Speech or Language Impairment

DEFINITION

Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines Speech or Language Impairment as …

“… a communication disorder, such as stuttering, impaired articulation, a language impairment, or a voice impairment, that adversely affects a child’s educational performance.”

[34 Code of Federal Regulations § 300.8(c) (11)]

TYPES

There are many kinds of speech and language disorders that can affect children. Disorders may occur in articulation, fluency, voice, and language. ASHA lists the following types of disorders:

Speech

• Childhood Apraxia of Speech
• Dysarthria
• Orofacial Myofunctional Disorders
• Speech Sound Disorders: Articulation and Phonological Processes
• Stuttering
• Voice (vocal cord nodules and polyps, vocal cord paralysis, paradoxical vocal fold movement, spasmodic dysphonia)

Language Disorders

• Preschool Language Disorders
• Learning Disabilities (Reading, Selling, and Writing)
• Selective Mutism

Medical and Developmental Conditions

• Attention Deficitit/Hyperactivity Disorder
• Autism (Autism Spectrum Disorders)
• Cleft Lip and Palate
• Right Hemisphere Brain Injury
• Traumatic Brain Injury

More information regarding types can be found on ASHA’s website: https://www.asha.org/public/speech/disorders/ChildSandL/

(American Speech-Language-Hearing Association, ASHA, 2019)

FACTS AND STATS

In Fall, 2016, of the more than 6.1 children with disabilities who received special education under IDEA in public schools in the Fall, more than 1.1 million were served under the category of speech or language impairment. The percentage of students (16.8%) is the second most common disability category. This estimate does not include children who have speech/language problems secondary to other conditions such as deafness, intellectual disability, autism, or cerebral palsy. Because many disabilities do impact that individual's ability to communicate, the actual incidence of children with speech-language impairment is undoubtedly much higher.

(U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs, 40th Annual Report to Congress on the Implementation of the Individuals with Disabilities Education Act, 2018).
http://www.ed.gov/about/reports/annual/osep

CAUSES

Some causes of speech and language disorders include hearing loss, neurological disorders, brain injury, intellectual disabilities, drug abuse, physical impairments (cleft lip or palate), and vocal abuse or misuse. Frequently, however, the cause is unknown.

(Center for Parent Information and Resources, CPIR, 2015)

PREVENTION

Having your child’s hearing and speech checked regularly at a local clinic or school are important prevention strategies to monitoring speech and language development. Talking, reading, and playing with a child every day can help children to learn sounds and words by hearing and seeing them. Take care that your child’s teeth and mouth are healthy and cared for can be a preventative for speech sound disorders. Allowing a child the time to talk without interruption may also help for those who stutter. Voice disorders in childhood and adulthood are prevented by taking care of the voice through the avoidance of shouting and screaming; drinking plenty of water; avoiding alcohol, caffeine, chemical fumes (i.e. some cleaning products); and smoking. Seeing a doctor about allergies or sinus/respiratory infections can also help protect the health of the voice.

(ASHA, 2019)

CHARACTERTISTICS

The characteristics of speech or language impairments will vary depending upon the type of impairment involved. There may also be a combination of several problems. ASHA’s speech and language milestone resource pages are useful to refer to when observing your child’s speech, language, and hearing development.
https://www.asha.org/public/speech/development/chart.htm

When a child has an articulation disorder, he or she has difficulty making certain sounds. These sounds may be left off, added, changed, or distorted, which makes it hard for people to understand the child. Leaving out or changing certain sounds is common when young children are learning to talk, of course. A good example is saying “wabbit” for “rabbit.” The incorrect articulation isn’t necessarily a cause for concern unless it continues past the age where children are expected to product such sounds correctly.

Fluency refers to the flow of speech. A fluency disorder means that something is disrupting the rhythmic and forward flow of speech - usually, a stutter. As a result, the child's speech contains an abnormal number of repetitions, hesitations, prolongations, or disturbances. Tension may also be seen in the face, neck, shoulders, or fists.

Voice is the sound that's produced when air from the lungs pushes through the voice box in the through, making the vocal folds within vibrate. From the the sound generated travels up through the spaces of the throat, nose, and mouth, and emerges as our voice. A voice disorder involves problems with the pitch, loudness, resonance, or quality of the voice. The voice may be hoarse, raspy, or harsh. For some, it may sound quite nasal; others might seem as if they are stuffed up. People with voice problems often notice changes in pitch, loss of voice, loss of endurance, and sometimes a sharp or dull pain associated with voice use.

Language has to do with meanings, rather than sounds. A language disorder refers to an impaired ability to understand and/or use words in context. A child may have an expressive language disorder (difficulty in expressing ideas or needs), a receptive language disorder (difficulty in understanding what others are saying, or a mixed language disorder (which involves both). Some characteristics of language disorders include: improper use of words and their meanings; inability to express ideas; inappropriate grammatical patterns; reduced vocabulary; and inability to follow directions.

Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate. These symptoms can easily be mistaken for other disabilities such as autism or learning disabilities, so it's very important to ensure that the child receives a thorough evaluation by a certified speech-language pathologist.

(CPIR, 2015)

More information about characteristics and types of disorders may also be can be found at ASHA’s website: https://www.asha.org/public/speech/disorders/ChildSandL/

PROGNOSIS

The prognosis depends on the cause and type of the disorder. Usually, speech can be improved with speech therapy. Prognosis improves with early intervention and effective use of speech-language pathology services. Children and adults with severe speech or language problems may need to find other ways to communicate. In these cases, they may use augmentative and alternative communication (AAC). Speech-language pathologists, or SLPs, can help.

EDUCATIONAL IMPLICATIONS

Communication skills are at the heart of the education experience. Most, if not all, students with a speech or language impairment will need speech-language pathology services that include: identification of children with speech or language impairments; diagnosis and appraisal of specific speech or language impairments; referral for medical or other professional attention necessary for the habilitation or prevention of communicative impairments; and counseling and guidance of parents, children and teachers regarding speech and language impairments.

In addition to diagnosing the nature of a child’s speech-language difficulties, speech-language pathologists also provide: individual therapy for the child; consultation with the child’s teacher about the most effective ways to facilitate the child’s communication in the class setting; closely working with the family to develop goals and techniques for effective therapy in class and at home.

Tips for Teachers:

• Learn as much as you can about the student's specific disability. Speech-language impairments differ considerably from one another, so it's important to know the specific impairment and how it affects the student's communication abilities.
• Find out what the student's strengths and interests are, and emphasize them. Create opportunities for success.
• If you are not part of the student's IEP team, ask for a copy of his or her IEP. The student's educational goals will be listed there, as well as the services and classroom accommodations he or she is to receive.
• Make sure that needed accommodations are provided for classwork, homework, and testing. These will help the student learn successfully.
• Consult with others (e.g., special educators, the SLP) who can help you identify strategies for teaching and supporting this student, ways to adapt the curriculum, and how to address the student's IEP goals in your classroom.
• Find out if your state or school district has material or resouces available to help educators address the learning needs of children with speech or language impairments.
• Communicate with the student's parents. Regularly share information about how the student is doing at school and at home.

Assistive technology (AT) can also be very helpful to students, especially those whose physical conditions make communication difficult. Each student's IEP team will need to consider if the student would benefit from AT such as electronic communication system or other device. AT is often the key that helps students engage in the give and take of shared thought, complete school work, and demonstrate their learning.

(CPIR, 2015)

Children and adults with severe speech or language problems may need to find other ways to communicate. There are many types of AAC that they can use. Speech-language pathologists, or SLPs, can help. ASHA provides more information on communication options at the following sites:

• Augmentative and Alternative Communication
• Speech for People with Tracheostomies or Ventilators

ORGANIZATIONS

American Speech-Language-Hearing Association (ASHA) 
https://www.asha.org 
2200 Research Boulevard 
Rockville, MD 20850 
301.296.5700; 301.296.5650 (V/TTY); 800.638.8255

ASHA is the professional, scientific, and credentialing association for more than 123,000 members and affiliates who are speech-language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally. The purpose of ASHA is to promote the interests of and provide the highest quality services for professionals in audiologist, speech-language pathology, and speech and hearing science, and to advocate for people with communication disabilities.

Childhood Apraxia of Speech Association of North America (CASANA) 
https://www.apraxia-kids.org 
Cardello Building 
1501 Reedsdale Street, Suite 202 
Pittsburgh, PA 15233 
info@apraxia-kids.org

The Childhood Apraxia of Speech Association is a non-profit publicly funded charity whose mission is to strengthen the support systems in the lives of children with apraxia so that each child is afforded their best opportunity to develop speech: to provide electronic and print information to families, professionals, policy-makers and other members of the public; to support and educate parents and professionals as advocates for children with apraxia; to facilitate better public policy and services for children affected by the disorder; to provide training opportunities for families and professionals; to encourage research to further understanding about childhood apraxia and to co-sponsor a biennial scientific research symposium.

American Cleft Palate-Craniofacial Association (ACPA) Family Services 
https://cleftline.org 
1504 East Franklin St, Suite 102 
Chapel Hill, NC 27514 
(919) 933-9044

ACPA Family Services is a program of the American Cleft Palate-Craniofacial Association (ACPA). ACPA Family Services provides education, personalized support, and resources for every stage of the cleft or craniofacial journey. ACPA is dedicated to providing comprehensive resources and individualized support, with a focus on education and team care. Their mission is to create a world where people with cleft and craniofacial conditions thrive.

International Society for Augmentative and Alternative Communication (ISAAC) 
https://www.isaac-online.org/english/home/ 
312 Dolomite Drive, Suite 216 
Toronto, ON M3J 2N2 
Canada 
+1.905.850.6848 
feedback@isaac-online.org

ISAAC—the International Society for AAC—works to improve the life of every child and adult with speech difficulties. ISAAC provides publications, researches, and events. It describes the many ways to help people who cannot speak or write - things like electronic talking boxes, computers, books and boards with pictures or letters, or sign language. The ISAAC website can display Bliss, PCS or Rebus symbols so that people who use one of these symbol systems instead of text, or who have learning difficulties, will be able to read it.

National Institute on Deafness & Other Communication Disorders 
https://www.nidcd.nih.gov 
31 Center Drive, MSC 2320 
Bethesda, MD USA 20892 
800.241.1044 
800.241.1055 (TTY) 
nidcdinfo@nidcd.nih.gov

The National Institute on Deafness and Other Communication Disorders (NIDCD) is to provide new knowledge to help prevent, detect, diagnose, and treat disease and disability. NIDCD conducts research in laboratories at the NIH, and the Extramural Research Program, a program of research grants, career development awards, individual and institutional research training awards, center grants, and contracts to public and private research institutions and organizations. The Institute also conducts and supports research and research training in disease prevention and health promotion and the special biomedical and behavioral problems associated with people having communication impairments and disorders.

The Stuttering Foundation 
https://www.stutteringhelp.org 
P.O. Box 11749 
Memphis, TN 38111 
800.992.9392 
901.761.0343 
info@stutteringhelp.org

The Stuttering Foundation provides free online resources, services and support to those who stutter and their families, as well as support for research into the causes of stuttering. There are several video clips for kids, youth, and teachers. The web site is well organized kids, young, and adult with stuttering. Moreover, they provide visual and research information for teachers and parents.

International Stuttering Association 
http://www.isastutter.org

ISA is a worldwide network of people who stutter, a non-profit umbrella association dedicated to close cooperation among independent national and international self-help organizations of people who stutter. ISA was founded in 1995. It is to provide people who stutter, their family and friends, speech-language pathologists, academics, students and the general public with information on stuttering resources available in world.

Last modified January 2020.