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Difficulties with Speech

Speech refers to the processes associated with the production and perception of sounds used in spoken language.

Difficulties with Speech - adjustments to practice

Speech refers to the processes associated with the production and perception of sounds used in spoken language.

Many skills are required for speech and language to effectively develop and there are many ways in which speech development can go wrong. Some people may have difficulty in moving the muscles that control speech; others can't understand how a conversation works or the meaning of a sentence. Some people can't understand or use language whatsoever. There are different terms to describe different types of difficulty - including:

  • phonological difficulties;
  • articulation difficulties;
  • verbal dyspraxia;
  • dysarthria;
  • semantic pragmatic disorder;
  • Asperger's Syndrome;
  • selective mutism.

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

Stuttering is a problem that interferes with fluent speech. A person who stutters may repeat the first part of a word (as in wa-wa-wa-water) or hold a single sound for a long time (as in caaaaaaake). Some people who stutter have trouble getting sounds out altogether. Stuttering is complex and it can affect speech in many different ways. One of the most frustrating features about stammering is its variability. The problem can fluctuate from mild to severe depending on the situation, the time of day or for some other unidentifiable reason. It is different for each person.

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

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

Apraxia (dyspraxia), also known as oral-motor speech disorder, is a problem with motor coordination or motor planning. A person with this speech problem has difficulty moving the muscles and structures necessary to form speech sounds into words.

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Difficulties with Speech - adjustments to practice

These strategies are suggestions for inclusive teaching and training. This list should not be considered exhaustive and it is important to remember that all learners are individuals, and good practice for one person may not necessarily be good practice for another. If you have any good practice that you would like to add to this list, please email your suggestions to ettad@worc.ac.uk.  

Environmental Factors 
  • Some speech impairments are affected by a person's emotional state. Speech is clearer when a person is confident and relaxed, and this is one of the most important factors to consider when communicating with people with speech difficulties. Make tutorials etc. relaxed and informal. 

 Learning Resources
  • Consider using a communication board (with letters and words on it) or a computer with a speech synthesiser.

Course Delivery
  • Initially ask questions that only need a short answer. However, avoid questions that required only yes or no answers, as these can appear patronising.
  • Listen closely to what learners say; always respond to the content of what someone is saying, and do not be misled by the style of delivery.
  • Allow time for learners to make their contributions.
  • People with communication difficulties may well find group work challenging and stressful. Ensure not to exclude learners with speech difficulties from group activities, and manage the pace of the discussion to ensure other learners do not interrupt inappropriately.
  • If the learner finds speaking in public particularly difficult and it exacerbates their problems, it may be preferable to allow them to record an oral presentation in advance to playback during a teaching session. 

General Guidance
  • Establish whether a learner who experiences communication difficulties has established a successful alternative system of communication, for example: using an assistant to act as communicator.
  • Just because a person has difficulties speaking this does not mean that they have problems with hearing or comprehension so speak to people naturally.
  • When it is difficult to understand learners, keep calm, watch their lips, and take account of facial expressions and body language. Try to avoid guessing or completing sentences for them, unless learners want this, to speed communication. Always check with the individual.
  • Ask people to repeat what has been said if it is difficult to understand. Repeat back to them to confirm understanding.
  • Be tactful and sensitive. Individuals may have previously had a negative educational experience which has resulted in poor self confidence.
  • People with speech impairments are likely to find telephone calls difficult. Email may be a more useful method of communication.

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