College of Healthcare Sciences Speech Pathology Speech Difficulties, Impairments and Disorders

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Speech Difficulties, Impairments and Disorders

Speech pathologists work with people across the life span with speech difficulties, impairments and disorders due to a range of causes.


Voice refers to the production of sound from the larynx (voice box). People with voice difficulties and impairments may experience a range of challenges such as vocal pain, difficulty maintaining a clear voice, difficulty being heard by other people or the inability to produce any voice at all. For example:

  • A professional singer may have strained the muscles in her larynx and have difficulty producing her normal singing voice.

  • A teenager may develop nodules (callouses) on her vocal folds through repeated yelling at social and sporting events.

  • A young security guard may have difficulty producing voice because his larynx was injured when he was punched in the neck.

  • An adult may need to have his voice box removed (laryngectomy) due to throat cancer caused by smoking.

Fluency (stuttering)

The most common form of fluency impairment is a stutter. Stuttering is a disruption to the fluency of speech with repetitions of sounds, prolongations of sounds, long pauses or not being able to begin a word. People who stutter may have difficulty getting their message across to other people. For example:

  • A preschool child may be helped by simple therapy methods that parents are taught to carry out at home.

  • A school aged child may be helped to reduce his/her stuttering through weekly or intensive therapy sessions as an individual or in small groups.

  • An adult may be helped to control stuttering and maintain fluent speech through weekly or intensive therapy sessions as an individual or in small groups.


Swallowing disorders can be life threatening due to reduced intake of food or choking. The speech pathologist’s management, in conjunction with medical management is a vital area of work. For example:

  • A premature or ill baby who has been tube fed for some time may have difficulty learning to suckle and swallow.

  • Children or adults with cerebral palsy may have difficulty with feeding themselves, chewing and swallowing due to poor muscle control.

  • A person may have poor neurological (brain) control of the muscles required for chewing and swallowing following a stroke.