Speech disorders and Language disorder

Language is the cornerstone of communication, which is given an audible expression by speaking. For someone to be able to exchange information in this way without any problems, a pronounced understanding of language and clear speaking skills are essential. However, both can be disturbed. Sometimes this affects the child’s language development. Sometimes language and speech disorders only appear much later. Read here what forms there are, what can be behind them and what you can do about it.

Speech disorders and Language disorder - What's the Difference?

Experts generally distinguish between Speech disorders and Language disorder:

In the case of a  language disorder, the mental formation of words and sentences, and sometimes also the understanding of language, is disturbed. It is caused by disturbances in the language center of the brain. For example, those affected have difficulty finding the right words, forming meaningful sentences, or understanding other people.

speech disorder is a motor impairment that impedes articulation. The production of sounds or the flow of speech is disturbed. Typical examples are lisp and stutter. The mental formation of the language is not impaired.

Language and speech disorders can occur individually but also together. Both can also become apparent in the context of language acquisition in childhood. They are then referred to as language development disorders: a child’s speaking ability lags behind that of peers.

language development in the child

Babble, first words, first sentences: Read here which phases of language development your child goes through and how you can support them.

In the case of a language development disorder, a child’s ability to speak is not age-appropriate. Read here about signs, causes, and therapy.

How are language disorders expressed?

There are different types of speech disorders, which manifest themselves differently depending on the cause. They can crystallize in childhood – for example, due to a developmental disorder. Or they appear as a result of a disease in adulthood.

Disorders of language expression (Expressive language disorders)

Language disorders can manifest themselves on the word level and the grammatical level. In children, the ability to express themselves with language is below average.

One possibility is a vocabulary deficit due to intellectual limitations, developmental disabilities, or illness-related disabilities. Those affected use generic terms (“the thing”) or wrong words, for example.

dysgrammatism (agrammatism) manifests itself in faulty sentence constructions or shortened two- or three-word sentences, as expressed by children in the early stages of language acquisition. Speaking in “telegram style” is also typical.

Dysgrammatism is a language disorder in children. Read here how you can recognize the disease and what you can do about it.

Disorders of language understanding (Receptive language disorder)

Children with a receptive language disorder have difficulty understanding language. This can be developmental or due to hearing loss. Since the understanding of language is the basis for language acquisition, the children usually also have an expressive language disorder, which means they can communicate poorly.

A receptive language disorder can also occur throughout life due to neurological diseases or brain injuries.

Speech degradation and speech loss syndromes

A whole series of illnesses are associated with a loss of the language skills that have already been acquired. These include strokes, brain injuries, inflammations, and dementia.

Aphasia

In aphasia, important language centers in the brain are damaged. In most cases, a stroke is a cause. Depending on the extent and affected brain area, there are different forms of aphasia. This includes Broca’s aphasia, in which those affected can no longer control their speech process properly. But also, Wernicke’s aphasia is associated with a disturbance in language understanding.

Aphasia is a devastating disease affecting more than 4 million Americans annually. It causes a person to struggle with language, speech, and comprehension. The cause of aphasia is unknown. Some cases have been attributed to other diseases or injuries, such as stroke or head trauma. In other cases, the reason may be unfamiliar. Read More

A stroke can cause severe damage to the brain. Read here how to recognize it and what to do in an emergency!

Speech loss in dementia

Dementia gradually affects all cognitive areas – including language and speaking. In the most common form, Alzheimer’s dementia, word-finding difficulties often appear early on. The sentence structure is also affected. As the disease progresses, the language often becomes meaningless. The patients repeatedly utter general phrases (“Yes, yes, that’s how it is.”). In the late phase of the disease, speech and language comprehension are severely disrupted.

Heller’s dementia ( also infantile dementia, disintegrative psychosis) is a severe developmental disorder. Affected children, who previously developed typically, suddenly lose within months from around the age of two to three years already acquired cognitive, motor, and social skills – including language in particular. Some trajectories resemble autistic disorders. The causes are unclear.

Landau-Kleffner syndrome ( aphasia-epilepsy syndrome) is a rare form of childhood epilepsy with aphasia. It occurs between the ages of five and seven and results in a loss of language skills. In the beginning, the children have increasing difficulties understanding what is being said. Later, the ability to speak recedes – sometimes to complete silence.

Alzheimer’s disease is a progressive disease characterized by the buildup of sticky protein plaques in the brains of senior citizens. These plaques gradually disrupt brain cell communication, leading to memory loss, impaired judgment, and death. There is currently no cure, but there are medications available to treat the symptoms of Alzheimer’s, including confusion, difficulty speaking and movement, and behavioral changes. Understanding Alzheimer’s and the symptoms can help you and your elderly parent learns how you can reduce your risk of developing the disease.

Read more about causes, what symptoms occur and how to treat the disease here.

Dysphasia

A language disorder of a somewhat milder nature is (cognitive) dysphasia. Language ability and understanding are reduced here, for example, due to a memory or attention disorder or limited cognitive abilities.

Overall, dysphasia is a term that has different meanings. Sometimes it stands for a mild form of aphasia or is equated with it. In places, doctors also describe dysgrammatism or, in general, the state of backward language development.

Disorders of written language

Some language disorders are limited to writing and reading texts. In the combination, one speaks of a disorder of the acquisition of written language or reading and spelling weakness (dyslexia). This is most often the result of a developmental disorder, but it can also occur later in life due to neurological disorders.

People who have dyslexia find it difficult to decode text or even individual words. You read slowly, haltingly, and incorrectly. They often have trouble grasping the content of a text. The maximum form is Alexia.

Dysgraphia refers to problems writing textsThose affected find it difficult to internalize and implement spelling, grammar, and punctuation. Even the correct copying of texts is a challenge for some. It is agraphia if they cannot write at all despite motor skills.

Dyslexia is a condition that affects between 5 and 15 percent of the world’s population. Although it is often seen as being associated with male children, the truth is that dyslexia can affect people in varying degrees. However, one thing is for sure: dyslexia cannot be cured. Learning to read and write is challenging enough, but for a person with dyslexia, these basic skills can present more problems than any other student.

Read everything you need to know about diagnosis and symptoms here.

How do you recognize speech disorders?

In speech disorders, grammar and choice of words are unremarkable. Instead, articulation disorders, disturbances in the flow of speech, or a disturbed speech melody occur.

Stuttering: The flow of speech is blocked in people who stutter. They overstretch words or “get stuck” and have to try several times to force a word out. This manifests itself in involuntary repetitions of sounds, syllables, or words.

Articulation disorders (dyslalia): With the so-called “stammering,” either the formation of the sound (phonetic) or the use of the sound (phonological) is faulty. A mixed form can also exist.

  • Among the phonetic articulation disorders, lisp (sigmatism), in which the formation of hissing sounds “slips,” is particularly widespread. This is a common phenomenon in childhood: the child misses the target sound (e.g., “s” instead of “ch”: “I’m hungry”). If the letter “r” is affected, one speaks of rhotacism, of capacism with “k.”
  • One speaks of a phonological pronunciation disorder when the affected swap sounds or omit individual sounds (“The Tirsche tastes dut”). On the other hand, the sound formation works without any problems. This is also common in childhood.

Cluttering: Cluttering describes a fluency disorder in which the speakers speak very quickly or arrhythmically. The words merge. Syllables and sounds are left out. The spoken word is then difficult to understand.

Rhinolalia (sound formation) / Rhinophony (sound): “Nasal” also falls under speech disorders. Experts distinguish between open and closed nasals. When the nose is open, a lot of air flows through the nose, which has a particular effect on the formation of vowels (a, e, i, o, u) and explosive sounds (e.g., p, t, k). Closed nasalization, on the other hand, changes the nasal sounds n and m in particular.

Dysarthria: Dysarthria occurs as a result of neurological disease or injury. This makes it difficult for the tongue and soft palate to move. Voice tone, volume, and speaking rhythm are then impaired. Dysarthria occurs, for example, in stroke patients (hypotonic dysarthria, “slurred speech”). Parkinson’s patients, on the other hand, often speak very quietly and monotonously (rigid hypokinetic dysarthria).

Apraxia: Speech apraxia occurs after damage to the left hemisphere of the brain. The areas of the brain that are responsible for planning speech movements are then affected. Patients cannot speak clearly. Speech apraxia usually occurs together with aphasia.

Verbal developmental dyspraxia: Verbal developmental dyspraxia is a most severe language and speech disorder located in the motor language center. Affected children have great difficulty formulating sounds and words because they have speech planning or coordination problems. This hinders the development of active vocabulary and grammatical skills. It is also difficult for those affected to understand others.

Many adults suffer from stuttering, and it’s more common than you might think. Some experts believe stuttering affects up to 30 million people in the United States, while others believe that estimate is too high and that estimates are closer to 10 million people. Either way, stuttering is a minor neurological issue. It doesn’t mean you have severe disease, such as schizophrenia, or you will never speak fluently. Instead, stuttering means you have trouble speaking because of some physical and neurological issues, and it will likely get worse as you get older.

Stuttering is a motor speech disorder in which the flow of speech is interrupted. Men are affected much more often than women. Read all about stuttering here.

Slurring sounds may sound like a natural part of normal speech, but if they occur frequently, then you may have a speech disorder known as dysarthria. Dysarthria is more than just slurred speech; it can also include unintelligible words, repeated words, and difficulty finding the right words that begin with the same letter or sound. Even though dysarthria is a mild speech disorder, many people may confuse it with Parkinson’s disease. However, the two conditions have very different causes.

Dysarthria is a speech disorder that originates in the brain or nerves. It can be caused by injuries or diseases of the nervous system. Read more here!

Apraxia is a specific type of speech disorder characterized by fine motor skills and coordination problems. Apraxia is a developmental condition, so people with apraxia typically suffer from it as children, but many people may struggle with it as adults. The disorder doesn’t affect a person’s speaking ability but can make learning new skills difficult.

The term apraxia describes the inability to perform voluntary movements and correctly handle objects such as cutlery or tools. Read more about apraxia here.

What are the causes of Language disorders ?

language disorders have a variety of causes. They can become apparent during language development in childhood or only occur after language acquisition has been completed due to illnesses or injuries. Psychological and social factors can also impair language ability.

Causes of acquired language disorders

Causes of acquired language disorders in adults include:

When you have a stroke, the blood flow to the brain is disrupted. Read here how this happens and what the signs are!

Dementia is a form of memory loss caused by many diseases. There are over five different types of dementia, the most common being Alzheimer’s. While most people have heard of Alzheimer’s, signs such as memory loss, difficulty speaking, and changes in mood or behavior often go unnoticed or misdiagnosed. Not all symptoms occur with everyone, and specific symptoms may not be present. Read more about forms and therapy of dementia!

A brain tumor is an abnormal growth of cells in the brain. This abnormal growth is called a tumor. Tumors can cause symptoms such as headaches, vision problems, balance, and coordination problems. These symptoms may be caused by a mass of brain tumor cells pressing on nearby brain tissue or by bleeding that increases the pressure on the brain tissue. A brain tumor affects the brain’s work and may cause different signs and symptoms in different brain areas. About 80% of brain tumors are malignant, which means they can invade nearby healthy brain tissue and spread to other parts of the brain, and 20% are benign, which means they do not invade other brain tissue. Children or the elderly are mostly affected. Read more!

Causes of language disorders in childhood

Language disorders in childhood are primarily developmental. They may have genetic roots, among other things. Speech disorders in childhood are based, among other things, on:

When most people think of Down syndrome, they think of an adorable cherubic baby, and while those kids certainly exist, they aren’t the only ones. Down syndrome, also known as Trisomy 21, is a condition in which a child is born with three, rather than two, copies of chromosome 21. People with Down syndrome often have mild to moderate developmental delays, but they also have the potential for higher cognitive development than is typical. Additionally, they may have distinctive physical features, including small stature, flat faces, large mouths, and wide, protruding eyes. Find out more here!

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that typically appears in the first three years of life and is caused by a combination of genetic and environmental factors. The condition affects a person’s social and communication skills and can cause behavioral problems such as repetitive behaviors. Symptoms increase over time, and a child with autism typically requires lifelong treatment.

Early childhood autism (also known as Kanner’s autism) is one of the severe forms of autism. Learn more now!

Stress as a cause of speech disorders

Psychological factors such as significant acute or chronic stress can also cause speech disorders. When you are stressed, your attention and ability to concentrate decrease. This can, for example, cause word-finding difficulties or cause you to lose the thread of the sentence.

Fearshock, or trauma can silence those affected completely. This can only affect certain situations (selective mutism). Doctors speak of mutism.

Note:

Sudden speech disorders are always an alarm signal. Call an ambulance! It can be caused by a stroke, for example. Then every minute counts!

What are the Causes of Speech disorders?

The causes of speech disorders are also manifold. Some are congenital. Others arise as a result of disease or injury. Social and psychological factors can also cause speech disorders.

Causes in Childhood

Disturbed speech or restricted speech development in children is due to, among other things:

  • Genetic malformations of the tongue, lips, tongue, jaw, palate and vocal folds impede the formation of sounds (e.g., in the case of a cleft lip and palate or trisomy 21).
  • Early childhood brain damage (e.g., lack of oxygen during birth). Impaired speech processing in the brain can then limit the mobility of the lips and tongue.
  • Hearing impairments or hearing loss during language acquisition make it difficult to differentiate sounds precisely and reproduce them accordingly.
  • Incorrect jaw and tooth positions can impair the correct formation of sounds.
  • Psychosocial causes (stress, traumatic experiences, unresolved feelings of fear, anger, and sadness, intense pressure to perform, chronic under-challenge).

Clefts of the lip and palate happen when a baby’s mouth and lip don’t form properly during pregnancy. These aren’t congenital disabilities, though. Instead, they’re developmental deformities resulting from the embryo not generally developing before birth. Cleft lip and palate are two different conditions, occurring at about the same frequency: one in 700 births.

A cleft lip and palate is a congenital malformation of the face. Read more about causes, forms, and treatment here.

Deafness is an impairment caused by a lack of sound information. The word “deaf” means without hearing. Deafness is a loss of the ability to understand or use spoken language. About one in every 1,000 babies is born with some form of hearing loss, usually in both ears. An additional 1 in 2,000 children is born with baby deafness—meaning they don’t begin hearing until the late 1st or 2nd year of life. Most deaf children become fluent in sign language, although often not until adolescence or later.
 
Deafness is the complete lack of hearing. Read all about deafness causes, symptoms, and more!

Neurological Diseases/Damages

Damage to central or peripheral nerves can cause speech disorders. This also applies if the brain region was responsible for speech motor skills changes due to illness. Important causes of speech disorders are:

A traumatic brain injury (TBI) is a type of injury where damage to the brain has forced it to function differently than it usually does. Brain injuries are caused by various circumstances, such as car accidents, labor accidents, sports injuries, and falls. However, while there are certainly several things that can help prevent a traumatic brain injury, there are, unfortunately, many circumstances that we can’t control. More here!

The nervous system (the brain and the spinal cord) comprises many parts and functions. Each region and system is critical to every aspect of health. The nervous system controls and influences the metabolic, endocrine, respiratory, cardiovascular, and immune systems. The nervous system has two major parts, the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS consists of the brain and spinal cord. The PNS consists of all nerves that connect the brain and spinal cord to muscles and organs. Altogether, the nervous system has about 100 billion nerve cells, or nerve cells, and millions of nerve fibers.

Neurological diseases affect the brain and nervous system. Which conditions are included? How do you recognize them? Read more!

How doctors diagnose speech disorders

Children develop at very different speeds. This also applies to language acquisition. Therefore, speech disorders in childhood are not easy to diagnose. Doctors usually diagnose adult language problems as part of a neurological exam.

Examinations and tests in childhood

To record the current level of development, pediatricians use various tests that record the vocabulary and grammatical skills of the children. For example, the child names objects, or the conversation with the parents is observed.

Hearing tests and newborn screening: If there is evidence that a child is lagging behind their peers in terms of language, a hearing test is used to determine whether a poor hearing is the cause of the developmental delay. Because if you hear a language poorly, you can’t learn it properly either. For this reason, every child has a right to a newborn hearing screening

Brain organic examinations: Further examinations that reveal possible pathological causes for the speech disorder can follow. These include, for example, imaging procedures such as magnetic resonance imaging (MRT) or CT ( computed tomography ). Doctors may also use electroencephalography (EEG), which measures brain activity.

In a hearing test, the function of the hearing is checked using various examination methods. Find out all about it here!

Electroencephalography, or EEG, is a test used to measure the electrical activity in the brain. It is primarily used to diagnose epilepsy and other conditions. An EEG measures our brain’s electrical activity by attaching wires to the scalp and placing metal discs on the scalp. Electrodes—metal discs coated with sticky gel—are placed on the brain’s surface. The process may only take a few minutes. Find out more about this study here!

A neurological examination is a check-up of the nervous system. It can be conducted to diagnose neurological or psychiatric problems. A neurological test can help identify diseases, injuries, and disorders of the peripheral nervous system, central nervous system, and neuromuscular junction. Neurologists and other doctors perform neurological exams to diagnose and rule out neurological disorders. Neurological exams often involve sensory, muscle strength, coordination, memory, and reflex tests. Read all about it!

Examinations and tests in adults

Speech disorders that occur after language development are complete are of pathological origin. The first thing to do here is to uncover the cause and treat it as best as possible – for example, a stroke, dementia, or a tumor disease.

This is what neurological examinations are used for. Depending on the initial suspicion, there are also EEG (electroencephalography), MRI (magnetic resonance imaging), or CT (computed tomography).

There are also various specialized tests for assessing and classifying the type and extent of the speech disorder.

One example is the Aachen Aphasia Test (AAT). A doctor or speech therapist checks the patient’s spontaneous speech using a standardized interview. The examiner then asks the patient to repeat words and sentences and to name objects and situations. Speech comprehension is tested by having the patient match drawings to sentences and phrases read aloud. 

Note:

Speech disorders are a symptom that must always be taken seriously – regardless of whether they appear suddenly or gradually. They can be a symptom of a severe medical condition and should therefore be checked by a doctor.

This is how the doctor assesses speech disorders

Speech disorders are pervasive in younger children and often become progressive. However, if they are very noticeable, persisting, or bother the child, it is best to consult your pediatrician. In adults, the underlying cause is often a neurological disease that requires medical evaluation.

The doctor tries to find out the cause of the speech disorder. For this purpose, he conducts a detailed conversation about his previous medical history (anamnesis). He then gradually rules out possible causes.

As with speech disorders, he also uses neurological tests and examinations with EEG (electroencephalography), MRT (magnetic resonance imaging), or CT (computed tomography).

Usually, several doctors and specialists are involved in a diagnosis. ENT doctors assess hearing, for example. Dentists and oral surgeons examine misaligned jaws and teeth.

Regardless of whether the cause is found, tests follow that record the form and extent of the speech disorder. The subsequent logopedic therapy plan is based on this.

Magnetic resonance imaging, or MRI, is similar to a CT scan in that it uses radio waves and a powerful magnetic field to take pictures of internal structures. But MRI uses magnetic particles instead of exposing you to radiation, as X-rays are. Using magnets to make the image, like with a compass, allows doctors to get inside your body. The machine creates a powerful magnetic field around your body, which distorts your internal structures. The MRI machine then picks up this distortion and creates precise cross-sectional images of the body. Read more about this radiation-free examination here!

Computerized axial tomography, or CT, is a diagnostic imaging procedure that uses x-rays and computer technology to produce cross-sectional, or axial, images (usually multiple images), both horizontally and vertically, of the internal structures of a patient. The CT shows detailed views of bones, muscles, fat, and organs and allows physicians to diagnose conditions such as head injuries, abdominal issues, and heart disease. This non-invasive exam is painless, safe, and does not require an intravenous (IV) dye. Read more about this and radiation exposure!

Speech disorders: therapy

If the speech disorder is due to an illness, it must first be treated, for example, with medication or an operation. This sometimes improves the language problems.

Speech therapy training

However, this is often not enough, for example, because the disease has already caused permanent damage. Then individual logopedic training is the most important measure.

The aim is to improve language and communication skills and thus enable patients to participate more in social life. The two basic strategies are:

  1. To restore the lost skills as far as possible or to build up skills that were not acquired
  2. Where this is not possible, to compensate for the disturbance

For this purpose, the speech therapist develops an individually tailored exercise plan. Role-playing games, for example, in which the patients practice speaking in everyday situations, are an essential part.

The relatives are also part of the speech therapy treatment. They learn what to consider when dealing with the patient. This includes, among other things, speaking in simple sentences or not speaking for the patient if the latter does not want it.

Note:

It is essential for children that speech therapy support takes place as early as possible during language acquisition. Otherwise, it is becoming increasingly difficult to close the distance to peers, also concerning other developmental and learning content that depends on speaking.

Speech therapy is a treatment for people who have speech impairments. Typically, it includes a combination of speech therapy and treatments, such as physical or occupational therapy, to improve mobility or motor skills. Speech therapy may help treat a congenital disability, such as cleft palate, if the condition does not improve on its own or with other treatments, such as surgery. It may also be used if a child has difficulty speaking or if a child’s speech is difficult to understand. Some illnesses or injuries can affect a person’s voice or ability to speak, such as a stroke, a head injury, or Parkinson’s disease. Speech therapy can help if a condition affects the quality of a person’s speech, such as if they have a weak voice, a hoarse voice, distorted sound, or trouble producing certain sounds. Read here when it is used and which exercises help.

Treatment of Speech disorders

If a treatable disease is the cause of a speech disorder, its therapy is the priority. This can also improve the speech disorder. If it persists to a disturbing extent, logopedic treatment is the essential measure.

This includes:

  • Speech motor training
  • Training of listening attention
  • Exercises for the more precise sound formation and differentiation of sounds
  • Strategies to improve the flow of speech: (e.g., reduced speaking speed, special breathing or speaking techniques)

Computer-assisted biofeedback training can provide practical support for many training contents. The person concerned can check, for example, with the help of corresponding visualizations on the computer screen, how cleanly he has pronounced a specific word or whether he has correctly identified sounds.

Additional psychotherapy is necessary if psychological stress has caused or exacerbates the speech disorder.

Note:

Speech disorders can limit children’s psychosocial development. Therefore, logopedic treatment in childhood should start as early as possible.

Biofeedback is the practice of observing your body’s various functions, like your heart beating or breathing. The sensor watches your function and records it on an electronic scale. Then, you control some aspects of your function, like breathing, to see how it affects the scale. Depending on the scale, the program may instruct you to hold your breath or speed up your breathing, for example. Read more about it!

We’ve all heard the term “talking cure” for psychotherapy, but there’s more to it. Psychotherapy is an umbrella term that refers to traditional talk therapy and other modalities, such as hypnosis, art therapy, cognitive behavioral therapy, and eye movement desensitization and reprocessing (EMDR). Though therapy has been a staple of the healthcare industry for ages, it’s still a relatively new concept in the general public’s mindset. Read on if you want to learn more about psychotherapy, including how it can help treat psychological issues like depression, anxiety, and phobias.

Psychotherapy helps people to cope with a mental illness. Read here what forms of psychotherapy there are and what to expect.

Mental consequences of language and speech disorders

Communication is a central aspect of human existence. Those who have difficulties communicating or understanding others are cut off from social participation. Learning and information are also made more difficult.

Even mild language and speech disorders can also be profoundly unsettling and lonely. Anyone who speaks poorly or unclearly is quickly excluded or bullied. Educational and professional opportunities are also limited. This hits children hard in their general development.

Anyone who loses their language skills as an adult often despairs and withdraws from social life. Mental disorders can be the result. Providing the best possible medical, logopedic (uncountable), psychiatric, or psychotherapeutic care for language and speech disorders is more important.

Mental illness is a natural and severe problem that affects millions of people around the world. Mental disorder can be caused by various factors, including genetics, environment, and stress. Mental illness can lead to many problems, including anxiety, depression, and suicide. If you or someone you know is struggling with mental illness, getting help is important. Many resources are available to help people struggling with mental illness.

Mental illnesses cause as much suffering as physical illnesses. Read here what forms, how they appear, and what helps.

Scientific standards:

This text corresponds to the requirements of specialist medical literature, medical guidelines, and current studies and has been checked by medical professionals.