervention and treatment in treated in the initial years.

Online Speech Therapy Resources:

Net Connections for Speech Disorders and Sciences

Speaking of Speech

Pinterest Speech Therapy Ideas

Funky First Grade Fun 

Want to learn more about us? Visit:  Speech Buddies How It Works  or  watch our Speech Buddies YouTube Video.  

Help for the speech impediment R: Sound: When Should Parents Get More Help?

Help for the “r: sound: when should parents get more help.

Is your child saying Wabbit instead of Rabbit or Maw instead of More ? If your child’s language contains these and other mispronunciations of the R sound or a “speech impediment r” issue, we are sure that you have experienced some difficulty in trying to correct it.

The R sound is one the most common sounds in English! Surprising!  And it is also one of the final sounds that you children master, frequently not maturing until they are 6 or 7 years old.

Often, one of the reasons a speech impediment R issue continues in a child’s speech is because of this. Because the sound develops later, one typical misunderstanding is to do nothing: Parents often think: “It will just take care of itself.” In many circumstances, it may resolve on its own, but sometimes kids and parents need some extra help.

If a child does not get help in a timely manner, incorrect R pronunciation might have a cascading effect. Children may become more self-conscious of their speech, their spelling may be harmed (see all the second grade spelling lists with r-controlled vowels? ), and they may be more vulnerable to teasing.

There is a scientific and medical term for the phenomenon of mispronunciation of the R sound. It is called Rhotacism , which refers to the inability or difficulty in pronouncing the /r/ sound.

So how should parents know when it’s time to get the help of a speech therapist? In general, you can review these questions to help guide your decision about getting help for a speech impediment R issue:

• Is your child frustrated when they try to communicate?
• Is their speech hard to understand?
• Is your child being teased?
• Is your child older than the suggested age at which articulation problems should start to fade? (The /r/ sound should be mastered by the age of seven)

According to studies, 7.5 percent of school-aged kids have articulation problems , with the R sound proving particularly challenging. Because this sound occurs before and after vowel sounds, children would need to learn various combinations of the R sound rather than just the sound alone. The vowel that is next to an R has an impact on how sounds and how it is produced.

Here are some examples:

• AR as in far
• AIR as in hair
• EAR as in deer
• ER as in mother
• IRE as in fire
• OR as in more
• RL as in curl
• Prevocalic R as in race

What Should Parents Do for Speech Impediment R Issues?

The initial step should be an articulation evaluation by a professional speech-language pathologist (SLP). You should anticipate a speech therapist to work with you on therapy alternatives once you’ve been diagnosed. Weekly visits with homework and practice directions may be one of these choices.

An SLP will Use Visual Cues:

Giving your child visual cues might also help them learn how to pronounce the /r/ sound correctly. They’ll have to adjust the way they move their mouth to pronounce this sound. This is obviously easier said than done.

Using your arm to demonstrate proper tongue movement is one approach that a therapist can show you how to teach your child: Extend your arm in front of you, then bring it up and in toward your body. Explain to your child that they should make the same action with their tongue when trying to pronounce the /r/ sound.

R Therapy Should Be Fun!

You’ll need to find ways to make these speech therapy activities interesting for your child if you want them to continue with them long enough to see benefits.

Fortunately, learning the R sound is a lot of fun. You can practice getting rid of a speech impediment R issue by:

• Have your child act as if they are an animal. They can practice growling like a bear or roaring like a lion in a fun and enjoyable method to improve their /r/ noises.
• You can even have kids dress up like pirates and practice their “argh” sound while wearing an eye patch.

The general prognosis is very favorable with early intervention and treatment in the early years for a speech impediment r issue. If parents see that the sound is not produced correctly by around age 6 or 7, it may be time to get help from a speech therapist.

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Types of Speech Impediments

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Phynart Studio / Getty Images

Articulation Errors

Ankyloglossia, treating speech disorders.

A speech impediment, also known as a speech disorder , is a condition that can affect a person’s ability to form sounds and words, making their speech difficult to understand.

Speech disorders generally become evident in early childhood, as children start speaking and learning language. While many children initially have trouble with certain sounds and words, most are able to speak easily by the time they are five years old. However, some speech disorders persist. Approximately 5% of children aged three to 17 in the United States experience speech disorders.

There are many different types of speech impediments, including:

• Articulation errors

This article explores the causes, symptoms, and treatment of the different types of speech disorders.

Speech impediments that break the flow of speech are known as disfluencies. Stuttering is the most common form of disfluency, however there are other types as well.

Symptoms and Characteristics of Disfluencies

These are some of the characteristics of disfluencies:

• Repeating certain phrases, words, or sounds after the age of 4 (For example: “O…orange,” “I like…like orange juice,” “I want…I want orange juice”)
• Adding in extra sounds or words into sentences (For example: “We…uh…went to buy…um…orange juice”)
• Elongating words (For example: Saying “orange joooose” instead of "orange juice")
• Replacing words (For example: “What…Where is the orange juice?”)
• Hesitating while speaking (For example: A long pause while thinking)
• Pausing mid-speech (For example: Stopping abruptly mid-speech, due to lack of airflow, causing no sounds to come out, leading to a tense pause)

In addition, someone with disfluencies may also experience the following symptoms while speaking:

• Vocal tension and strain
• Head jerking
• Eye blinking
• Lip trembling

Causes of Disfluencies

People with disfluencies tend to have neurological differences in areas of the brain that control language processing and coordinate speech, which may be caused by:

• Genetic factors
• Trauma or infection to the brain
• Environmental stressors that cause anxiety or emotional distress
• Neurodevelopmental conditions like attention-deficit hyperactivity disorder (ADHD)

Articulation disorders occur when a person has trouble placing their tongue in the correct position to form certain speech sounds. Lisping is the most common type of articulation disorder.

Symptoms and Characteristics of Articulation Errors

These are some of the characteristics of articulation disorders:

• Substituting one sound for another . People typically have trouble with ‘r’ and ‘l’ sounds. (For example: Being unable to say “rabbit” and saying “wabbit” instead)
• Lisping , which refers specifically to difficulty with ‘s’ and ‘z’ sounds. (For example: Saying “thugar” instead of “sugar” or producing a whistling sound while trying to pronounce these letters)
• Omitting sounds (For example: Saying “coo” instead of “school”)
• Adding sounds (For example: Saying “pinanio” instead of “piano”)
• Making other speech errors that can make it difficult to decipher what the person is saying. For instance, only family members may be able to understand what they’re trying to say.

Causes of Articulation Errors

Articulation errors may be caused by:

• Genetic factors, as it can run in families
• Hearing loss , as mishearing sounds can affect the person’s ability to reproduce the sound
• Changes in the bones or muscles that are needed for speech, including a cleft palate (a hole in the roof of the mouth) and tooth problems
• Damage to the nerves or parts of the brain that coordinate speech, caused by conditions such as cerebral palsy , for instance

Ankyloglossia, also known as tongue-tie, is a condition where the person’s tongue is attached to the bottom of their mouth. This can restrict the tongue’s movement and make it hard for the person to move their tongue.

Symptoms and Characteristics of Ankyloglossia

Ankyloglossia is characterized by difficulty pronouncing ‘d,’ ‘n,’ ‘s,’ ‘t,’ ‘th,’ and ‘z’ sounds that require the person’s tongue to touch the roof of their mouth or their upper teeth, as their tongue may not be able to reach there.

Apart from speech impediments, people with ankyloglossia may also experience other symptoms as a result of their tongue-tie. These symptoms include:

• Difficulty breastfeeding in newborns
• Trouble swallowing
• Limited ability to move the tongue from side to side or stick it out
• Difficulty with activities like playing wind instruments, licking ice cream, or kissing
• Mouth breathing

Causes of Ankyloglossia

Ankyloglossia is a congenital condition, which means it is present from birth. A tissue known as the lingual frenulum attaches the tongue to the base of the mouth. People with ankyloglossia have a shorter lingual frenulum, or it is attached further along their tongue than most people’s.

Dysarthria is a condition where people slur their words because they cannot control the muscles that are required for speech, due to brain, nerve, or organ damage.

Symptoms and Characteristics of Dysarthria

Dysarthria is characterized by:

• Slurred, choppy, or robotic speech
• Rapid, slow, or soft speech
• Breathy, hoarse, or nasal voice

Additionally, someone with dysarthria may also have other symptoms such as difficulty swallowing and inability to move their tongue, lips, or jaw easily.

Causes of Dysarthria

Dysarthria is caused by paralysis or weakness of the speech muscles. The causes of the weakness can vary depending on the type of dysarthria the person has:

• Central dysarthria is caused by brain damage. It may be the result of neuromuscular diseases, such as cerebral palsy, Huntington’s disease, multiple sclerosis, muscular dystrophy, Huntington’s disease, Parkinson’s disease, or Lou Gehrig’s disease. Central dysarthria may also be caused by injuries or illnesses that damage the brain, such as dementia, stroke, brain tumor, or traumatic brain injury .
• Peripheral dysarthria is caused by damage to the organs involved in speech. It may be caused by congenital structural problems, trauma to the mouth or face, or surgery to the tongue, mouth, head, neck, or voice box.

Apraxia, also known as dyspraxia, verbal apraxia, or apraxia of speech, is a neurological condition that can cause a person to have trouble moving the muscles they need to create sounds or words. The person’s brain knows what they want to say, but is unable to plan and sequence the words accordingly.

Symptoms and Characteristics of Apraxia

These are some of the characteristics of apraxia:

• Distorting sounds: The person may have trouble pronouncing certain sounds, particularly vowels, because they may be unable to move their tongue or jaw in the manner required to produce the right sound. Longer or more complex words may be especially harder to manage.
• Being inconsistent in their speech: For instance, the person may be able to pronounce a word correctly once, but may not be able to repeat it. Or, they may pronounce it correctly today and differently on another day.
• Grasping for words: The person may appear to be searching for the right word or sound, or attempt the pronunciation several times before getting it right.
• Making errors with the rhythm or tone of speech: The person may struggle with using tone and inflection to communicate meaning. For instance, they may not stress any of the words in a sentence, have trouble going from one syllable in a word to another, or pause at an inappropriate part of a sentence.

Causes of Apraxia

Apraxia occurs when nerve pathways in the brain are interrupted, which can make it difficult for the brain to send messages to the organs involved in speaking. The causes of these neurological disturbances can vary depending on the type of apraxia the person has:

• Childhood apraxia of speech (CAS): This condition is present from birth and is often hereditary. A person may be more likely to have it if a biological relative has a learning disability or communication disorder.
• Acquired apraxia of speech (AOS): This condition can occur in adults, due to brain damage as a result of a tumor, head injury , stroke, or other illness that affects the parts of the brain involved in speech.

If you have a speech impediment, or suspect your child might have one, it can be helpful to visit your healthcare provider. Your primary care physician can refer you to a speech-language pathologist, who can evaluate speech, diagnose speech disorders, and recommend treatment options.

The diagnostic process may involve a physical examination as well as psychological, neurological, or hearing tests, in order to confirm the diagnosis and rule out other causes.

Treatment for speech disorders often involves speech therapy, which can help you learn how to move your muscles and position your tongue correctly in order to create specific sounds. It can be quite effective in improving your speech.

Children often grow out of milder speech disorders; however, special education and speech therapy can help with more serious ones.

For ankyloglossia, or tongue-tie, a minor surgery known as a frenectomy can help detach the tongue from the bottom of the mouth.

A Word From Verywell

A speech impediment can make it difficult to pronounce certain sounds, speak clearly, or communicate fluently. 

Living with a speech disorder can be frustrating because people may cut you off while you’re speaking, try to finish your sentences, or treat you differently. It can be helpful to talk to your healthcare providers about how to cope with these situations.

You may also benefit from joining a support group, where you can connect with others living with speech disorders.

National Library of Medicine. Speech disorders . Medline Plus.

Centers for Disease Control and Prevention. Language and speech disorders .

Cincinnati Children's Hospital. Stuttering .

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, and language .

Cleveland Clinic. Speech impediment .

Lee H, Sim H, Lee E, Choi D. Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms . J Commun Disord . 2017;65:54-64. doi:10.1016/j.jcomdis.2016.12.001

Nemours Foundation. Speech problems .

Penn Medicine. Speech and language disorders .

Cleveland Clinic. Tongue-tie .

University of Rochester Medical Center. Ankyloglossia .

Cleveland Clinic. Dysarthria .

National Institute on Deafness and Other Communication Disorders. Apraxia of speech .

Cleveland Clinic. Childhood apraxia of speech .

Stanford Children’s Hospital. Speech sound disorders in children .

Abbastabar H, Alizadeh A, Darparesh M, Mohseni S, Roozbeh N. Spatial distribution and the prevalence of speech disorders in the provinces of Iran . J Med Life . 2015;8(Spec Iss 2):99-104.

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Establishing New Treatment Directions For “Hard-To-Treat” Speech Sounds

Posted in: Communication Sciences Disorders

While most children outgrow common speech sound disorders — such as producing a “w” for an “r” — others persist in making speech sound errors, which can create academic and social issues that can persist for years.

Researchers Elaine Hitchcock of Montclair State University, Tara McAllister of New York University, and Jonathan Preston of Syracuse University, are working to change that.

Many people are aware that children with speech sound disorder exhibit atypical speech patterns that can result in reduced intelligibility. Speech intelligibility reflects how easily a child can be understood and poor speech intelligibility can pose a barrier to social and academic participation with potentially lifelong consequences for educational and occupational outcomes. Typically, delayed speech development resolves by 8-9 years old, but between 2-5% of children exhibit residual speech sound disorder (RSSD) which persists through adolescence. Children with RSSD commonly exhibit differences in phonological awareness, reading, and spelling. Differences in auditory perception of speech are also known to play a critical role in the development of typical speech production as well as literacy. This suggests that interventions enhancing auditory perception and providing feedback on the acoustics of speech errors could improve treatment outcomes for RSSD.

Consider Amanda Gorman, the Poet Laureate who spoke at the 2021 presidential inauguration. She clearly exemplifies a person with much to say, but who might not have always been understood. She describes having difficulty saying certain sounds, including “r” which she worked extremely hard to overcome with determination and hard work. But what if there were intervention techniques that decreased the challenge of acquiring difficult sounds such as “r”?

According to Hitchcock, McAllister and Preston, the use of acoustic and ultrasound biofeedback can significantly increase the accuracy of “r” pronunciation in children and adolescents, although few clinicians currently have access to this method as a means of speech sound intervention. Visual-acoustic biofeedback uses instrumentation to provide a real-time display of acoustic events such as formant patterns (Figure 1) and has been linked to positive outcomes in individuals with RSE who have not responded to previous intervention. Ultrasound biofeedback uses an ultrasound probe (Figure 2) – similar to ones used in cardiac and tissue imaging – which is held under the chin, and sound waves capture real-time images of the tongue. The images provide both the child and speech pathologist with information about the tongue’s position and shape.

Research suggests that visual biofeedback enhances the sensory experience of producing a sound like “r”. In addition to hearing the sound of speech, the child sees a visual display of her own speech and a model representing the correct pronunciation of the sound. The model creates a target. Using the visual display, the child can adjust her speech to achieve a better match with the target.

After a decade of testing these approaches with small scale studies, the research team has sufficient evidence to attribute the success of the treatment model to the unconventional approach it brings to the task of learning speech. In traditional methods, the clinician typically asks the child to imitate the “r” sound that they hear. However, many children who are unable to produce a clear “r” sound also have trouble hearing the difference between a clearly produced “r” and incorrect “r”. The theory is that biofeedback is successful because it bypasses that auditory channel. Even if the child can’t hear the difference between good and bad “r”, they can see whether they are matching the target on the screen. Matching the target lets them know if they are saying the “r” sound clearly.

Until recently, the research team was only able to offer these treatments via in-person services at Montclair, New York University or Syracuse University. Telepractice delivery of speech services has been increasing in recent years, with an explosive rise in the past two years due to the COVID-19 pandemic. Even after the pandemic subsides, a long-term shift toward greater use of telepractice is likely. Telepractice can improve flexibility for clients and clinicians and may be the only means for individuals in rural or underserved areas to access the services of a certified speech-language pathologist. Eliminating geographic barriers may also improve delivery of specialized services, such as visual biofeedback. Starting in February, 2022, both in-person and online treatment options using visual biofeedback are available for children ages 9-16.

Funded by the National Institutes of Health for in-person and online intervention options, the current research projects will meet a public health need by conducting the first randomized controlled trials comparing the efficacy and efficiency of speech intervention with and without real-time visual biofeedback. If you are interested in learning more about these research opportunities, please contact Elaine R. Hitchcock, PhD at [email protected] , Tara McAllister, PhD at [email protected] , or Jonathan Preston, PhD at [email protected] .

Why children have trouble making the ‘R’ sound, and when to call a therapist

How to tell if your child needs a speech therapist.

Learning to talk and communicate is an exciting time for toddlers and their parents, and it can be incredibly sweet to see how your little one’s speech advances over time. Anyone who has spent any time around little kids knows that it’s common for them to say “twuck” instead of “truck” and to struggle with other words that involve making that “R” sound.

• Why do kids have trouble with the “R” sound?

When do most kids learn the sound?

How can speech therapy help, does speech therapy cost money, how do i find a speech therapist for my child.

But what is it about the “R” sound that makes it so challenging? And how do you know whether this common speech issue will resolve itself, or if you need to seek help from a professional?

Why do kids have trouble with the “R” sound?

The formal name for difficulty with the “R” sound is “rhoticism,” and is so common among children partly because it’s hard for children to observe how the adults in their lives make that particular sound. When adults make other common sounds, such as “s” or “th,” babies can easily observe the position of their lips and tongue and mimic them. When we make “R” sounds, nothing about our mouths changes. That makes it a more challenging process of trial and error for young children to learn to make the proper sound.

According to Christine Ristuccia, a certified speech-language pathologist and the president of the organization Say it Right , it’s common for children to fail to master the “R” sound until kindergarten or after. She suggests that parents look at the “R” sound in the broader context of their child’s speech.

A 3-year-old who substitutes the “W” sound where the “R” should be is not a cause for concern if his speech is mostly intelligible; a three-year-old whose speech is unintelligible to anyone but his parents likely needs early intervention. By second grade, when they’re between 7 and 8 years old, children should have mastered the sound.

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Ristuccia notes that children who are still struggling with the sound in second grade may have other adverse effects if they don’t get help. She writes that these children “may become more self-conscious of their speech, spelling may be affected adversely (notice all the second-grade spelling lists with R-controlled vowels?), and they may be open to teasing, resulting in a withdrawal from participation in discussions and activities.”

Meredith Avren, a speech and language pathologist from the speech therapy company Peachie Speechie, explains the various methods that speech therapists can use to help children learn to master this tricky sound. Speech-language pathologists may use tools like a “mouth puppet” to visually show children where to place their tongues and then have children make Play-Doh models of their own tongues to show the proper placement when making the “R” sound. (The website TeachersPayTeachers includes some examples of worksheets, showing the different tongue shapes.) She also uses tools like dental floss picks and lollipops to help children understand and remember how to place their tongue in order to differentiate between “R” and “W.”

Some parents might be intimidated by the price tag of speech therapy, and thus keep crossing their fingers and waiting for the problem to resolve on its own. And private speech therapy can be expensive. A certified speech and language pathologist can charge anywhere from $100 to $250 an hour. The good news, however, is that speech therapy can often be covered by medical insurance, including Medicaid.

If a child is school-aged, a parent may request that her child be evaluated for an IEP (Individualized Education Plan). If the child’s IEP mandates that they receive speech therapy services, the public school district is required to ensure that the child gets provided that service at no cost to the parents. While it can often be an uphill battle for parents to ensure that their child receives all the mandated services in their IEP, a school’s failure to do so is a violation of federal law.

It may seem a little overwhelming to find a speech therapist for your child, but it doesn’t have to be. If you’re concerned that your child’s speech isn’t developing as it should, ask your doctor for a recommendation for a trusted speech therapist. If your child is in preschool or school, their teacher will probably be able to refer you to someone as well.

You can also check the ASHA (American Speech-Language-Hearing Association) website for speech therapist’s near you. If your child does suffer from rhotacism, treating it early can eradicate the issue. In short, if your four-year-old is still calling the fairy tale “Wittle Wed Widing Hood,” it’s probably too early to seek professional help; by the time they’re six, they might be “R”-ing like a pirate just from having a few more years of practice.

But if your 7- to 8-year-old child is still pronouncing her “R’s” as the “W” sound, or if you notice that your 3- to 5-year-old has numerous mispronunciations or that teachers and other adults struggle to understand them, it may be time to look into getting your child evaluated for speech services. A speech evaluation can help pinpoint the problems and recommend the necessary services to ensure that your child will grow up to be a confident speaker whose mispronunciations are just a cute childhood memory.

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Speech Impediment Guide: Definition, Causes, and Resources

December 8, 2020 

Tables of Contents

What Is a Speech Impediment?

Types of speech disorders, speech impediment causes, how to fix a speech impediment, making a difference in speech disorders.

Communication is a cornerstone of human relationships. When an individual struggles to verbalize information, thoughts, and feelings, it can cause major barriers in personal, learning, and business interactions.

Speech impediments, or speech disorders, can lead to feelings of insecurity and frustration. They can also cause worry for family members and friends who don’t know how to help their loved ones express themselves.

Fortunately, there are a number of ways that speech disorders can be treated, and in many cases, cured. Health professionals in fields including speech-language pathology and audiology can work with patients to overcome communication disorders, and individuals and families can learn techniques to help.

Commonly referred to as a speech disorder, a speech impediment is a condition that impacts an individual’s ability to speak fluently, correctly, or with clear resonance or tone. Individuals with speech disorders have problems creating understandable sounds or forming words, leading to communication difficulties.

Some 7.7% of U.S. children — or 1 in 12 youths between the ages of 3 and 17 — have speech, voice, language, or swallowing disorders, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). About 70 million people worldwide, including some 3 million Americans, experience stuttering difficulties, according to the Stuttering Foundation.

Common signs of a speech disorder

There are several symptoms and indicators that can point to a speech disorder.

• Unintelligible speech — A speech disorder may be present when others have difficulty understanding a person’s verbalizations.
• Omitted sounds — This symptom can include the omission of part of a word, such as saying “bo” instead of “boat,” and may include omission of consonants or syllables.
• Added sounds — This can involve adding extra sounds in a word, such as “buhlack” instead of “black,” or repeating sounds like “b-b-b-ball.”
• Substituted sounds — When sounds are substituted or distorted, such as saying “wabbit” instead of “rabbit,” it may indicate a speech disorder.
• Use of gestures — When individuals use gestures to communicate instead of words, a speech impediment may be the cause.
• Inappropriate pitch — This symptom is characterized by speaking with a strange pitch or volume.

In children, signs might also include a lack of babbling or making limited sounds. Symptoms may also include the incorrect use of specific sounds in words, according to the American Speech-Language-Hearing Association (ASHA). This may include the sounds p, m, b, w, and h among children aged 1-2, and k, f, g, d, n, and t for children aged 2-3.

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Categories of Speech Impediments

Speech impediments can range from speech sound disorders (articulation and phonological disorders) to voice disorders. Speech sound disorders may be organic — resulting from a motor or sensory cause — or may be functional with no known cause. Voice disorders deal with physical problems that limit speech. The main categories of speech impediments include the following:

Fluency disorders occur when a patient has trouble with speech timing or rhythms. This can lead to hesitations, repetitions, or prolonged sounds. Fluency disorders include stuttering (repetition of sounds) or   (rapid or irregular rate of speech).

Resonance disorders are related to voice quality that is impacted by the shape of the nose, throat, and/or mouth. Examples of resonance disorders include hyponasality and cul-de-sac resonance.

Articulation disorders occur when a patient has difficulty producing speech sounds. These disorders may stem from physical or anatomical limitations such as muscular, neuromuscular, or skeletal support. Examples of articulation speech impairments include sound omissions, substitutions, and distortions.

Phonological disorders result in the misuse of certain speech sounds to form words. Conditions include fronting, stopping, and the omission of final consonants.

Voice disorders are the result of problems in the larynx that harm the quality or use of an individual’s voice. This can impact pitch, resonance, and loudness.

Impact of Speech Disorders

Some speech disorders have little impact on socialization and daily activities, but other conditions can make some tasks difficult for individuals. Following are a few of the impacts of speech impediments.

• Poor communication — Children may be unable to participate in certain learning activities, such as answering questions or reading out loud, due to communication difficulties. Adults may avoid work or social activities such as giving speeches or attending parties.
• Mental health and confidence — Speech disorders may cause children or adults to feel different from peers, leading to a lack of self-confidence and, potentially, self-isolation.

Resources on Speech Disorders

The following resources may help those who are seeking more information about speech impediments.

Health Information : Information and statistics on common voice and speech disorders from the NIDCD

Speech Disorders : Information on childhood speech disorders from Cincinnati Children’s Hospital Medical Center

Speech, Language, and Swallowing : Resources about speech and language development from the ASHA

Children and adults can suffer from a variety of speech impairments that may have mild to severe impacts on their ability to communicate. The following 10 conditions are examples of specific types of speech disorders and voice disorders.

1. Stuttering

This condition is one of the most common speech disorders. Stuttering is the repetition of syllables or words, interruptions in speech, or prolonged use of a sound.

This organic speech disorder is a result of damage to the neural pathways that connect the brain to speech-producing muscles. This results in a person knowing what they want to say, but being unable to speak the words.

This consists of the lost ability to speak, understand, or write languages. It is common in stroke, brain tumor, or traumatic brain injury patients.

4. Dysarthria

This condition is an organic speech sound disorder that involves difficulty expressing certain noises. This may involve slurring, or poor pronunciation, and rhythm differences related to nerve or brain disorders.

The condition of lisping is the replacing of sounds in words, including “th” for “s.” Lisping is a functional speech impediment.

6. Hyponasality

This condition is a resonance disorder related to limited sound coming through the nose, causing a “stopped up” quality to speech.

7. Cul-de-sac resonance

This speech disorder is the result of blockage in the mouth, throat, or nose that results in quiet or muffled speech.

8. Orofacial myofunctional disorders

These conditions involve abnormal patterns of mouth and face movement. Conditions include tongue thrusting (fronting), where individuals push out their tongue while eating or talking.

9. Spasmodic Dysphonia

This condition is a voice disorder in which spasms in the vocal cords produce speech that is hoarse, strained, or jittery.

10. Other voice disorders

These conditions can include having a voice that sounds breathy, hoarse, or scratchy. Some disorders deal with vocal folds closing when they should open (paradoxical vocal fold movement) or the presence of polyps or nodules in the vocal folds.

Speech Disorders vs. Language Disorders

Speech disorders deal with difficulty in creating sounds due to articulation, fluency, phonology, and voice problems. These problems are typically related to physical, motor, sensory, neurological, or mental health issues.

Language disorders, on the other hand, occur when individuals have difficulty communicating the meaning of what they want to express. Common in children, these disorders may result in low vocabulary and difficulty saying complex sentences. Such a disorder may reflect difficulty in comprehending school lessons or adopting new words, or it may be related to a learning disability such as dyslexia. Language disorders can also involve receptive language difficulties, where individuals have trouble understanding the messages that others are trying to convey.  

Resources on Types of Speech Disorders

The following resources may provide additional information on the types of speech impediments.

Common Speech Disorders: A guide to the most common speech impediments from GreatSpeech

Speech impairment in adults: Descriptions of common adult speech issues from MedlinePlus

Stuttering Facts: Information on stuttering indications and causes from the Stuttering Foundation

Speech disorders may be caused by a variety of factors related to physical features, neurological ailments, or mental health conditions. In children, they may be related to developmental issues or unknown causes and may go away naturally over time.

Physical and neurological issues. Speech impediment causes related to physical characteristics may include:

• Brain damage
• Nervous system damage
• Respiratory system damage
• Hearing difficulties
• Cancerous or noncancerous growths
• Muscle and bone problems such as dental issues or cleft palate

Mental health issues. Some speech disorders are related to clinical conditions such as:

• Autism spectrum disorder
• Down syndrome or other genetic syndromes
• Cerebral palsy or other neurological disorders
• Multiple sclerosis

Some speech impairments may also have to do with family history, such as when parents or siblings have experienced language or speech difficulties. Other causes may include premature birth, pregnancy complications, or delivery difficulties. Voice overuse and chronic coughs can also cause speech issues.

The most common way that speech disorders are treated involves seeking professional help. If patients and families feel that symptoms warrant therapy, health professionals can help determine how to fix a speech impediment. Early treatment is best to curb speech disorders, but impairments can also be treated later in life.

Professionals in the speech therapy field include speech-language pathologists (SLPs) . These practitioners assess, diagnose, and treat communication disorders including speech, language, social, cognitive, and swallowing disorders in both adults and children. They may have an SLP assistant to help with diagnostic and therapy activities.

Speech-language pathologists may also share a practice with audiologists and audiology assistants. Audiologists help identify and treat hearing, balance, and other auditory disorders.

How Are Speech Disorders Diagnosed?

Typically, a pediatrician, social worker, teacher, or other concerned party will recognize the symptoms of a speech disorder in children. These individuals, who frequently deal with speech and language conditions and are more familiar with symptoms, will recommend that parents have their child evaluated. Adults who struggle with speech problems may seek direct guidance from a physician or speech evaluation specialist.

When evaluating a patient for a potential speech impediment, a physician will:

• Conduct hearing and vision tests
• Evaluate patient records
• Observe patient symptoms

A speech-language pathologist will conduct an initial screening that might include:

• An evaluation of speech sounds in words and sentences
• An evaluation of oral motor function
• An orofacial examination
• An assessment of language comprehension

The initial screening might result in no action if speech symptoms are determined to be developmentally appropriate. If a disorder is suspected, the initial screening might result in a referral for a comprehensive speech sound assessment, comprehensive language assessment, audiology evaluation, or other medical services.

Initial assessments and more in-depth screenings might occur in a private speech therapy practice, rehabilitation center, school, childcare program, or early intervention center. For older adults, skilled nursing centers and nursing homes may assess patients for speech, hearing, and language disorders.

How Are Speech Impediments Treated?

Once an evaluation determines precisely what type of speech sound disorder is present, patients can begin treatment. Speech-language pathologists use a combination of therapy, exercise, and assistive devices to treat speech disorders.

Speech therapy might focus on motor production (articulation) or linguistic (phonological or language-based) elements of speech, according to ASHA. There are various types of speech therapy available to patients.

Contextual Utilization  — This therapeutic approach teaches methods for producing sounds consistently in different syllable-based contexts, such as phonemic or phonetic contexts. These methods are helpful for patients who produce sounds inconsistently.

Phonological Contrast — This approach focuses on improving speech through emphasis of phonemic contrasts that serve to differentiate words. Examples might include minimal opposition words (pot vs. spot) or maximal oppositions (mall vs. call). These therapy methods can help patients who use phonological error patterns.

Distinctive Feature — In this category of therapy, SLPs focus on elements that are missing in speech, such as articulation or nasality. This helps patients who substitute sounds by teaching them to distinguish target sounds from substituted sounds.

Core Vocabulary — This therapeutic approach involves practicing whole words that are commonly used in a specific patient’s communications. It is effective for patients with inconsistent sound production.

Metaphon — In this type of therapy, patients are taught to identify phonological language structures. The technique focuses on contrasting sound elements, such as loud vs. quiet, and helps patients with unintelligible speech issues.

Oral-Motor — This approach uses non-speech exercises to supplement sound therapies. This helps patients gain oral-motor strength and control to improve articulation.

Other methods professionals may use to help fix speech impediments include relaxation, breathing, muscle strengthening, and voice exercises. They may also recommend assistive devices, which may include:

• Radio transmission systems
• Personal amplifiers
• Picture boards
• Touch screens
• Text displays
• Speech-generating devices
• Hearing aids
• Cochlear implants

Resources for Professionals on How to Fix a Speech Impediment

The following resources provide information for speech therapists and other health professionals.

Assistive Devices: Information on hearing and speech aids from the NIDCD

Information for Audiologists: Publications, news, and practice aids for audiologists from ASHA

Information for Speech-Language Pathologists: Publications, news, and practice aids for SLPs from ASHA

Speech Disorder Tips for Families

For parents who are concerned that their child might have a speech disorder — or who want to prevent the development of a disorder — there are a number of activities that can help. The following are tasks that parents can engage in on a regular basis to develop literacy and speech skills.

• Introducing new vocabulary words
• Reading picture and story books with various sounds and patterns
• Talking to children about objects and events
• Answering children’s questions during routine activities
• Encouraging drawing and scribbling
• Pointing to words while reading books
• Pointing out words and sentences in objects and signs

Parents can take the following steps to make sure that potential speech impediments are identified early on.

• Discussing concerns with physicians
• Asking for hearing, vision, and speech screenings from doctors
• Requesting special education assessments from school officials
• Requesting a referral to a speech-language pathologist, audiologist, or other specialist

When a child is engaged in speech therapy, speech-language pathologists will typically establish collaborative relationships with families, sharing information and encouraging parents to participate in therapy decisions and practices.

SLPs will work with patients and their families to set goals for therapy outcomes. In addition to therapy sessions, they may develop activities and exercises for families to work on at home. It is important that caregivers are encouraging and patient with children during therapy.  

Resources for Parents on How to Fix a Speech Impediment

The following resources provide additional information on treatment options for speech disorders.

Speech, Language, and Swallowing Disorders Groups: Listing of self-help groups from ASHA

ProFind: Search tool for finding certified SLPs and audiologists from ASHA

Baby’s Hearing and Communication Development Checklist: Listing of milestones that children should meet by certain ages from the NIDCD

If identified during childhood, speech disorders can be corrected efficiently, giving children greater communication opportunities. If left untreated, speech impediments can cause a variety of problems in adulthood, and may be more difficult to diagnose and treat.

Parents, teachers, doctors, speech and language professionals, and other concerned parties all have unique responsibilities in recognizing and treating speech disorders. Through professional therapy, family engagement, positive encouragement and a strong support network, individuals with speech impediments can overcome their challenges and develop essential communication skills.

Additional Sources

American Speech-Language-Hearing Association, Speech Sound Disorders

Identify the Signs, Signs of Speech and Language Disorders

Intermountain Healthcare, Phonological Disorders

MedlinePlus, Speech disorders – children

National Institutes of Health, National Institutes on Deafness and Other Communication Disorders, “Quick Statistics About Voice, Speech, Language”

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Common Speech Impediments: Causes, Symptoms, Treatment, And Support

Speech impediments include a variety of both language and speech disorders, some of which can be addressed through  online speech therapy  with speech-language pathologists. They can arise because of heredity and genetics, developmental delays, or even damage to Broca’s area—the part of the brain that’s involved in language skills and speech skills. They may also be linked to other conditions like autism spectrum disorder, cerebral palsy, dyslexia, or even hearing loss. It depends on the type and the cause, but most speech impediments and speech impairments can be treated through speech therapy.

That said, recognizing when a speech impediment may be present can help you get yourself or your child the treatment and support they may need for improved academic and/or social functioning and self-confidence.

Common symptoms of a speech impediment

There are many different types of speech impediments a person can have, so the symptoms can vary. That said, those listed below are common symptoms that could be initial indicators that you or your child may be experiencing speech problems or challenges:

• Elongating words
• Quiet or muffled speech
• Blinking frequently
• Distorted sounds while talking
• Frequent changes in pitch
• Poor voice quality
• Visible frustration when trying to communicate
• Overall difficulty communicating and expressing thoughts and ideas
• Inability to repeat words
• Inability to pronounce words the same way twice
• A phobia of speaking in public
• Speaking slowly and carefully
• Speech delay
• Frequent pauses when talking
• Limited vocabulary over several years, delayed language development

Some speech and language disorders are consistent with underlying mental health conditions such as autism. You can visit licensed health professionals or speech therapists to receive an accurate diagnosis and find out how to treat a speech impediment or language disorder, and its underlying cause, if applicable.

Key categories of speech impediments

Speech impediments or communication disorders can take many forms, from speech sound disorders to voice-related disorders. While speech sound disorders mostly result from sensory or motor causes, voice-related disorders deal with physical problems regarding speech. Read on for a list of some of the most common categories of speech impediments.

Voice disorders

Voice disorders  primarily arise due to issues regarding the health and structure of the larynx or the voice box. They can impact pitch, resonance, volume, and voice quality. Symptoms of a voice disorder may include having a hoarse, quivering, strained, choppy, or weak and whispery voice, which can make it difficult to produce speech sounds.

The root cause of these disorders can be either organic, like alterations to respiratory, laryngeal, or vocal tract mechanisms, or functional, like improper use of the voice. Some risk factors that may contribute to vocal health challenges include allergies, psychological stress, age, excessive alcohol or drug use, screaming, scarring from neck surgery, or even gastroesophageal reflux disease (GERD). Examples of voice disorders include laryngitis, vocal cord paralysis/weakness, polyps or nodes present on the vocal cords, leukoplakia, or muscle tension dysphonia.

Fluency disorders

A person may be diagnosed with a fluency disorder if they have trouble with speech timing and rhythm which makes it difficult to create a normal speech pattern. These disorders are characterized by interruptions in the typical flow of speaking, including abnormal repetitions, hesitation, and prolongations. Their cause is unknown, but it may be genetic. Symptoms can also be exacerbated by stress and anxiety. Stuttering is the most common example of fluency disorders. 

Symptoms of a fluency disorder may include dragging out syllables, speaking breathlessly, repetition of words, speaking slowly, and being tense while speaking. Secondary symptoms may include fidgeting, mumbling, saying “um” or “uh” often, not using certain problematic words, rearranging words in sentences, and anxiety around speaking. Treatment options vary depending on the specific disorder. With stuttering, for example, slowing down, practicing, using speech monitors, attending speech therapy, and receiving cognitive behavioral therapy (CBT) are all potential treatment options.

Articulation disorders and phonological disorders

Articulation and phonological disorders are two types of speech disorders classified as speech sound disorders that may impact communication. An articulation disorder includes speech that commonly exhibits errors such as substitution, omission, distortion, and/or addition (SODA). Although the actual causes of articulation disorders aren’t well understood, contributing factors may include brain injuries, a cleft palate/cleft lip, or nerve damage. Phonological disorders typically involve producing sounds correctly but using them in the wrong place and are more predictable than articulation errors. There may also be a genetic factor that contributes to both disorders and other families may be impacted as well. A licensed speech-language pathologist (SLP) can determine if an individual may have an articulation disorder or a phonological disorder. Ongoing speech therapy is typically the recommended treatment method.

Speech impediments versus language impairments

A speech impediment is typically characterized by difficulty creating sound due to factors like fluency disorders or other voice problems. These disorders may arise from underlying mental health issues, neurological problems, or physical factors or conditions impacting speech muscles.

Language impairments, on the other hand, are more about difficulty processing, reading, and writing and can be connected to an issue processing receptive language. They’re common in children, especially when they first start school. Language impairments relate to meaning, whereas speech impediments relate to sound. It’s also very common for a language impairment disorder to present alongside a learning disability like dyslexia.

Examples of speech impediments

Below is a brief overview of a few of the most common speech disorders and speech impediments, along with symptoms and potential treatment options.

Apraxia  of speech is a speech sound disorder that affects the pathways of the brain. It’s characterized by a person having difficulty expressing their thoughts accurately and consistently. It involves the brain being able to form the words and knowing exactly what to say, but the person then being unable to properly execute the required speech movements to deliver accurate sounds. In mild cases, a person will only have small limitations in their ability to form speech sounds. In severe cases, alternate communication methods may need to be used.

An SLP is the type of provider who can diagnose apraxia. To diagnose speech disorders, including both childhood apraxia (sometimes called verbal apraxia) and acquired apraxia, they may ask the individual to perform simple speech tasks like repeating a particular word several times or repeating a list of words that increase in length. Apraxia generally needs to be monitored by both parents and an SLP over time for an accurate diagnosis to be possible.

There are various treatment options for apraxia, the most common being one-on-one meetings with a speech pathologist. They’ll likely help you or your child build helpful strategies and skills to help strengthen problem areas and communicate more clearly. Some other treatment methods include improving speech intelligibility or using alternate forms of communication, like electronic speech or manual signs and gestures.

The National Institute on Deafness and Other Communication Disorders describes aphasia as a communication disorder that results in a person’s inability to speak, write, and/or understand language. Like other communication disorders, it may occur because of damage to the portions of the brain that are involved in language, which is common in those who have experienced a stroke. It may also come on gradually in those who have a tumor or a progressive neurological disease like Alzheimer’s. Symptoms may include saying or writing sentences that don’t make sense, a reduction in a person’s ability to understand a conversation, and substituting certain sounds and words for others.

Since this disorder is usually caused by damage to parts of the brain, it will typically first be recognized in an MRI or CT scan that can confirm the presence of a brain injury. The extent and type of aphasia can generally only be determined by observing the affected part of the brain and determining how extensively it has been damaged, which is often done with the help of an SLP.

Treatment options for aphasia can be restorative (aimed at restoring impaired function) or compensatory (aimed at compensating for deficits).

Dysarthria 

Dysarthria is usually caused by brain damage or facial paralysis that affects the muscles of the jaw, tongue, or throat, which may result in deficits in a person’s speech. It may also be caused by other conditions like Lou Gehrig’s disease, Parkinson’s, or a stroke. It’s considered a nervous system disorder, subclassified as a motor speech disorder. It’s commonly seen in those who already have other speech disorders, such as aphasia or apraxia. Symptoms of dysarthria include slurred speech, speaking too slowly, speaking too quickly, speaking very softly, being unable to move one’s lips or jaw, and having monotonous speech.

Dysarthria can be diagnosed by an expert in speech-language pathology through an exam and tests like MRI, CT, electromyography, or the Denver articulation screening examination. Treatment depends upon the severity and rate of progression of the disorder. Some potential examples include tactics like slowing down while talking, doing exercises to help strengthen jaw muscles, moving the lips and tongue more, and learning strategies for speaking more loudly. Hand gestures and speech machines may also help. 

The importance of treatment

It is important to treat speech disorders; the consequences of an untreated speech or language impediment can vary widely depending on the type, symptoms, and severity, as well as the age and life situation of the individual. In general, it’s usually helpful to seek professional advice on treating speech disorders as soon as you notice or suspect an impediment present in yours or your child’s speech. Especially for moderate to severe cases, some potential effects of leaving these common speech disorders untreated can include:

• Poor academic performance/dropping out of school
• Decrease in quality of life
• Social anxiety and an inability to connect with people
• Damaged relationships
• Social isolation
• Hospitalization

Seeking professional support

Meeting with an SLP is usually the recommended first step for someone who believes they or their child may have a speech impediment. If you have a teenager with dyslexia, there are  resources for dyslexic teens  that can give supportive information about the condition. Healthcare providers may also provide helpful insights and ask about your family members’ history when it comes to speech and language-related issues as they can be hereditary. While these professionals can help with the physical aspects of a variety of speech and language impediments, you or your child may also benefit from emotional support in relation to the mental health effects of having an impediment. A therapist may be able to provide this type of guidance. If your child is experiencing a speech impediment, a counselor may be able to work with them to process their feelings of frustration and learn healthy coping mechanisms for stress. They can help you manage the same feelings if you receive a speech or language impediment diagnosis, or may be able to support you in your journey of parenting a child with a speech or language impediment diagnosis.

In addition to support at home, teenagers with a diagnosed speech impairment or impediment can receive special education services at school. The Centers for Disease Control notes that under the Individuals with Disabilities Act (IDEA) and Section 504, schools must provide support and accommodations for students with speech disorders. For some children, support groups can provide outlets for social connections and advice for coping. 

Meeting with a therapist in person is an option if there are providers in your area. That said, many people find it less intimidating or more comfortable to meet with a therapist virtually. For example, a teen who is experiencing a speech or language impediment may feel better interacting with a counselor through the online chat feature that virtual therapy platforms like TeenCounseling provide. It may allow them to express themselves more clearly than they could face-to-face or over the phone. Parents who need support in caring for a child with a speech or language impediment may find the availability and convenience of meeting with a therapist through an online therapy service like BetterHelp to be most beneficial. Research suggests that online and in-person therapy offer similar benefits for a variety of conditions, so you can choose the format that’s best for you.

Counselor reviews

See below for reviews of TeenCounseling therapists written by parents who sought help for their children through this service. 

“Kathleen has been good for my daughter to talk to. I am thankful for her to give my daughter someone else's perspective other than her parents. Thank you.”

“I love Ms. Jones. She doesn’t over-talk or judge you. She gives really good advice and if you're confused she knows how to break it down or explain whatever it is so you can understand. If you need to talk about anything, she’s always an open ear and responds quickly. Not only does she give you points from others' perspectives but she steps into yours so she can understand why certain things are the way they are. In my first session, I was nervous and I think she could tell. She’ll crack a joke every now and then to make me feel more comfortable. She’s just such a bundle of joy and a good counselor to have.”

Speech and language impediments can vary widely in terms of types, causes, symptoms, and severity. These are diagnosed by professionals in the field of speech and language pathology or by a medical doctor. A therapist can provide emotional support for those who are having difficulty coping with their own or their child’s diagnosis or other related challenges. 

What are the 3 speech impediments?

Speech impediments can manifest in a variety of ways. Three of the most common are listed below: 

• Voice disorders affect the tone, pitch, quality, and volume of a person’s voice. A person with a voice disorder may have difficulty speaking or being heard clearly by others. Voice disorders can be either functional or organic. Functional disorders occur due to improper use of the parts of the throat that produce speech, such as overuse of the voice leading to vocal fatigue. Organic voice disorders result from physical anatomical changes, such as nodules on the vocal cords. 
• Fluency disorders affect the rate, rhythm, and cadence of speech. Those with fluency disorders may speak in a disjointed, choppy, or prolonged fashion, making them difficult for others to understand clearly. While many types of fluency disorders exist, stuttering is likely the best-known. Speech often requires precise timing to convey a message accurately, which fluency disorders can disrupt. 
• Speech sound disorders are a broad category of disorders that interferes with a person’s ability to produce sounds and words correctly. Speech sound disorders can present very differently from person to person. Sometimes word sounds are omitted or added where not appropriate, and sometimes word sounds are distorted or substituted completely. A typical example of a speech sound disorder is the substitution of “r” for “w” in words like “rabbit” (becoming “wabbit”). Many children experience that substitution, but it does not become a disorder until the child does not outgrow it. 

Other types of disorders can cause problems with expressive communication or tongue-tie those experiencing them, such as developmental language disorder . Language disorders also cause concerns related to expressive communication, but the concerns are due to a lack of understanding of one or more components of language , not an inability to produce or use word sounds. 

What do you call a speech impediment?

Speech impediments are typically referred to as speech disorders . Speech refers to the ability to form speech sounds using the vocal cords, mouth, lips, and tongue. Speech also requires that a rhythm and cadence be maintained. Speech disorders indicate a problem producing intelligible speech; word sounds may be omitted or misplaced, the rhythm of the speech may be difficult to follow, or a person’s voice might be strangely pitched or too soft to hear clearly. 

It is important not to confuse speech disorders with language disorders . Language disorders arise due to difficulty understanding what words mean, how word sounds fit together, or how to use spoken language to communicate. Language problems may affect how a person speaks, but the root cause of the concern is linked to their understanding of language, not their ability to produce intelligible speech. 

How do I know if I have a speech impediment?

If you’re experiencing a sudden onset of impaired speech with no apparent cause, seek medical attention immediately. Strokes, traumatic brain injuries, and other serious medical conditions can cause sudden changes in speaking ability. Gradual changes in speaking ability may also indicate an underlying medical problem. If you’re concerned that your speaking ability has been gradually deteriorating, consider making an appointment with a healthcare provider in the near future. 

Most people with a speech disorder are diagnosed in childhood. Parents often identify speech-related concerns in early childhood based on their child’s speech patterns. The child’s pediatrician may also refer the child to a speech-language pathologist, a professional specializing in evaluating and treating speech disorders. If problems persist until the child is in school, teachers and other school officials might initiate a referral for an evaluation if they believe speech concerns are present. Children often receive speech and language therapy that resolves or improves their speech problems. 

Speech disorders also appear in adulthood, often due to injury or illness. It is also possible, although rare, for speech problems to be misdiagnosed or missed outright during a person’s childhood. In that case, the speech disorder may have been present since childhood and symptoms persisted into adulthood.

If you’re finding it difficult to communicate verbally with others, have an easily identifiable speech problem (like stuttering), or receive feedback that others have trouble understanding you, consider making an appointment with your doctor for an evaluation and referral to the appropriate healthcare providers. 

What are 5 causes of speech impairment?

Speech and language disorders can result from conditions that interfere with the development of perceptual, structural, motor, cognitive, or socioemotional functions. The cause of many speech disorders is unknown, but research has indicated several underlying factors that may be responsible: 

• Pre-existing genetic conditions, like Down’s syndrome or Fragile X syndrome. Evidence suggests that genes may play a role even if genetic abnormalities do not result in a diagnosable genetic condition. 
• Physical abnormalities, such as damage or improper development of the respiratory system, facial muscles, or cranial nerves. 
• Hearing problems, which can delay a child’s acquisition of speech. 
• Neurodevelopmental disorders, such as autism spectrum disorder, may interfere with speech development. There is also evidence to suggest that those with attention-deficit hyperactivity disorder may have a more challenging time acquiring speech skills. 
• Neurological conditions such as cerebral palsy. 

Mental health concerns can also cause problems communicating with others. For example, an underlying anxiety disorder may lead to selective mutism , wherein a child speaks only under certain circumstances. 

Is speech impediment a disability?

A speech-language disorder is considered a “ communication disability ” under the Americans with Disabilities Act (ADA). The ADA requires government and businesses to establish “effective communication” with people who have communication disabilities. Effective communication can be established in several ways. For those with a speech disorder, accommodation may be as simple as ensuring the person can get hold of writing materials if they need to express themselves quickly. In some cases, organizations may use a transliterator, or person trained to recognize unclear speech and repeat it clearly. 

Because speech disorders are known to lead to academic struggles in K-12 and higher education settings, they are categorized as a disability under the Individuals with Disabilities Education Improvement Act (IDEIA) . The IDEIA sets guidelines for all schools in the United States, public or not public, guaranteeing each child a right to accommodations and interventions for their speech disorder. 

Can I fix my speech impediment?

Whether or not a speech disorder can be completely eliminated depends heavily on individual factors. The cause of the disorder, its severity, and the type of speech dysfunction all play a role in determining whether a particular disorder can be completely resolved. While it is not possible to guarantee that a speech disorder can be “cured,” nearly all disorders are treatable, and improvement is likely possible. 

Can you treat a speech impediment?

Yes, many speech disorders are highly treatable. Most people receive treatment as children when most speech disorders become apparent. For children, speech-language pathologists will identify the specific speech disorder, search for an underlying cause, and design an intervention that targets that child’s speech problem. For example, a child who struggles with articulation errors and producing word sounds consistently may benefit from a contextual utilization approach . Contextual utilization leverages the fact that one sound is easier or more difficult to pronounce depending on which other sounds surround it. 

Speech disorders that emerge in adulthood may be more challenging to treat due to underlying factors, such as brain injury. Suppose an adult experiences a traumatic brain injury that affects their speaking ability. In that case, a speech-language pathologist may help them find alternative communication methods, such as using a computer. They may also help them directly restore some of their speaking ability by leading them through exercises that improve nerve function and muscle control.  

Is a speech impediment mental?

Speech disorders can be caused by various factors, many of which have nothing to do with the brain. However, there is a relationship between psychiatric mental health concerns and difficulty with spoken communication . Although researchers are still unsure of the exact cause, studies have identified a significant link between speech disorders and mental health disorders like schizophrenia, bipolar disorder, and major depression. 

Neurodevelopmental disorders, such as autism spectrum disorder and attention-deficit hyperactivity disorder, are also associated with an increased risk of developing a speech disorder. Although the link between neurodevelopmental disorders and speech disorders is not fully understood, evidence suggests that treating the speech disorder is still possible. 

Finally, speech disorders can also be caused by illness or injury in the brain, such as cancer, an infection, or traumatic brain injury. Although these are not considered mental or developmental disorders, they may affect brain function and mental acuity. Speaking is a complex process, and there are many ways it can be affected. 

Is autism a speech impediment?

Autism spectrum disorder is not a speech disorder, but it is heavily associated with communication problems. Those on the autism spectrum often use repetitive or rigid language and may not follow communication norms. They may repeat phrases continuously, use a modified tone of voice, or introduce information that has little to do with the conversation at hand. 

Those on the autism spectrum are often able to form word sounds properly. The communication deficits of autism spectrum disorder are more closely related to language disorders than speech disorders. Speech disorders are associated with difficulty producing or using word sounds correctly, whereas language disorders are associated with a lack of understanding of one or more language components.

Autism spectrum disorder is also characterized by difficulties using pragmatic communication , or communication that is appropriate to a specific social situation. Although not a disorder of speech, a limited ability to recognize the socioemotional content of speech can significantly impact interpersonal communication and social interactions. 

• Recognizing and navigating teen depression Medically reviewed by Elizabeth Erban , LMFT, IMH-E
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Jesse Ronson vs. Tony Hervey

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Ronson vs. hervey fight predictions, fight predictions, tapology community picks: 95, bout information, event poster.

Fight Details

• Event: Score Fighting Series 3
• Date: Saturday 12.03.2011 at 07:45 PM ET
• Referee: Yves Lavigne
• Venue: RBC Centre
• Enclosure: Cage
• Location: Sarnia, Ontario, Canada
• Bout Billing: Main Card (fight 5 of 9)
• Pro/Am: Professional
• Weight: 155 lbs (70.3 kg)
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• Ronson Total Disclosed Pay: Ronson Disclosed Pay: None Disclosed
• Hervey Total Disclosed Pay: Hervey Disclosed Pay: None Disclosed

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