The speech impairment in adults can include many symptoms which is causing the adult to have difficulties with the vocal communication. Examples of speech impairment are including rapid speech, stuttered speech, hoarse speech, slowed speech and slurred speech. The speech impairment can affect the way a person creates sounds to form words . There are certain voice disorders which can be considered as speech disorders. Stuttering is one of the most commonly experienced speech disorders. Also there are other speech disorders, such as apraxia (this is a motor speech disorder that is caused by damage to the parts of the brain which are related to speaking) and dysarthria (this is motor speech disorder in which muscles of face, mouth or the respiratory system can become weak or they have difficulty moving). There are some people who have speech impairment and they are aware of what they would like to say but they are not able to articulate their thoughts . This can lead to lower self – esteem and development of depression. Speech impairment can affect adults and children. The early treatment is important because it can correct these conditions.
Symptoms of Speech impairment
There are many symptoms which can be present and this depends on the cause for the speech disorder . Here are the most common symptoms that are experienced by people who have speech impairment:
- Hoarseness or speaking with a raspy or gravelly sounding voice
- Distorting sounds when talking
- Taking frequent pauses when talking
- Visible frustration when trying to communicate
- Blinking several times while talking
- Making jerky movements while talking, usually involving the head
- Elongating words
- Adding extra sounds and words
- Repeating sounds, which is most often seen in people who stutter
If you have noticed a sudden onset of impaired speech, then you should ask for medical help as soon as possible. This can be a sign of potentially life – threatening condition, such as stroke. If you develop speech impairment more gradually, then you should talk with your doctor. This can be a sign of underlying health condition. If your speech impairment is caused by a viral infection or using your voice too much, then it can resolve on its own but if the speech impairment is caused by other causes, then it can worsen so you need to start your treatment as soon as possible.
Causes of Speech impairment
The speech impairment can affect the nerves, muscles, vocal cords and other structures within the throat. Here are some causes for speech impairment:
- Vocal cord paralysis
- Polyps or nodules on the vocal cords
- Respiratory weakness
- Muscle weakness
- Brain damage
- Vocal cord damage
Those people who have some medical or developmental condition can have speech disorders. Here are some conditions which can lead to speech disorders:
- Amyotrophic lateral sclerosis (ALS) which is also known as Lou Gehrig’s disease
- Huntington’s disease
- Laryngeal cancer
- Oral cancer
- Attention deficit hyperactivity disorder (ADHD)
Also speech impairment can be hereditary and it can develop over time [3,4].
Types of Speech impairment
Here are some types of speech impairments:
Aphasia is a condition in which people are having trouble thinking words or pronouncing them correctly. This can be a symptom of brain damage, such as stroke. Also there can be other causes for aphasia, such as cognitive degenerative conditions, such as Alzheimer’s disease, brain tumor and head trauma. 
This condition can happen when you are having trouble moving the muscles of your diaphragm, vocal folds, tongue or lips. It can happen from degenerative muscle and motor conditions, such as Parkinson’s disease, cerebral palsy, muscular dystrophy and multiple sclerosis. Also there can be other potential causes for dysarhria, such as alcohol consumption; tight or loose dentures; facial paralysis, such as Bell’s palsy; Lyme disease; brain tumor; head trauma and stroke. 
This condition is involving involuntary movements of the vocal cords when you speak. This condition can be caused by abnormal brain functioning and the exact cause for it is not known.
There are many injuries, activities and other conditions which can affect your vocal cords and the ability to speak. They can include ingestion of certain drugs, such as amphetamines, antidepressants or caffeine; polyps, nodules or other growths on your vocal cords; and throat cancer.
 Prelock PA, Hutchins T, Glascoe FP. Speech-language impairment: How to identify the most common and least diagnosed disability of childhood. The Medscape Journal of Medicine. 2008;10(6):136.
 Sices L, Taylor HG, Freebairn L, et al. Relationship between speech-sound disorders and early literacy skills in preschool-age children: Impact of comorbid language impairment. Journal of Developmental & Behavioral Pediatrics. 2007;28(6):438–47.
 Kang C, Drayna D. Genetics of speech and language disorders. Annual Review of Genomics and Human Genetics. 2011;12:145-64.
 Hayiou-Thomas ME. Genetic and environmental influences on early speech, language and literacy development. Journal of Communication Disorders. 2008;41(5).
 Thompson CK. Single subject controlled experiments in aphasia: The science and the state of the science. Journal of Communication Disorders. 2006;39(4):266–91.
 Pennington L, Parker NK, Kelly H, Miller N. Speech therapy for children with dysarthria ac quired before three years of age. Cochrane. 2016.