Adult speech difficulties are common and come in many forms including stuttering, dysarthria, voice problems, and articulation difficulties. Often with speech therapy and some strategies many adults can improve their speech and communication skills. Our understanding of the myriad conditions out there grows every day, as do our tools for working with them. We are hopeful for the future! It is not necessary for people to struggle on in silence with their problems. We believe that it is possible for anyone to make progress with their communication so long as there is the will to learn. With the wealth of technological innovations out there designed to ameliorate difficulties with speech and communication, there are many options available.

There are a number of reasons speech difficulties occur in Adulthood:

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Stuttering

The National Institute on Deafness and Other Communication Disorders estimates that around three million Americans stutter. It’s not widely known, but stuttering can also include other physical tics like blinking. What causes stuttering is not known, although it is thought there might be a hereditary element to it. The treatment for stuttering, as a result, is behavioral. Triggers can often precede a stuttering episode. Speech language pathologists can help sufferers identify and take these triggers into account.

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Accident and Injury

Unfortunately accidents happens, and these can lead to damage of the brain or speech muscles. Sometimes these things correct themselves naturally, but often there are long lasting effects. Contusions, as swellings on the brain are called, can limit function for a period. Traumatic brain injuries are a common cause of this sort of damage, such as those you might get in an auto collision. Check out our Downloads section which has some fact-sheets with information and strategies to help a range of adult speech difficulties.

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Disease and Illness

Certain disease and illness can cause speech difficulties because of muscle or brain cell degeneration, but often there are many strategies that you can put in place to improve communication. Our section on Adult Acquired Difficulties will focus heavily on communication difficulties caused by disease such as Parkinson’s disease and MS etc. Working with a speech language pathologist is one of the best ways to help your communication issues.  Also check our Resource Centre for information and fact-sheets relating to improving communication following disease or illness.

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Articulatory Difficulties

“I’ve always had a speech problem” – some adults have had speech difficulties since childhood and the speech difficulty only became a problem when they reached adulthood. Some people might describe this as a “speech impediment”, “speech problem”, or a “pronunciation problem”. Sometimes it can be difficult to change some speech difficulties that have been present since childhood because they are so embedded. However, change is not impossible, and if you and your speech therapist / pathologist cannot “fix” the speech problem, there may be alternative strategies to help. While some larynx problems, such as hoarseness, are temporary, others may be chronic. Where there are therapy-based solutions available, we can help you with your therapy.

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Larynx Issues

These are some of the most common larynx issues adults face. Polyps or nodules on the vocal cords can make it difficult for the vocal cords to vibrate and produce speech. There are many potential causes for them. Smaller polyps or nodules can be managed by addressing the cause, but large growths require surgery. Spasmodic dysphonia is the name for the condition which makes your vocal folds spasm or tighten during speech. It can sometimes inhibit all speech entirely. Voice therapy can help you communicate in spite of this incurable condition. There is also the possibility of being referred to an ear, nose, and throat physician so that Botox can be used to loosen your vocal folds. Vocal fold paralysis, which is when your vocal folds are incapable of moving, can cause serious breathing and swallowing problems as well as speech difficulties. In cases this serious, a tracheotomy may be necessary to breathe. Speech therapy can assist in preventing food entering the trachea.

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Dysarthria

This is a motor speech disorder caused by a neurological injury or disease and it can affect one or more of the speech subsystems – respiration, phonation, resonance, prosody, articulation. When the part of the brain that controls speech production is damaged, the link from the brain to the muscles of speech is affected. Dysarthria can present in varying degrees of severity depending on localization and severity of brain damage. The production of speech sounds may be very difficult and in some cases speech may not be possible. The lips, tongue, palate, facial muscles, and the vocal folds (chords), may be uncoordinated or immobile. Further difficulties may occur if breathing is also affected as the lungs provide the energy for speech. An individual with dysarthria may have slurred, hoarse, jerky or strained speech and may be difficult to understand or completely unintelligible. Intelligibility may be further hindered by low volume, variable rate and rhythm, and irregular pitch. Brain injury causing dysarthria can be due to brain tumour, stroke, cerebral palsy, long term use of certain medications, or a degenerative diseases such as Parkinsons. Other co-occuring problems may include difficulties with swallowing and saliva control. This swallowing issue is known as dysphagia. There are different types of Dysarthria depending on the area of and type of brain damage. Treatment for dysarthria can be carried out by a speech and language therapist / pathologist and may involve strengthening or relaxing speech muscles, using compensatory techniques, or looking at assistive communication strategies or devices. For a more detailed explanation of Dysarthria and the compensatory strategies can be found in the Dysarthria section, and a factsheet can be found in the Downloads section.

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Voice

Many adults experience voice problems for a range of reasons. icommunicate has a section dedicated to adult voice problems with information, voice care tips and ideas to improve your voice. See our Voice Problems Section.

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Assistive Technology (AAC)

There are now many new hi- and low-tech assistive communication devices that can help with a number of different speech and communication difficulties. If you have a speech problem and are finding it hard to make yourself understood, you may find that an assistive device that has voice output, or where you can write messages, may help. In our Assistive Technology Section we discuss the use of assistive technology and lo-tech devices to facilitate communication. With the advent of new technology, this is becoming a major growth area for communication and communication difficulties. This website promotes communication and a total communication environment. This means we focus on every modality that can be used to facilitate communication.

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General Tips to Make Speech More Understandable

There are many things you can do in your day to day life that will make you clearer and easier to understand.

• Look at the person you are talking to.
• Avoid communicating in noisy and distracting environments.
• Slow down, and do not speak to quickly.
• Make your sentences smaller between breaths.
• Look forward, not down, when talking.
• Use gesture and facial expression to enhance your message.
• Use your lungs, and breathe from your diaphragm when talking to give your voice more power.
• Follow conversational rules such as turn taking and staying on topic.
• If you are having real problems being understood investigate other forms of communication. You can try writing your message, signing or using an electronic device to speak for you.

If you have concerns about your speech or voice, visit a qualified speech therapist / pathologist for assessment and speech therapy.