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Speech-Language Therapy

Answers to Questions About Communication Disorders

What is a Speech Impairment?

When a person is unable to produce speech sounds correctly or fluently, or has problems with his or her voice, then he or she has a speech disorder. A child who has difficulty saying sounds correctly may have a speech delay or oral-motor weaknesses. If such difficulties have an adverse educational impact, the child may have an impairment that qualifies for special education services. The Missouri Department of Elementary and Secondary Education recognizes three categories of speech impairments: Sound System Disorder, Speech-Voice Disorder, and Speech-Fluency Disorder.

A SOUND SYSTEM DISORDER refers to problems with either articulation or phonology. Errors may include:

  • Saying one sound for another (“wabbit” for rabbit)
  • Omitting a sound in a word (“i-cream” for ice cream)
  • Distorting a sound (“thee” for see)
  • Adding a sound or transposing sounds (“bastek” for basket)

A VOICE DISORDER refers to speech that is:

  • Too high, low, or monotonous in pitch
  • Interrupted by breaks
  • Too loud or too soft
  • Harsh, hoarse, breathy, or nasal

A FLUENCY DISORDER refers to speech that has excessive interruptions in flow or rhythm that:

  • Can include hesitations, repetitions, or prolongations
  • Can affect sounds, syllables, words, or phrases
  • Is commonly known as “stuttering”

What is a Language Impairment?

A child with a language impairment may have difficulty with understanding and using words and sentence structures. These difficulties may be reflected in the areas of vocabulary, grammar, abstract reasoning, the processing of information, and/or social skills. These difficulties may impact the student’s speaking, listening, reading comprehension, and/or written expression skills.

These are some of the characteristics of students with language impairments:

  1. Difficulty in seeing relationships, categorizing, classifying
    ex: Chalk is to chalkboard as pencil is to paper (relationships)
    Car, train, plane = transportation (categorizing)
  2. Difficulty in sequencing ideas and events in relation to time
    ex: Story sequencing (“first…then…next…finally”)
    Relating events of the day in terms of “before” and “after”
  3. Difficulty in following a series of commands
    ex: Completes tasks in the wrong order
    Omits parts because of memory weaknesses
  4. Lack of spontaneity in verbalization
    ex: Doesn’t start a conversation or ask questions very often
  5. Use of telegraphic or brief responses
    ex: “Boy saw doctor hospital.”
  6. Incorrect use of verb tense
    ex: “Yesterday, I swim.” “Yesterday, I go swimming.”
    (Past and future tenses are the most often deviant)
  7. Incorrect use of plurality in noun and verb forms
    ex: “Mom and Jan is going to school.” “I saw three tree.”
    “The boys is climbing the tree.”
  8. Incorrect use of pronouns
    ex: “Her have a new dress.” “Me tear my paper.”
  9. Misnaming or difficulty in word finding
    ex: “I want a-a-a knife, no, fork.”
    “Kitchen” when shown a picture of a stove
    “That thing you use to take it off the paper” (eraser)
  10. Difficulty in using or interpreting question forms
    ex: Where do you go to school? “First grade.”
    Much difficulty with “wh-” forms (who, what, where, when, why, how)
  11. Irrelevant or slow responses
    ex: Where do you live? “I like popsicles.”
  12. Difficulty in following oral and written directions
    ex: Write your last name first and your first name last.
    Difficulty understanding prepositions (under, around, above, through, etc.)
  13. Reduced comprehension of basic concepts and/or of vocabulary
    ex: Uses “circle” for wheel
    Difficulty with multiple meanings (“bat” as in baseball, or flying mammal, or to hit)
  14. Incorrect word order in sentences
    ex: “I can have the book?”
    “Soda my Mom’s drinking.”
  15. Difficulty with rote memory tasks
    ex: Days of the week, counting
  16. Difficulty in understanding humor, idioms, and figures of speech
    ex: What’s black and white and read all over?
    Let’s put some light on the subject.
  17. Difficulty with pretending or play-acting
    ex: Make believe you are a ________.
  18. Difficulty with abstracting
    ex: What would you do if _____?
    What would happen if ______?
  19. Difficulty in generalizing
    ex: Can do a math problem in school but can’t determine correct change at the store.
    Says “two pennies” but writes “two penny”
  20. Difficulty initiating/maintaining/ending a conversation; lack of greetings/farewells
    ex: I just read a book about cats. “I have a cat. I got it from my grandma. My grandma likes peanuts but I like almonds, but walnuts are okay. Unless you’re allergic to nuts.”
    Hello, Bob! How are you today? “My mom said I have to ride the bus home.”

The Role of Speech-Language Pathologists in the Schools

Click to view a power point presentation provided by the American Speech-Language Hearing Association (ASHA).


Suggestions for Teachers

How Can Teachers Help Students with Language Impairments in their Classrooms?

Here are some suggestions that teachers may find to be helpful in teaching a child with a language impairment.


  • Have a routine or set schedule of daily activities.
  • Keep assignments on the blackboard or bulletin board.
  • Keep general noise level down during directions and introduction of information.
  • Provide preferential seating that allows for frequent monitoring of comprehension.


Present academic material in a number of different ways:

The use of visual material is recommended.

  • Use of overhead projector and transparencies or “Smartboard.”
  • Use of written outlines during discussion.
  • Use of graphic organizers, webs, flow charts, etc. to make information, relationships, sequences, etc. more visual.
  • Teacher demonstration of instructions whenever possible.
  • Use of pictures or objects to illustrate ideas.
  • Color coding of directions in workbooks and textbooks.
  • Highlighting or circling key words in worksheet directions.
  • Provide corrected form of written language errors.

Modification of oral presentation can be structured in the following ways:

  • Repetition of commands/directions.
  • Rephrasing statements by varying vocabulary and sentence structure.
  • Breaking statements into shorter segments.
  • Varying types of activities to lessen auditory fatigue.
  • Adjusting speaking rate to level of child’s comprehension.
  • Giving ample time for child to respond.


  • Pre-teach key vocabulary.
  • Be aware that the child may have a very literal understanding of words. Figures of speech may need to be clarified.
  • Make available vocabulary lists from textbooks to SLP and parent.
  • Specialized vocabulary needs can be shared with SLP at appropriate times (i.e., field trips, special events, etc.).

Also, check out the article, “Thinking with Language, Images, and Strategies” at the link below: