Speech Vs. Language Disorders

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Speech Vs. Language Disorders

What is Speech?

Speech refers to the spoken form of language; it’s the sounds that make up language.  It is the verbal expression of language that includes articulation (pronunciation).  Speech sounds are made of phonemes (the smallest units of sound that have meaning).  A phoneme is a mental representation of a sound that has predictable variants that are called allophone.

What is language?

Language refers to the entire system of expressing and receiving information in the code/rules that make up a specific language via speaking, reading, writing, and/or gesturing.

A child may present with delay or disorder in speech, language or both.  For example a child may not have any difficulty pronouncing his/her words correctly, however may be unable to put more than two words together.  In retrospect, he/she may use words and/or phrases to express ideas, but may be difficult to understand by his/her environment.  Another child may both be difficult to understand and have difficulty following directions.

What are speech and language disorders?

Any problems or disruption in communication and related areas such as oral motor function, cognition, swallowing and/or social pragmatics is considered a disorder in speech, language or both.  These delays/disorders may range from simple sound substitutions to the inability to understand or express oneself, or use the oral-motor mechanism for functional speech and feeding.  Some causes of speech and language disorders may include hearing loss, neurological disorders, brain injury, mental retardation, drug/alcohol abuse, physical impairments (i.e. cleft lip/palate), vocal abuse/misuse, weakness of the oral-motor musculature, and maturation.

What are speech disorders?

Speech disorders include the following problems according to the American Speech-Language-Hearing Association (ASHA):

Articulation/Phonological disorders à Difficulty forming and combining sounds when speaking such as sound omission (ha for hat), sound distortion (sirt for shirt), sound substitution (wabbit for rabbit), addition of sounds (cuhlock for clock).  It is difficulties in producing sounds in syllables or saying words incorrectly to the point that other people can’t understand what’s being said.

Apraxia of speech à A speech sound disorder that affects the ability to initiate speech; to sequence and say sounds, syllables or words consistently; and/or to use appropriate syllable stress in speech.  The problem is not due to muscle weakness or paralysis, but rather the brain’s ability to plan movement of the body parts needed for speech (lips, tongue, jaw).

Fluency/Stuttering à An interruption in the flow or normal rhythm of speech, difficulties maintaining appropriate rate of speech.  It is characterized by hesitations, repetitions (st-st-stuttering), or prolongations (ssssstuttering) of sound, syllables, words, or phrases.  Most often, stuttering begins in children ages 2-6 years who are developing language skills.  It may go away by itself or may last a lifetime.

Resonance/Voice disorders à A problem characterized by poor voice quality (harsh, hoarse, breathy, nasal), inapropriate pitch (too high, too low, never changing, interrupted by breaks), or inappropriate loudness (too loud, too soft) and may accompany pain or discomfort for the child when speaking.

Resonance disorders à A problem with hypernasality where the child sounds very nasal in spontaneous speech across all speech sounds other than /m/, /n/, /ing/.  This problem is often mistaken as a voice disorder, however, it is rather a problem with the velopharyngeal mechanism.

Dysarthria à A combination of speech sound, fluency, and/or voice problems stemming from weakness, paralysis, or lack of coordination among the body parts used for speech.  Neurological causes may include stroke, cerebral palsy, Parkinson’s disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease).

What are language disorders?

Language disorders are difficulties in receiving, processing, formulating, and/or sending messages).  It is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Language disorders may be due to any of the following:

Word meaning à Reduced vocabulary size or trouble finding words.

Word endings-incorrect grammar à not using correct plurals, possessives, or tense.

Word order à Using incorrect grammar.

Word use à Not taking turns or staying on topic during conversations, not being able to describe an event in sequence, using slang expressions in formal speaking situations, or making demands rather than asking questions.

Listening à Understanding and remembering and following directions.

Asking and answering WH-questions.

Reasoning and problems solving.


What is typical speech and language development?

It is crucial to discuss your child’s speech and language as well as other development concerns with his/her pediatrician from an early stage at every routine to differentiate immature development vs. their ability to communicate due to a problem.  Below is a guideline of developmental norms:

Receptive Language Development — learning to listen and understand language:


  • They are aware of environmental sounds.
  • Are very attentive to sounds close to them and startle/cry if there is an unexpected noise.

0 – 3 months

  • They turn to the adult/caregiver when they are speaking.
  • They smile and recognize the caregiver/parent’s voice.
  • May stop their activity and attend to unfamiliar sounds.
  • They often respond to comforting tones regardless of the familiarity of the voice.

4 – 6 months

  • They often respond to the word “no”.
  • They are responsive to changes in your tone of voice (i.e. angry, happy, sleepy).
  • They begin to enjoy rhythm and music and look for the source of sounds.

7 – 12 months

  • They listen when they’re spoken to.
  • They turn to look at your face when called by name.
  • They discover and engage in games.
  • They recognize the names of familiar objects.
  • They begin to respond to requests.

1 – 2 years

  • They point to pictures in a book when the objects are named.
  • They point to a few body parts when asked.
  • They can follow simple-single commands.
  • They understand simple questions.
  • They like listening to simple stories and enjoy songs and rhymes.

2 – 3 years

  • They understand two stage commands.
  • They understand contrasting concepts or meanings.
  • They notice sounds like the telephone or doorbell ringing.
  • They may point to or become excited, get you to answer, or attempt to answer themselves.

3 – 4 years

  • They understand simple “who,” “what,” and “where”.
  • They can hear you when you call from another room.

4 – 5 years

  • They enjoy stories and can answer simple questions about them.
  • They hear and understand nearly everything that is said to them.

Expressive Language Development – learning to speak and use language.


  • They communicate via different sounds to let others know they are experiencing pleasure, discomfort or pain.

0 – 3 months

  • They smile at people when they come into view.
  • They “coo and goo” when content.
  • Their cries “differentiate” depending on the situation.

4 – 6 months

  • They gurgle sounds or “vocal play” while playing with adults or themselves.
  • Their babbling intensifies and it will sound like they are “talking.”
  • The “speech-like” babbling includes many sounds including the bilabial (two lip) sounds “p”, “b”, “m.”
  • By using sounds or gestures, they express their needs and wants.
  • They can make very “urgent” noises to prompt you into action.

7 – 12 months

  • The sound of their babbling changes and they acquire more consonants as well as long and short vowels.
  • They use speech or other sounds to get attention.
  • Their first words should have appeared (i.e. mama, doggie, night-night, bye-bye)

1 – 2 years

  • They accumulate more words as each month passes.
  • They ask 2-word questions (i.e. where ball?, what’s that?, more chippies?, what that?).
  • They combine two words in other ways to make “stage one sentence types” (i.e. birdie go, no doggie, more push).
  • Words are produced more clearly as more initial consonants are used in words.

2 – 3 years

  • Their vocabulary expands and can name most things in their environment.
  • They usually use one, two or three word utterances which family members can usually understand.
  • They ask for or draw attention to what they want by naming it, using one of its attributes or by commenting.

3 – 4 years

  • Their sentences become longer as they combine four or more words.
  • They talk about things that have happened away from home, and are interested in talking about pre-school, friends, outings, and interesting experiences.
  • They usually present with fluent and/or clear speech where other people/strangers can understand them.

4 – 5 years

  • They speak clearly and fluently in an easy-to-listen-to voice.
  • They use long and detailed sentences (i.e. we went to the zoo but we had to come home early because mommy wasn’t feeling well).
  • They use “adult-like” grammar to tell long and involved stories and maintain topics.
  • Most sounds are pronounced correctly, with some lisping present on sounds “r”, “v” and “th”.
  • They communicate easily with familiar adults and with other children.

When would I use the services of a speech-language pathologist?

The Speech-language pathologist thrives to meet the needs of each child in developing their competence in communication skills.  A communication disability may interfere with one or all of the following elements of the educational process: academic achievement, frustration in speaking situations, social interactions, task completion, or intelligibility.  The program provides speech & language services to children in Infant Toddler Programs (birth to three), in PreSchool Programs (three & four-year-olds), Regular & in Special Education Programs (Kindergarten-12th Grade).  You might use the services of a speech-language pathologist if…

  • You have difficulty understanding what the child is trying to say;
  • You think the child is speaking differently from children of the same age;
  • The child has difficulty telling you what he or she wants; or
  • The child has difficulty understanding what people are saying.

What is a speech-language pathologist (SLP)?

An SLP is a licensed health care professional who diagnose, evaluate, and treats children & adults who have difficulty speaking (speech & language), listening, fluency (stuttering), pragmatics (social skills; turn-taking), voice, swallowing, differences in dialects or accents, reading, and/or writing. SLPs are educated to work with people who use more than one language. They are skilled at distinguishing communication disorders from communication differences that may result from being multilingual. SLPs also work with people who want to improve the effectiveness of their daily or professional communication or modify their accent.  Speech-language therapy is the treatment for most kids with speech and/or language disorders/delays.  Remember that a speech disorder refers to a problem with sound production, whereas a language disorder refers to a difficulty understanding or putting words together to communicate ideas.