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Speech impairment
Definition:
Speech impairment can be any of several speech problems:
  • Dysarthria is difficult, poorly articulated speech.
  • Aphasia is impaired expression or comprehension of written or spoken language.
Dysarthria is occasionally confused with aphasia. It is important to distinguish between a difficulty in articulation of words versus a problem with the production of language.
Alternative Names:
Language impairment; Impairment of speech; Poor speech; Inability to speak; Aphasia; Dysarthria; Slurred speech; Dysphasia
Considerations:
DYSARTHRIA
Dysarthria is generally apparent in daily conversation where there is difficulty expressing certain sounds or words.

Dysarthria is often caused by excess medications such as narcotics, phenytoin, or carbamazepine amongst others. Alcohol intoxication causes dysarthria (slurred speech). Degenerative neurological disorders affecting the cerebellum or brainstem cause dysarthria.

APHASIA
In some cases of aphasia, the problem eventually resolves itself, in others the condition is irreversible.

This term does not apply to children who have never developed communication skills. It only applies to the loss of communication skills previously learned. It commonly occurs in strokes and tumors as well as degenerative diseases that affect language areas of the brain.
Common Causes:
DYSARTHRIA APHASIA

Home Care:
For dysarthria, speaking slowly is encouraged and the use of hand gestures, when necessary, is recommended. Family and friends need to provide ample time for those afflicted with the disease to express themselves.

For aphasia, frequent orientation reminders (such as what day it is and what has happened) by family members may be needed. That is because disorientation and confusion often follow the onset of aphasia.

A relaxed, calm environment where external stimuli are kept to a minimum is important.

Speak in a normal tone of voice (this condition is not a hearing or emotional problem), use simple phrases to avoid misunderstanding, and don't assume that the afflicted person understands. Frustration, profanity, and depression are typical responses in people suffering from aphasia.

Provide the necessary communication aids.
Call your health care provider if:
  • Impairment or loss of communication comes on suddenly -- call your health care provider immediately.
  • There is any unexplained impairment of speech or written language.
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed. The medical history may require the assistance of family or friends.

Medical history questions documenting speech impairment in detail may include:
  • Time pattern
    • When did it develop?
    • Did it develop suddenly?
  • Quality
    • Is there a problem with clearly pronouncing words (dysarthria)?
    • Is there a problem understanding speech?
    • Is there a problem expressing thoughts through speech?
    • Is there a problem understanding writing?
    • Is there a problem expressing thoughts through writing?
  • Aggravating factors
    • Has there been a recent head injury?
    • Are there problems with the dentures?
  • Other
    • What other symptoms are also present?
The physical examination will include a detailed evaluation of brain function.

Diagnostic tests that may be performed include: Intervention:
Referral to a speech pathologist, and in some cases a social worker, may be indicated.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to a speech impairment, you may want to note that diagnosis in your personal medical record.
Review Date: 7/30/2001
Reviewed By: Galit Kleiner-Fisman MD, FRCP(C), Department of Neurology, University of Toronto, Toronto, Ontario, Canada. Review provided by VeriMed Healthcare Network.

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