Speech Impairments Overview

Speech impairments can be caused by a variety of factors, including head trauma or stroke, which may impact the part of the brain which controls speech (dysarthria or aphasia). Other people with speech impairments have them from a young age, such as a stammer.

What are the types and signs of speech impairment?

The three basic types of speech impairment are:

  • Articulation disorders – causing mispronunciations of varying kinds, as a result of muscular or skeletal abnormalities which affect speech production.
  • Fluency disorders – stammers being among the most common.
  • Voice disorders – resulting from problems with the larynx and so the person struggles to make sounds at the required pitch or volume, for example.

Speech impairments such as aphasia – difficulty choosing the right words to use – result from damage to the left side of the brain, which is most common following a stroke, but can be the result of a head injury or brain tumour.

Dysarthria can also be caused by a stroke or brain injury, but can also be present from birth in people with cerebral palsy, for example. It is also present in people with motor neurone disease and includes impairments such as:

  • Slurred speech
  • Hoarse voice
  • Loud or quiet speech
  • Gurgling
  • Difficulties with tongue and lip movements.

How are speech impairments diagnosed and treated?

A GP can refer someone with a fluency disorder such as a stammer to a speech and language therapist and this is often integrated into school or education in the case of children with speech impairments. Speech and language therapy involves learning techniques to manage the impairment, such as breathing techniques or speaking more slowly.

Therapy will involve work on feelings such as anxiety which can trigger or aggravate a speech impairment.

For a brain damage-related speech impairment, diagnosis can be done via a scan of the brain to work out how severely the parts of the brain which coordinate speech are affected.

Speech and language therapy is usually the course of action for aphasia and dysarthria too – and most people recover their speech fully following a stroke, with the help of therapy. For people with motor neurone disease and other progressive neurological conditions, therapy will help them manage their speech deterioration, which is often inevitable.

Psychological therapy – such as cognitive behavioural therapy –  is also often offered to help someone deal with the emotional impact of the speech impairment on their lives.

There are a few ways to determine whether an employee has speech impairments, or to confirm a speech impairment which requires reasonable adjustments:

  • The employee will likely raise the issue of their impairment upfront, particularly in the case of more severe impairments if their impairment is very evident or affects their ability to be understood verbally upon a first encounter.
  • Even if the employee does not wish to disclose their speech impairment, an employer can focus on making reasonable adjustments, rather than seeking to determine the precise disability their employee has.
  • Given that speech impairments can evolve over time – or come on suddenly as a result of a head trauma or stroke – it is important to maintain regular communication with the employee who has speech impairments so that the reasonable adjustments remain appropriate.

What reasonable adjustments are possible with speech impairments?

Employers have a legal duty to make reasonable adjustments for employees with speech impairments if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has one of these impairments. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance upfront, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of speech impairments:

  • Accommodating time off: for appointments relating to their impairment, such as speech therapy or stroke rehabilitation.
  • Providing an adapted equipment: such as a feedback device for the employee’s ear so that they hear their own voice differently (this has been shown to help some people who stammer). Feedback equipment can come in app or computer form too.
  • Adjusting office set-up and layout: to avoid the impact that background noise has on the employee’s ability to listen and communicate.
  • Emphasising the employee’s skills, rather than the difficulties they have as a result of their speech impairments: people with speech impairments have the same cognitive function as people without it, and so their intellectual abilities will be unaffected by their disability. It is important not to make assumptions about what the employee with the impairment can and cannot do. Dialogue can also help reduce the employee’s stress, which may aggravate their stammer or speech impairment.
  • Provide a means of informing clients if the employee is client-facing. This may involve a card or app on their phone which can concisely explain that the client may need to be patient when listening to the employee, as they have a stammer, etc.
  • Raise awareness: for the employees with speech impairments to be better understood in the workplace, and to make employees feel comfortable if asking for help related to their impairment. Simple things like making eye contact, allowing the employee to finish what they are saying and avoiding prompting or finishing their sentences for them can help support the person with the impairment.

Speech impairments Signposting

Stamma – charity supporting people with stammers and other speech difficulties live their lives with dignity by campaigning against discrimination and tackle stigma and ignorance towards people with speech impairments (0808 802 0002).

Speak with IT – charity supporting people with speech difficulties following a stroke or other illness, particularly through the means of technology, to enable people with acquired speech impairments to regain confidence.

The Sequal Trust – charity providing assistive technology for people with communication difficulties, including speech impairments (01691 624 222).

Other Research Resources

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