If you or someone you love is having issues with speech, language and/or communication, we want you to know that it’s never too late to ask for help. Language difficulties are common in adults with or without underlying medical conditions and can affect a person’s ability to talk, read, write or understand.
Whatever you’re struggling with, know that you can work on these skills with a speech-language pathologist in a supportive space whenever you’re ready.
Types of speech difficulties in adults
Motor speech issues
When there is damage to the brain, muscles or nerves used to speak, it’s possible to develop a motor speech problem. Adults can experience a motor speech problem due to stroke, head injury or diseases like Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), Parkinson’s Disease or Huntington’s Disease.
The most common types of motor speech problems are dysarthria, when muscle weakness makes it hard to talk, or apraxia, when you have trouble getting messages from your brain to your muscles to make them move.
Every motor speech problem is different, but you might notice the following signs and symptoms:
- Trouble saying certain sounds or long words
- Difficulty when you start to speak
- Getting stuck while saying a word (this can sound like stuttering)
- Changes in your voice (e.g. talking in an unusually soft or hoarse voice)
- Friends and family have trouble understanding you
Stuttering (speech fluency)
Stuttering interrupts the flow of speech and makes communication challenging. A person’s beliefs and feelings about themselves and their social interactions all play a part in stuttering. Speech fluency can be different depending on the person, on the situation and the day.
Stuttering can lead to anxiety or nervousness about speaking, causing some to avoid situations where speaking is required, like phone calls, school, work or social situations. Unfortunately, these challenges can also negatively affect mental health and contribute to low self-esteem and depression.
Signs & symptoms of stuttering include:
- Difficulty starting a word or phrase
- Prolonging a word or sounds within a word
- Repeating a sound, syllable or word
- A brief silence for certain sounds, syllables or words
- Adding extra words such as “um” or “like” when thinking you may stutter on the next word
- Tension, tightness or movement in the face or body to help say a word
- Anxiety about talking
Causes of stuttering:
There isn’t one known cause of stuttering, but there are factors that make some people more vulnerable:
- Boys are more likely to stutter than girls
- People may stutter because of differences in the areas in the brain that control speech
- A family history of stuttering
- Head injury, stroke and other brain disorders
- Emotional trauma and stress can increase stuttering
Stuttering management and treatment
While there’s no known cure for stuttering yet, speech therapy and counselling can improve a stutter and boost speaking confidence. The best thing you can do if you or someone you know has a concern with stuttering is to make an appointment with a speech-language pathologist.
Voice disorders
We use our voices to speak, sing, laugh and work. Even the sound of our own voices tells others a lot about us. It’s hard for most people to imagine losing their voice for even a day. Voice disorders can have a huge impact on our personal and professional lives. People who use their voice constantly through their workday (e.g. teacher, gym instructor, broadcasters) may encounter difficulties with their voice.
Signs and symptoms of a voice disorder:
- A voice that is weak or tires out quickly
- A feeling of soreness or a lump in the throat from talking
- Hoarseness or unpredictable changes in the sounds of the voice
- Difficulty changing loudness (too soft or too loud)
- Problems singing
- A chronic cough or throat clearing habit
- Vocal fold dysfunction (a breathing problem)
- A voice that’s unusually high or low
- A Voice that's too high or too low (doesn't match gender)
Voice disorder management
If a voice problem lasts for more than two weeks, you should ask your doctor for a referral to an Ear, Nose and Throat (ENT) doctor to look at your vocal cords. Your ENT may then refer you to be seen by a Hearing and Speech Nova Scotia speech-language pathologist with experience treating voice disorders.
Individuals looking for gender-affirming voice training do not need to be seen by ENT and may self-refer directly to Hearing and Speech Nova Scotia.
It’s possible your ENT will refer you to a voice lab — a specialized clinic operated by a Laryngologist (an ENT with a voice and airway specialty) and a speech-language pathologist with advanced training in voice assessment and treatment.