ICD-10 Code: F80.9
Speech sound disorder is part of a cluster of diagnoses called communication disorders. Communication disorders are a group of psychiatric conditions that include:
A communication disorder is an impairment in the processes of speech, language or communication. Speech is the expressive production of sounds and includes an individual's articulation, fluency, voice and resonance quality. Language includes the form, function, and use of a convention system of symbols (i.e., spoken words, written words, sign language, pictures) in a rule-governed manner for communication. Communication includes any verbal or nonverbal behavior that influences the behavior, ideas, or attitudes of another individual. An adult with a communication problem may exhibit many different symptoms. These may include difficulty following directions, attending to a conversation, pronouncing words, perceiving what was said, expressing oneself, or being understood because of a stutter or a hoarse voice. An assessment of speech, language and communication abilities must take into account the individual's cultural and language context, particularly for individuals growing up in bilingual environments.
Information and prevalence data on speech sound disorder in adults is limited. Most adults remediate any speech sound difficulties in childhood with speech and language therapy. If problems persist, they are typically attributed to an acquired or neurological impairment such as dysphagia or apraxia.
The limited epidemiologic data that are available suggest that prevalence is slightly higher in boys than girls, and has a low positive correlation with socioeconomic status.
Speech sound disorder refers to any combination of difficulties with perception, motor production, and/or the phonological representation of speech sounds and speech segments that impact speech intelligibility. The disorder is characterized by:
Speech sound disorders can impact the form of speech sounds or the function of speech sounds within a language. Adults with speech production difficulties may experience trouble with phonological knowledge of speech sounds or the ability to coordinate movements of the articulator (i.e, the jaw, tongue, and lips), with breathing and vocalizing for speech. A speech sound disorder is diagnosed when speech sound production is not what would be expected based on the child's age and developmental stage and when the deficits are not a result of a physical, structural, neurological, or hearing impairment.
Signs and symptoms of speech sound disorders include:
Not all sound substitutions and omissions are speech errors. Instead, they may be related to a feature of a speaker's dialect or accent. Any regional, social or cultural/ethnic variations should be taken into account before considering a diagnosis.
Learning to produce speech sounds clearly and accurately follows a developmental pattern. Children with speech sound disorder utilize phonological simplifications and misarticulate words far longer than their typically developing peers. The cause of speech sound disorders in most adults is unknown.
A number of studies have identified risk factors associated with speech sound disorders in children. These risk factors include male sex, oral sucking habits in infancy, ear, nose and throat problems, family history of speech and language problems, low facial muscle tone, inability to coordinate facial musculature, and low parental education.
If they are not successfully treated in the early years, functional speech disorders can persist into adulthood, often causing considerable distress. These adults may have difficulty pronouncing just one or two sounds, like /s/ and /z/ or just /r/, or just /l/. Adults often overcome these disorders, achieving "standard" speech sound production of any of the sounds that were previously in error.
autism, as well as in families of individuals with specific language disorders. However, having a genetic predisposition to social (pragmatic) communication disorder does not necessarily mean that someone will develop social (pragmatic) communication disorder.
Speech Sound disorder is treatable. Intervention recommendations for speech sound disorder in adults are outlined in the American Speech-Language and Hearing Association.
Clinical research suggests the following treatments are indicated for the treatment of adults with speech sound disorder:
Under the Americans with Disabilities Act (ADA), particularly Title I, employers are required to provide workplace accommodations for individuals with learning disabilities, but only for disabilities that have been disclosed. Individuals have the right to determine whether, when, how, and to whom to disclose their disabilities, and many choose to withhold disability information. The following sources provide recommendations of workplace accommodations for adults with learning disabilities: ADA and LdAmerica.org.
In addition, research suggests the following interventions are promising: