Speech impairment (adult)

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Brain

Language impairment; Impairment of speech; Inability to speak; Aphasia; Dysarthria; Slurred speech; Dysphonia voice disorders

For dysarthria, speaking slowly and using hand gestures are recommended. Family and friends need to provide plenty of time for those with the disorder to express themselves. Stop the use of medications that are causing the problem, if possible. Minimize the use of alcohol.

For aphasia, family members may need to provide frequent orientation reminders, such as the day of the week. Disorientation and confusion often occur with aphasia. Often, people assume that patients with aphasia are incompetent. But patients and caregivers can sometimes learn nonverbal ways of communicating.

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Recognition and treatment of depression is also important for people with severe speech and language disorders.

It's important to maintain a relaxed, calm environment and keep external stimuli to a minimum.

• Speak in a normal tone of voice (this condition is not a hearing or emotional problem).
• Use simple phrases to avoid misunderstandings.
• Don't assume that the affected person understands.
• Provide communication aids, if possible, depending on the person and condition.

Frustration, profanity, and depression are typical responses in people with aphasia.

Contact your health care provider if:

• Impairment or loss of communication comes on suddenly
• There is any unexplained impairment of speech or written language

Unless the problems have developed after an emergency event, the health care provider will take a medical history and perform a physical examination. The medical history may require the assistance of family or friends.

Medical history questions documenting speech impairment may include the following:

• When did it develop?
• Did it develop suddenly?
• Is there a problem with clearly pronouncing words (dysarthria)?
• Is there a problem understanding speech?
• Is there a problem expressing thoughts through speech?
• Is there a problem understanding writing?
• Is there a problem expressing thoughts through writing?
• Has there been a head injury?
• Are there problems with dentures?
• What medications are used?
• Is there recent or former heavy alcohol use?
• What other symptoms are present?

The physical examination will include a detailed evaluation of brain function.

Diagnostic tests that may be performed include the following:

• Blood tests
• Cerebral angiography
• CT scan of the head
• EEG
• Electromyography (EMG)
• Lumbar puncture
• MR angiography
• MRI of the head
• Urine tests
• X-rays of the skull

The health care provider may refer you to a speech and language therapist or social worker.

Review Date: 04/23/2008
Reviewed By: Luc Jasmin, MD, PhD, Department of Neurology and Gene Therapeutics Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).