hard words to pronounce with speech impediment

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Top 10 hardest words to say with a lisp

Michael Nelli , Online Sports Editor | October 21, 2020

• Michael Nelli

The only thing that scares me is the letter S.

A lisp is something that is usually only found in kids before the age of five. It is a speaking disability that makes an S or a soft C sound like a “th” or a “sh.” I happen to have a lisp and would like to show the top 10 hardest words to say when having one.

There are some criteria. If you were hoping to see “Sally sells sea shells on the sea shore” or something of that nature, you will not find it. The list is based on ten somewhat common words in the English dictionary.

Number 10: Assassin. This word is difficult to say because of the amount of S’s and the prominence of them within the word. 4/9 of the letters are “s” and that is just overly difficult to say when you have a lisp. 3/10 difficulty factor.

Number 9: Sassy. Another problematic word as it is 60% the letter S. The letter starts to build up and because of the lisp my mouth gets spit riddled whenever I start to say it. 3.5/10 difficulty factor.

Number 8: Sauce. This one is a surprising one, I understand. With the combination of the S and soft C it is a very tough one to get across. I get caught up trying to say the right letters that most of the time it just sounds like gibberish. 4.5/10 difficulty factor.

Number 7: Senses. I personally don’t think this is a tough tough one. I struggle with it when I say it after a couple other words. Senseless or sense could have made sense here but senses is one that I have extreme trouble with mid-sentence. 4.5/10 difficulty factor

Number 6: Assists. Another weird word for some people to see. Yet again, this is one where the amount of S’s in it just gives you a run for your money. It is a tough one to use in any circumstance and I try my best to stay away from it at all costs. 5.25/10 difficulty factor.

Number 5: Mississippi. This is one that could be argued to be higher up on the list. It can be, but because of the difficulty the next four words, Mississippi is placed here. It isn’t easy by any means, it just doesn’t hold up to the next four. 6.5/10 difficulty factor.

Number 4: Systematic. A shocker here at number four as it doesn’t have a multitude of S’s or soft C’s. That “S” as the third letter really sneaks up on you when you say it, causing mayhem and distress for the rest of the word. 7/10 difficulty factor.

Number 3: Suspension. I struggle with this word more than students struggle taking standardized tests. It is in no way, shape or form an easy or anywhere close to easy word to say. The amount of S’s and the repetitive nature of them leads to a mind-boggling word of nothing. 8.5/10 difficulty factor.

Number 2: Specificities. This word is immensely more difficult to pronounce than any of the previously mentioned words. The S’s and C’s that are used in this word makes it nearly impossible for those with a speech impediment to truly pronounce. 9.75/10 difficulty factor.

Number 1: Statistician. It gives me nightmares even pondering over this word. The close-quartered combat of the S and C in the middle of the word is detrimental to my mouth when I attempt to say it in any circumstance. I stay away from this word as much as a rabbit would stay away from a wolf. 10/10 difficulty factor.

Now I understand this is a lighthearted list and it is meant to have some fun, but that doesn’t mean lessons can’t be taken. If you know someone with a speech impediment, don’t ask them to keep repeating phrases or words for your amusement; it’s not funny, it is hurtful. As I was taught from a young age, if you have nothing nice to say, don’t say anything at all.

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Comments (12)

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Morgan Murphy • Mar 16, 2024 at 1:53 pm

Thank you now I know. The sassy assassin sauce stops the systematic racism in missisipi, is the worst tongue twister

John • Jun 22, 2023 at 6:01 pm

Hardest thing to say with a lisp, coming from someone with a lisp, is scissors

Breezy • Apr 14, 2023 at 12:17 pm

I am 42 years old and this is the most beautiful description of my trouble with words i have ever read. Thank you for assisting me to understand my lisp & pronunciation of the troubled words. ☮️?

Breezy • Apr 14, 2023 at 12:04 pm

I also was taught at a young age and still fully believe today that if you don’t have anything nice to say than do not say anything at all.

Peace & Love, Breezy

Stephanie • Feb 19, 2023 at 2:24 pm

i could not say ‘statistician’ i am not happy

Kat • Feb 16, 2023 at 11:20 am

I had a speech impediment until the 9th grade. This is when I started public school. They sent me to a speech therapist and it was corrected probably within a month. I don’t think most kids knew about it at my new school. I couldn’t do s. I would have to call out my graded paper in class, with A being a six. B was a five. I was an A student, but would only call out five. I believe the speech therapist changed my life. I am 70 now, am very successful and people say very attractive. I had low self esteem, some due to my speech. I have an amazing successful husband and am great full I got corrected. He is a psychologist and would probably not have rejected me because of that. But I probably would not have had the self esteem to have got into the relationship. I think you should correct it as early as possible. Surprisingly it my be fixed in no time

Justin • Apr 2, 2022 at 11:12 pm

I have a friend (fellow parent) and their son (9) clearly has a lisp. My concern is that they have raised him, thought it was cute, didn’t hear it, and/ or may not even notice it. My question is, should I pull them aside and address it, or just let it go? My intent is to help correct it before he gets too old and his peers get more aggressive and nasty. He’s intelligent and kind but I’m extremely concerned he is going to get picked on the older he gets. In my mind it seems better to nip it in the bud and work to correct it rather than expect the problem to solve itself via the public school system.

Daisy • Sep 23, 2022 at 1:14 am

Hey Justin, I’m not the writer of the post, but I am someone with a lisp. I can honestly say I’ve never experienced bullying of any kind over my lisp. If kids want to bully, they will find something to tease him over regardless of the lisp. I also can say that I’ve never had it interfere with me professionally as an engineer. Lisps really aren’t a big deal. I’d probably just leave it alone.

Melanie Smith • Sep 26, 2021 at 7:52 pm

What a cool article! And educational too. It was soulful and–yes–humorous–written. Well done!

angie • Apr 5, 2021 at 11:25 am

damn u cute

Baylee • Jan 7, 2021 at 1:05 am

So i tried this with my retainer in & omg. So hilarious!!

Perry DiGirolamo • Dec 25, 2020 at 2:07 pm

Really enjoyed this article. Very creative subject matter. Never would have that it could make/did make a great article.

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Rhotacism: A complete guide to this speech impediment

Remember when you were a child and spoke by making your “R’s” sound like “W’s” and everything thought it was cute? That’s known as rhotacism and some people live with it even as adults. What is rhotacism, what is it like in other languages, and what are its symptoms? What does it look like as a speech impediment and what are some examples? What are its causes? How does it affect the brain ? Is it curable and how can it be fixed? This article will answer all your doubts about rhotacism. 

What is rhotacism?

Rhotacism is a speech impediment that is defined by the lack of ability, or difficulty in, pronouncing the sound R . Some speech pathologists, those who work with speech impediments may call this impediment de-rhotacization because the sounds don’t become rhotic, rather they lose their rhotic quality. It could also be called a residual R error.

It’s not such an uncommon phenomenon and actually also happens with the letter L , a phenomenon known as lambdacism . Sometimes people mistake these speech impediments for a lisp, of which they are not. Within the 2000-2001 school year, more than 700,000 students within the American public school system were categorized as having either a language impediment or a speech impediment. Ironically, all three speech impediments contain the troubled letter within them.

The word rhotacism comes from the New Latin rhotacism meaning peculiar or excessive use of [r]. The Latin word came from Ancient Greek word rhōtakismós which means to incorrectly use “rho” which is the equivalent of the Greek R. For language nerds, here’s a really great explanation of how the word came into being.

How does rhotacism work in different languages?

Rhotacism is, in theory , more common among people whose native language has a trilled R. For example, in Spanish the “rr” is a trilled R. Other languages with a trilled R include Bulgarian, Hungarian, Arabic, Finnish, Romanian, Indonesian, Russian , Italian, and most Swedish speakers. Some people might mock Asians, specifically Chinese, for not being able to pronounce the English word “broccoli” correctly- rather pronouncing it “browccoli”. This isn’t due to a rhotacism, however. It’s actually due to the fact that Mandarin (Chinese) words can have an “r” sound in the beginning of a word, but not in the middle or end of a word. This leads them to have issues in their phonotactics and creates an inability to pronounce the English “R” in the middle of words.

The leader of Hezbollah, Hasan Nasrallah, is a Lebanese leader and is mocked for his rhotacism when he says, “ Amwīka ” and “ Iswā’īl ” for the Arabic Amrīka (America), and Isrā’īl (Israel). He is a native Arabic speaker- a language which has the trilled R. Notice how he puts a W sound in those two words where the R sound usually is.

Symptoms of rhotacism

• Some people try to hide their impediment by avoiding words with R ’s in them.
• An overall inability to say R sounds
• Using trilled R’s or guttural R’s (such as the French R) when trying to pronounce the regular English R.

Rhotacism as a speech impediment

Using a strict classification, only about 5%-10% of the human population speaks in a completely normal way. Everyone else suffers from some type of speech disorder or another. For children of any language, the R sounds are usually the hardest to master and often end up being the last ones a child learns. That’s why baby talk if you think about it, doesn’t really use explicit or strong R sounds. In English, rhotacism often comes off as a W sound which is why “Roger Rabbit” sounds like “Woger Wabbit”. R is often more difficult because a child has to learn the different combination of the /r/ sounds, not just the letter itself, unlike other letters. For example, when it comes before and after vowel sounds. The combination of a vowel with the /r/ sound is called a phenome and in English, there are eight combinations of these:

–        The prevocalic R , such as “rain”

–        The RL , such as “girl”

–        The IRE, such as “tire”

–        The AR, such as “car”

–        The EAR , “such as “beer”

–        The OR , such as “seashore”

–        The ER , such as “butter”

–        The AIR , such as “software”

A speech impediment is a speech disorder , not a language disorder . Speech disorders are problems in being able to produce the sounds of speech whereas language disorders are problems with understanding and/or being able to use words. Language disorders, unlike speech disorders, have nothing to do with speech production.

Often what happens is that the person speaking isn’t tensing their tongue enough, or not moving their tongue correctly (up and backward depending on the dialect) which makes the W or “uh” sound come out. It may also be that the person is moving their lips instead of their tongue.

Examples of rhotacism

• Barry Kripke from the TV show The Big Bang Theory has both rhotacism and lambdacism- meaning he has issues pronouncing both his R ’s and his L ’s.
• The most famous of rhotacism would be Elmer Fudd from Looney Tunes . He pronounces the word “rabbit” [ˈɹ̠ʷæbɪ̈t] as “wabbit” [ˈwæbɪ̈t]
• In Monty Python’s Life of Brian , the 1979 film’s character Pilate suffers from rhotacism. In the film, people mock him for his inability to be understood easily.

Here’s a video with a woman who suffers from rhotacism. She explains how difficult it can be to have the speech impediment.

Causes of rhotacism

For many people, the causes of rhotacism are relatively unknown-, especially in adults. However, scientists theorize that the biggest cause is that the person grew up in an environment where they heard R ’s in a weird way, the shape of their mouths are different than normal, or their tongues and lips never learned how to produce the letter. In children, this could happen because the parents or adults around think the way the child talks (using baby talk) is cute and the child never actually learns how to produce it.

For one internet forum user, it has to do with how they learned the language , “I speak various languages, I pronounce the “R” normal in Dutch, French, and Spanish, but I have a rhotacism when speaking English. It’s the way I learnt it.”

For other people, speech issues are a secondary condition to an already existing, serious condition. Physically, it would be a cleft lip or a cleft palate. Neurologically, it could be a condition such as cerebral palsy. It may also be a tongue tie . Almost everyone has a stretch of skin that runs along the bottom of their tongue. If that skin is too tight and reaches the tip of the tongue, it can make pronouncing (and learning how to pronounce) R ’s and L ’s difficult. If the tongue tie isn’t fixed early on, it can be incredibly difficult to fix and learn how to pronounce later.

How the brain affects rhotacism

The brain affects rhotacism only for those who suffer from it not due to a physical impediment (such as a cleft palate). For some, this could happen because the brain doesn’t have the phonemic awareness and never actually learned what the letter R is supposed to sound like. This is common with kids whose parents spoke to them in “baby talk” and encouraged the child’s baby talk, too. This kind of behavior only strengthens a child’s inner concept that / R / is pronounced like “w” or “uh”.

Another reason could be that the brain connections simply don’t allow the lips or mouth to move in the way they need to in order to pronounce the R . This inability has little to do with physical incapabilities and more to do with mental ones. Some people with rhotacism have an issue with their oral-motor skills which means that there isn’t sufficient communication in the parts of the brain responsible for speech production.

Treatment for rhotacism

Is rhotacism curable.

It can have negative social effects- especially among younger children, such as bullying, which lowers self-esteem and can have a lasting effect. However, if the impediment is caught early enough on and is treated rather quickly, there is a good overall prognosis meaning it’s curable.

        However, some people never end up being able to properly pronounce that R and they end up substituting other sounds, such as the velar approximant (like w sounds) , the uvular approximant (also known as the “French R ”), and the uvular trill ( like the trilled R in Spanish).

How to fix rhotacism

Rhotacism is fixed by speech therapy . Before anything else, there needs to be an assessment from a Speech Language Pathologist (SLP) who will help decide if the problem can be fixed. If a child is involved, the SLP would predict if the child can outgrow the problem or not. After the diagnosis, a speech therapist will work with the person who suffers from the speech impediment by possibly having weekly visits with some homework and practice instructions. Therapy happens in spouts- a period of a few weeks and a break. There is a follow-up to see if there has been an improvement in pronunciation. In the U.S., children who are in school and have a speech disorder are placed in a special education program. Most school districts provide these children with speech therapy during school hours.

Another option, often used alongside speech therapy, is using a speech therapy hand-held tool that helps isolate the sound being pronounced badly and gives an image of the proper tongue placement to enable better pronunciation.

One study tested a handheld tactical tool (known as Speech Buddies) and the traditional speech therapy methods. The study found that students who used the hand-held tool (alongside speech therapy) improved 33% faster than those who used only the traditional speech therapy methods.

Have you or someone you know ever struggled with rhotacism? Let us know what you think in the comments below!

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Hard Words to Say with a Lisp: How to Work Around Your Speech Disability

Saying hard words is never easy, but it can be especially difficult when you have a speech disability. A lisp is a common speech disability that can make it difficult to pronounce certain sounds. If you have a lisp, don’t worry! There are plenty of ways to work around your speech disability and still communicate effectively with others. In this blog post, we will discuss some strategies that you can use to overcome your lisp and say hard words with ease!

What is a lisp, and how do you know if you have one?

Common causes of lisps, hard words to say with a lisp, how to correct a lisp, when is the best time to seek help for a lisp, how speech therapy can help correct a lisp.

What is a lisp? A l isp is a speech disorder that can make it difficult to say certain words. This disorder can make it difficult to produce the /s/ and /z/ sounds. A lisp is a very common sort of speech impediment.

It does not matter if you find the English language difficult or the Spanish language is harder. But the way you pronounce a difficult word, whether it’s from a native or foreign language, is what involves a lisp. If you are not sure if you have a lisp, there are a few ways that you can check. One way is to say the word “seesaw”. You will most likely say “seesaw” as “seesaow” if you have a lisp. Another way to check is to say the word “lizard”. If you have a lisp, you will most likely say “lizard” as “lidger”. If you think you may have a lisp, it is important to speak with your doctor.

Common causes of this functional speech disorder can include:

• Neurological problems:  Some people may develop a lisp due to a neurological problem, such as a stroke.
• Mouth and teeth problems:  Some people may develop a lisp if they have problems with their mouth or teeth, such as a misaligned jaw. Or they may either have a tongue tie or tongue thrust. Tongue-tie is a condition where the tongue is firmly connected to the floor of the mouth and movement is restricted. Tongue thrust is when the tongue protrudes between the front teeth.
• Speech disorders:  Some people may develop a lisp if they have another speech disorder or learn to pronounce sounds incorrectly.

What Are the Types of Lisps?

There are four professional categories of lisps , as the Speech-Language Pathology Graduate Programs outlines.

A  frontal lisp  is the most common and occurs when individuals push their tongues too far forward.

A  lateral lisp  happens if air moves over the sides of the tongue when speaking, resulting in a slurred sound.

People with  palatal lisps  touch their tongue to the roof of their mouth while saying certain sounds.

Dental lisps  are easily confused with frontal lisps, but these occur with the wrong mouth position; the individual pushes their tongue against the teeth — not through them.

If you have a lisp, it can be difficult to say certain words. Some of the hardest words to say with a lisp include “th” sounds (as in “think”), “s” sounds (as in “see”), and “z” sounds (as in “zoo”). Many people think that a lisp is usually only found in kids before the age of five. By the time they attend school, many would think they wouldn’t have lisp anymore and go on with their everyday lives. But honestly, it can still be present in adults who did not take this speech impediment seriously and did not seek help. If you have difficulty in pronouncing the word with s, z, and th, please consider that you have a lisp.

Here are some hard words to say with a lisp:

• narcissistic
• sixth sense
• statistician
• specificities
• Mississippi

This is just a shortlist of problematic word lisp, and there sure are plenty more speech sound errors that you may find as you continue reading words.

If you have a lisp , there are a few things that you can do to help correct it.

Practice on your own.

One thing is to practice saying the words that are difficult for you. Another thing is to make sure that you are using the right muscles when you speak. You can do this by practicing your speech in front of a mirror.

Seek out a Speech pathologist

They are specialists who can help children with lisps. They will evaluate what type of lisp your child has and then help them with it over a period of time. It can take a few months to a few years to get rid of a lisp. If a child is older when working with a speech-language pathologist, it may take longer.

Frenotomy or frenulopasty

If your child’s lisp is from a tongue-tie, a doctor may recommend a simple in-office procedure called a frenotomy to reduce the tethering. They take a pair of scissors and snip the excess tissue holding the tongue down. If the tongue-tie is more severe, they might require a surgery called frenuloplasty.

Other strategies

Another strategy is to mime the words that you are trying to say. This can help you get the pronunciation correct. You can also try speaking more slowly and enunciating each word clearly.

If you are having difficulty pronouncing certain words, it is best to seek help as soon as possible. The earlier you seek help, the easier it will be to correct the lisp. If you wait too long, the speech muscles may become harder to retrain.

If you have a lisp, speech therapy can help correct it. Speech therapists will evaluate your lisp and give you exercises to help improve your pronunciation. It may take time and effort, but you can overcome your lisp with patience and practice.

Speech pathologists work with people who have lisps to help them recognize what their lisp sounds like and how to position their tongue in the correct place to make the sound. They do this by giving them exercises, like saying specific words or phrases with the sounds in them. Once your child has been working on their lisp for a while, your speech pathologist will engage them in conversation to challenge them to remember proper tongue placement.

Lisps are just one type of speech impediment. There are still others who have difficulty saying short or long words with R, L, D, K, and many more. Now that you know some of the mispronounced words that you need to work on, you can either practice on your own or find professional help to help you pronounce words correctly.

References:

https://www.colgate.com/en-us/oral-health/developmental-disabilities/what-is-a-lisp-and-what-causes-it

https://www.wordnik.com/lists/lispers-nemeses

https://www.webmd.com/children/what-is-a-lisp#091e9c5e8217eb1b-1-4

https://www.wikihow.com/Talk-with-a-Lisp

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Wrap Your Head Around These 26 Hard Words To Pronounce

• Hard-To-Pronounce Words

The pronunciation of words in English is not always straightforward. Unlike some languages, such as French or Spanish, there is not always a direct relationship between the spelling of words and how they are said aloud. In technical terms, there is not always a consistent relationship between graphemes  (basically, writing units) and their phonemes  (sounds) in English. There are a couple of reasons for this. The English language is a wondrous hodgepodge of loanwords , or words borrowed from other languages all of which follow their own conventions for pronunciation, and English spelling was not standardized until relatively recently in its history. For native English speakers and English language learners alike, there are words that are hard to pronounce.

To help give you a leg up on some of the trickier words you may come across in everyday life, we have broken down 26 of the hardest-to-pronounce words in the English language, from A–Z … or from A–W, anyway. Bonus: click on each word to hear its proper pronunciation on its entry page!

The double C in accessory is part of what makes this word tricky. People are often tempted to replace the C with a single S sound. However, each of these C letters represents a different sound (a “hard C” and a “soft C”). With that in mind, accessory is pronounced [ ak- ses – uh -ree ].

This word is so hard to pronounce that it was even featured as a joke in the popular Pixar film Finding Nemo . There are two elements that make the word anemone tricky—the preponderance of M and N sounds and the [ uh -nee ] ending that looks like it should be pronounced like the number one . That said, this word does have a particular rhythm to it that can help you pronounce it correctly: [  uh – nem – uh -nee ].

It’s tempting to pronounce the CH in choir with a [ ch ] sound, but that would be incorrect. The word choir is actually pronounced [ kwahy uh r ]. An antique and sadly obsolete spelling of this word is quire , which is a clearer representation of how it is pronounced.

The word colonel came to English through French, where it was spelled coronel . For historical reasons, which you can read about at our entry for the word, the R was eventually replaced with an L . Keeping this in mind, colonel is still pronounced [ kur -nl ].

Learn about where colonels sit in military rankings, here.

Another word that has been adopted into English from French, complicating pronunciation, is coup . In French, the letters -oup at the end of a word is pronounced [ oo ]. We didn’t just adopt this French word into English, we adopted the French pronunciation, too. That means coup is correctly pronounced [ koo ].

In words that have been adopted into English from Greek, it is typical to pronounce all of the vowels. This is how we get the pronunciation epitome , from the Greek epitomḗ . Unlike many words in English, the final -e here is not silent; epitome is pronounced [ ih- pit – uh -mee ].

Coffee snobs love to correct folks on their pronunciation of the word espresso . It’s tempting to replace that first S with an X , because ex – is a common prefix in English. However, the word comes from Italian and is correctly pronounced [ e- spres -oh ].

Sip on even more coffee terms that may be easier to pronounce but are just as tricky to spell.

The word February is often pronounced as if the first R is not present: [ feb -yoo-er-ee ]. This is because R sounds and Y sounds are quite closely related. Therefore, this is considered a correct pronunciation of the word. However, it is also considered correct to pronounce the R , as in [ feb -roo-er-ee ].

Like the other words from Greek we have covered, the final -e in hyperbole is not silent. Hyperbole , from the Greek hyperbolḗ , is correctly pronounced [ hahy- pur -b uh -lee ].

The word isthmus presents a challenge of pronunciation when read aloud, because most English speakers would be tempted to pronounce the TH in this word. However, in this case, the TH is silent, making the correct pronunciation [ is -m uh s ]. Another word you may be familiar with that has a silent TH is asthma [ az -m uh ].

The R sounds in English can be particularly tricky. It can be hard to get your mouth around them. The word juror is pronounced [  joor -er ] or [  joor -awr ]. Pronouncing R sounds in English simply takes practice. Relaxing your jaw and reciting tongue twisters like “Round and round the rugged rocks the ragged rascal ran” can help.

Speaking of R sounds, the R in library throws many people off. They feel tempted to make the first R sound an [ er ], making the word four syllables, as in [ lahy -ber-er-ee ]. However, there is no E in library , so the word is simply pronounced with three syllables: [ lahy -brer-ee ].

mischievous

Another word where you may be tempted to add an unnecessary syllable or two is mischievous . The – ie and – ous endings often make people think there are [ ee ] sounds in the word [ mis -chee-vee- uh s ], but there aren’t. The word is simply three syllables long, without any [ ee ] sounds: [ mis -ch uh -v uh s ].

As we noted earlier, the R sound in English can be tricky. That’s what makes murderer , with its three R sounds particularly difficult to pronounce. The word is pronounced [ mur -der-er ].

Did you know a group of crows is called a “murder”?Learn about other fanciful and strange names for groups of animals.

For whatever reason, many people like to add an additional [ yoo ] sound to the word nuclear . However, it is pronounced with a single [ oo ] or [ yoo ] sound: [ noo -klee-er ] or [ nyoo -klee-er ].

onomatopoeia

The word onomatopoeia is a riot of vowels, making it a challenge to pronounce. The ending – poeia is pronounced simply [ pee – uh ]. The O is silent. Onomatopoeia , which describes a word that imitates a sound, is pronounced [ on- uh -mat- uh – pee – uh ].

remuneration

A common mistake people make when pronouncing the word remuneration is to swap the easily-confused M and N sounds, likely because the word number is so common in the English language. The word, although it describes pay, does not come from the word number , but the Latin mūnus , meaning “gift.” Remuneration is pronounced [ ri-myoo-n uh – rey -sh uh n ].

Rural , like juror and murderer , is challenging because of all of its R sounds. Rural is pronounced [ roor – uh l ].

schadenfreude

The word schadenfreude is a loanword from German. It means “satisfaction or pleasure felt at someone else’s misfortune.” The pronunciation of schadenfreude also comes from German, so it does not follow typical English pronunciation guidelines: [ shahd -n-froi-d uh ].

Like in our first example, accessory, there is some confusion about whether the C in scissors is a “hard C sound” or a “soft C sound.” Well, the SC in scissors is pronounced simply [ s ], making the correct pronunciation of this word [ siz -erz ].

People often like to swap the S and P sounds in the word specific , rendering it closer to the name of the ocean: Pacific . However, the word is pronounced with the sounds in the order they appear, [ spi- sif -ik ].

One of the hardest words in the English language to pronounce, especially for non-native English speakers, is squirrel . They tend to want to add an additional [ uh ] sound in there. However, remember that this slippery-sounding word has only two syllables: [ skwur – uh l ].

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Types of Speech Impediments

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

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Articulation Errors

Ankyloglossia, treating speech disorders.

A speech impediment, also known as a speech disorder , is a condition that can affect a person’s ability to form sounds and words, making their speech difficult to understand.

Speech disorders generally become evident in early childhood, as children start speaking and learning language. While many children initially have trouble with certain sounds and words, most are able to speak easily by the time they are five years old. However, some speech disorders persist. Approximately 5% of children aged three to 17 in the United States experience speech disorders.

There are many different types of speech impediments, including:

• Articulation errors

This article explores the causes, symptoms, and treatment of the different types of speech disorders.

Speech impediments that break the flow of speech are known as disfluencies. Stuttering is the most common form of disfluency, however there are other types as well.

Symptoms and Characteristics of Disfluencies

These are some of the characteristics of disfluencies:

• Repeating certain phrases, words, or sounds after the age of 4 (For example: “O…orange,” “I like…like orange juice,” “I want…I want orange juice”)
• Adding in extra sounds or words into sentences (For example: “We…uh…went to buy…um…orange juice”)
• Elongating words (For example: Saying “orange joooose” instead of "orange juice")
• Replacing words (For example: “What…Where is the orange juice?”)
• Hesitating while speaking (For example: A long pause while thinking)
• Pausing mid-speech (For example: Stopping abruptly mid-speech, due to lack of airflow, causing no sounds to come out, leading to a tense pause)

In addition, someone with disfluencies may also experience the following symptoms while speaking:

• Vocal tension and strain
• Head jerking
• Eye blinking
• Lip trembling

Causes of Disfluencies

People with disfluencies tend to have neurological differences in areas of the brain that control language processing and coordinate speech, which may be caused by:

• Genetic factors
• Trauma or infection to the brain
• Environmental stressors that cause anxiety or emotional distress
• Neurodevelopmental conditions like attention-deficit hyperactivity disorder (ADHD)

Articulation disorders occur when a person has trouble placing their tongue in the correct position to form certain speech sounds. Lisping is the most common type of articulation disorder.

Symptoms and Characteristics of Articulation Errors

These are some of the characteristics of articulation disorders:

• Substituting one sound for another . People typically have trouble with ‘r’ and ‘l’ sounds. (For example: Being unable to say “rabbit” and saying “wabbit” instead)
• Lisping , which refers specifically to difficulty with ‘s’ and ‘z’ sounds. (For example: Saying “thugar” instead of “sugar” or producing a whistling sound while trying to pronounce these letters)
• Omitting sounds (For example: Saying “coo” instead of “school”)
• Adding sounds (For example: Saying “pinanio” instead of “piano”)
• Making other speech errors that can make it difficult to decipher what the person is saying. For instance, only family members may be able to understand what they’re trying to say.

Causes of Articulation Errors

Articulation errors may be caused by:

• Genetic factors, as it can run in families
• Hearing loss , as mishearing sounds can affect the person’s ability to reproduce the sound
• Changes in the bones or muscles that are needed for speech, including a cleft palate (a hole in the roof of the mouth) and tooth problems
• Damage to the nerves or parts of the brain that coordinate speech, caused by conditions such as cerebral palsy , for instance

Ankyloglossia, also known as tongue-tie, is a condition where the person’s tongue is attached to the bottom of their mouth. This can restrict the tongue’s movement and make it hard for the person to move their tongue.

Symptoms and Characteristics of Ankyloglossia

Ankyloglossia is characterized by difficulty pronouncing ‘d,’ ‘n,’ ‘s,’ ‘t,’ ‘th,’ and ‘z’ sounds that require the person’s tongue to touch the roof of their mouth or their upper teeth, as their tongue may not be able to reach there.

Apart from speech impediments, people with ankyloglossia may also experience other symptoms as a result of their tongue-tie. These symptoms include:

• Difficulty breastfeeding in newborns
• Trouble swallowing
• Limited ability to move the tongue from side to side or stick it out
• Difficulty with activities like playing wind instruments, licking ice cream, or kissing
• Mouth breathing

Causes of Ankyloglossia

Ankyloglossia is a congenital condition, which means it is present from birth. A tissue known as the lingual frenulum attaches the tongue to the base of the mouth. People with ankyloglossia have a shorter lingual frenulum, or it is attached further along their tongue than most people’s.

Dysarthria is a condition where people slur their words because they cannot control the muscles that are required for speech, due to brain, nerve, or organ damage.

Symptoms and Characteristics of Dysarthria

Dysarthria is characterized by:

• Slurred, choppy, or robotic speech
• Rapid, slow, or soft speech
• Breathy, hoarse, or nasal voice

Additionally, someone with dysarthria may also have other symptoms such as difficulty swallowing and inability to move their tongue, lips, or jaw easily.

Causes of Dysarthria

Dysarthria is caused by paralysis or weakness of the speech muscles. The causes of the weakness can vary depending on the type of dysarthria the person has:

• Central dysarthria is caused by brain damage. It may be the result of neuromuscular diseases, such as cerebral palsy, Huntington’s disease, multiple sclerosis, muscular dystrophy, Huntington’s disease, Parkinson’s disease, or Lou Gehrig’s disease. Central dysarthria may also be caused by injuries or illnesses that damage the brain, such as dementia, stroke, brain tumor, or traumatic brain injury .
• Peripheral dysarthria is caused by damage to the organs involved in speech. It may be caused by congenital structural problems, trauma to the mouth or face, or surgery to the tongue, mouth, head, neck, or voice box.

Apraxia, also known as dyspraxia, verbal apraxia, or apraxia of speech, is a neurological condition that can cause a person to have trouble moving the muscles they need to create sounds or words. The person’s brain knows what they want to say, but is unable to plan and sequence the words accordingly.

Symptoms and Characteristics of Apraxia

These are some of the characteristics of apraxia:

• Distorting sounds: The person may have trouble pronouncing certain sounds, particularly vowels, because they may be unable to move their tongue or jaw in the manner required to produce the right sound. Longer or more complex words may be especially harder to manage.
• Being inconsistent in their speech: For instance, the person may be able to pronounce a word correctly once, but may not be able to repeat it. Or, they may pronounce it correctly today and differently on another day.
• Grasping for words: The person may appear to be searching for the right word or sound, or attempt the pronunciation several times before getting it right.
• Making errors with the rhythm or tone of speech: The person may struggle with using tone and inflection to communicate meaning. For instance, they may not stress any of the words in a sentence, have trouble going from one syllable in a word to another, or pause at an inappropriate part of a sentence.

Causes of Apraxia

Apraxia occurs when nerve pathways in the brain are interrupted, which can make it difficult for the brain to send messages to the organs involved in speaking. The causes of these neurological disturbances can vary depending on the type of apraxia the person has:

• Childhood apraxia of speech (CAS): This condition is present from birth and is often hereditary. A person may be more likely to have it if a biological relative has a learning disability or communication disorder.
• Acquired apraxia of speech (AOS): This condition can occur in adults, due to brain damage as a result of a tumor, head injury , stroke, or other illness that affects the parts of the brain involved in speech.

If you have a speech impediment, or suspect your child might have one, it can be helpful to visit your healthcare provider. Your primary care physician can refer you to a speech-language pathologist, who can evaluate speech, diagnose speech disorders, and recommend treatment options.

The diagnostic process may involve a physical examination as well as psychological, neurological, or hearing tests, in order to confirm the diagnosis and rule out other causes.

Treatment for speech disorders often involves speech therapy, which can help you learn how to move your muscles and position your tongue correctly in order to create specific sounds. It can be quite effective in improving your speech.

Children often grow out of milder speech disorders; however, special education and speech therapy can help with more serious ones.

For ankyloglossia, or tongue-tie, a minor surgery known as a frenectomy can help detach the tongue from the bottom of the mouth.

A Word From Verywell

A speech impediment can make it difficult to pronounce certain sounds, speak clearly, or communicate fluently. 

Living with a speech disorder can be frustrating because people may cut you off while you’re speaking, try to finish your sentences, or treat you differently. It can be helpful to talk to your healthcare providers about how to cope with these situations.

You may also benefit from joining a support group, where you can connect with others living with speech disorders.

National Library of Medicine. Speech disorders . Medline Plus.

Centers for Disease Control and Prevention. Language and speech disorders .

Cincinnati Children's Hospital. Stuttering .

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, and language .

Cleveland Clinic. Speech impediment .

Lee H, Sim H, Lee E, Choi D. Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms . J Commun Disord . 2017;65:54-64. doi:10.1016/j.jcomdis.2016.12.001

Nemours Foundation. Speech problems .

Penn Medicine. Speech and language disorders .

Cleveland Clinic. Tongue-tie .

University of Rochester Medical Center. Ankyloglossia .

Cleveland Clinic. Dysarthria .

National Institute on Deafness and Other Communication Disorders. Apraxia of speech .

Cleveland Clinic. Childhood apraxia of speech .

Stanford Children’s Hospital. Speech sound disorders in children .

Abbastabar H, Alizadeh A, Darparesh M, Mohseni S, Roozbeh N. Spatial distribution and the prevalence of speech disorders in the provinces of Iran . J Med Life . 2015;8(Spec Iss 2):99-104.

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Trouble with the /R/ Sound (Rhotacism)? Read This Guide

Many children and adults experience problems pronouncing the /r/ sound and are unsure of whether they can fix it or if speech therapy is needed? The /r/ sound is one of the most difficult consonants in the English language to master, so in this article, we cover some important information about the speech issue called rhotacism.

One of the most frequent speech errors that children make as their speech develops is the /r/ sound. It is also one of the most difficult to learn and master. Yet your child can achieve success with good direction, and enough practice, and repetition.

Why is Saying the /r/ Sound so Hard?

There are various reasons that make mastering the /r/ sound so difficult. Here are some reasons why:

• Vowel Placement: when the /r/ sound comes before a vowel or after vowel, it affects the pronunciation of the /r/ sound. Say the combinations “ar” “air” “ear” “er” “or” and “ire” and notice how each one affects the sound differently
• Position in a Word: the vowel combinations above are also affected by their position in the word. The sound can be in the beginning, middle, or final position.
• Combinations with Consonants : /r/ also becomes more difficult to produce when it is in a combination with a consonant such as “tr,” “br,” “str.”
• How it is Produced: since the /r/ sound is made exclusively by the position of the tongue, it is significantly more difficult to picture than other sounds. Other sounds are easier to model and visualize for children. For example the /p/ or /th/ sounds are easy to show a child. The placement of the lips or tongue are easy to demonstrate and help a child produce accurately.

The /r/ sound has more variations than just about any other sound in the English language. Yet rhotacism is still possible to remedy and produce correctly.

At What Age Do Children Say the /r/ Sound Correctly?

While children learn to correctly produce different sounds at different ages, each sound in the English language has a certain age at which it is mastered.

Around the age of 6, a child should be able to produce the /r/ sound accurately in everyday conversational speech.

Yet it may be right to start working on decreasing rhotacism even earlier than age 6. Why? Because the longer one waits, the harder the sound is to fix. In addition, children who have difficulty with the  /r/ sound may sometimes seem less mature than their classmates.

If you see that your child is making improvements on their own over time, this is great. Yet sometimes correct production plateaus and more complex production remains difficult. If around age 6 rhotacism is still an issue, speaking with a speech therapist may be a good idea.

Is there a Cause for Rhotacism?

There is no definitive cause for trouble with the /r/ sound. Sometimes, a child with a tongue-tie (ankyloglossia) may have more trouble since it limits the movement of the tongue, which is critical for correct speech production.

Another potential reason is that a child has a speech sound disorder which affects placement of the oral structures. Lastely, there may be more severe disorders such as apraxia of speech . Yet those would affect many more sounds than just the /r/ sound.

No matter the cause, speech therapy can help a child who has rhotacism.

Typical Errors in /r/ Sound Production

When a young child tries to say words with the /r/ sound, they may end up making a few common errors.

The /r/ sound is usually substituted for the /w/ sound. For example, the word “run” may sound like “wun” or “cherry” can sound like “che-wy.”

Words that end with the /r/ sound may be produced differently. For example, the word “mother” may be pronounced as “muthuh,” or the word “bear” may be pronounced as “be-uh.”

When is a Child Ready to Practice the /r/ Sound?

There are a few ways for parents to tell if a child is ready to work on the /r/ sound:

• Imitation: One method is to see if a child can correctly imitate the sound  /r/ by itself (in isolation), even with some assistance. If a child needs a lot of cueing or modeling, they might not be ready to practice yet.
• Can they tell the difference between correct vs. incorrect production: Can they distinguish between the correct and incorrect production of the /r/ sound in a word? If not, it is important to start by working on their ability to discriminate the correct /r/ sound before moving ahead with practice.
• Age : When a child is very young, it is worth giving them some more time, and to monitor their production. If they are approaching the age of 6 and still have trouble, it may be time to get some help from a speech therapist.

Correct Tongue Positions for /r/ Production

There are two alternative tongue positions that might be employed when producing the /r/ sound. They are called the “bunched position” and the “retroflexed position.” Here they are described:

• Bunched Tongue Position: there is a lot of tension in the tongue and it should be pulled back and bunched up in a mound.
• Retroflexed Position: For this version, the tongue curls and points back towards the throat.

(Delattre & Freeman 1968)

Tips for Practicing the /r/ Sound

If you would like to help your child work on their /r/ sound production at home, here are some tips:

• Giving your child visual cues: this can be beneficial in helping produce the /r/ correctly. This can be done with a mirror to show them where to place their lips or tongue.
• Use other materials and toys: other visuals to model the correct shape of the tongue. Use play-doh or shape your hand in to mimic the correct shape of the tongue. Use a visual to better explain tongue position, such as demonstrating with your hand to show the shape of the tongue, or make your own visual of the tongue shape (play-doh works great!). You can also try to model the /r/ tongue position for your child, opening your mouth slightly and pointing.
• Remind them to tense their tongue: If your child’s /r/ sound still doesn’t sound right after a lot of practice, remind them to keep their tongue “tight.” Tongue tension is needed for proper pronunciation.
• Remind them to touch the back of their mouth: Remind your child to maintain their tongue high enough in their mouth and use their tongue to touch the inside of their upper rear molars on the back side.
• Practice ten minutes every day: it’s very easy to slide back into old patterns. You child will need to practice often to learn to reposition their tongue and keep it there for production during speech.

Ways to Practice the /r/ Sound at Home

Here are some fun ways to practice the /r/ should at home with your child:

• Read books and catch the /r/ sound: Have your child point out each /r/ sound that they read or hear you pronounce when you read books with them. They can also catch you saying it correctly or incorrectly.
• Talk about anatomy: Talk to your child about how the tongue is a muscle that needs to be “tight and powerful.” You can show them how they can tighten their fists or biceps to note how it feels when a muscle is tight and relaxed. Your child can better grasp how to produce work on speech skills by practicing it in other activities.
• Make a play-doh model: Make model tongues out of play-doh and place them in the bunched or retroflexed position, depending on your child’s preference. This can help visual learners.
• Integrate practice into other games: Play a turn-taking game with your child to practice the target /r/ sounds. You can play a card or board game and have them say the /r/ sound three times before each turn.

How to Help at Home When Your Child Improves

The ultimate objective of all speech practice is for children to be able to use their newly acquired speech skills in everyday speaking situations. Here are some ideas for working on the /r/ sound when your child has progressed beyond words and needs to practice in conversation.

• Talk about their day: When your child likes to talk, tell them you’ll pay attention to their correct /r/ sound. Talk about anything for 5-10 minutes and note how they are making their /r/ sound. Do they self-correct when they make an error?
• Story retell: have your child retell a favorite story. If they mispronounce a word, give a visual cue that they need to correct like raising your hand.
• Rhyming Poems/Tongue Twisters: You can say these for an extra laugh and if your child is ok with making a mistake sometimes. Repeat rhymed poems (such as “Mary, Mary Quite Contrary”) and try a tongue twister like “I scream, you scream, we all scream, for ice cream.”

Speech Therapy Online for Rhotacism

Online articulation therapy for improving the /r/ sound is a great way to allow the therapist and child to practice speech.

A formal evaluation by the treating speech therapist is the first step in treating the /r/ sound. This assessment helps the speech therapist to determine which sorts of /r/ sounds a child is having trouble with, as well as whether other speech sounds need to be addressed. Therapy goals are developed in light of the results of the evaluation.

During subsequent sessions, the speech therapist will work with a child on these specific goals. In order to elicit regular practice of the /r/ sound, they will most likely use a variety of games and activities that are age appropriate and the child enjoys. The speech therapist will also provide suggestions for homework that the parent/caregiver and child can do throughout the week. The more practice and repetition, the faster a child will achieve their communication goals and learn the /r/ sound at the conversational level.

When Will a Child Graduate from Speech Therapy for Rhotacism?

The time it takes to fix /r/ productions varies depending on the child. Some factors that influence the total length of speech therapy include:

• How old the child is
• Is the child starting speech therapy aware that there is an issue to work on?
• Is the child able to quickly learn the /r/ sound in isolation
• The amount of different types of /r/ sounds needed to work on
• Is the child motivated to improve
• How often does the child practice at home aside from speech therapy sessions

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Home / Blog

Speech Impediment Guide: Definition, Causes, and Resources

December 8, 2020 

Tables of Contents

What Is a Speech Impediment?

Types of speech disorders, speech impediment causes, how to fix a speech impediment, making a difference in speech disorders.

Communication is a cornerstone of human relationships. When an individual struggles to verbalize information, thoughts, and feelings, it can cause major barriers in personal, learning, and business interactions.

Speech impediments, or speech disorders, can lead to feelings of insecurity and frustration. They can also cause worry for family members and friends who don’t know how to help their loved ones express themselves.

Fortunately, there are a number of ways that speech disorders can be treated, and in many cases, cured. Health professionals in fields including speech-language pathology and audiology can work with patients to overcome communication disorders, and individuals and families can learn techniques to help.

Commonly referred to as a speech disorder, a speech impediment is a condition that impacts an individual’s ability to speak fluently, correctly, or with clear resonance or tone. Individuals with speech disorders have problems creating understandable sounds or forming words, leading to communication difficulties.

Some 7.7% of U.S. children — or 1 in 12 youths between the ages of 3 and 17 — have speech, voice, language, or swallowing disorders, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). About 70 million people worldwide, including some 3 million Americans, experience stuttering difficulties, according to the Stuttering Foundation.

Common signs of a speech disorder

There are several symptoms and indicators that can point to a speech disorder.

• Unintelligible speech — A speech disorder may be present when others have difficulty understanding a person’s verbalizations.
• Omitted sounds — This symptom can include the omission of part of a word, such as saying “bo” instead of “boat,” and may include omission of consonants or syllables.
• Added sounds — This can involve adding extra sounds in a word, such as “buhlack” instead of “black,” or repeating sounds like “b-b-b-ball.”
• Substituted sounds — When sounds are substituted or distorted, such as saying “wabbit” instead of “rabbit,” it may indicate a speech disorder.
• Use of gestures — When individuals use gestures to communicate instead of words, a speech impediment may be the cause.
• Inappropriate pitch — This symptom is characterized by speaking with a strange pitch or volume.

In children, signs might also include a lack of babbling or making limited sounds. Symptoms may also include the incorrect use of specific sounds in words, according to the American Speech-Language-Hearing Association (ASHA). This may include the sounds p, m, b, w, and h among children aged 1-2, and k, f, g, d, n, and t for children aged 2-3.

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Categories of Speech Impediments

Speech impediments can range from speech sound disorders (articulation and phonological disorders) to voice disorders. Speech sound disorders may be organic — resulting from a motor or sensory cause — or may be functional with no known cause. Voice disorders deal with physical problems that limit speech. The main categories of speech impediments include the following:

Fluency disorders occur when a patient has trouble with speech timing or rhythms. This can lead to hesitations, repetitions, or prolonged sounds. Fluency disorders include stuttering (repetition of sounds) or   (rapid or irregular rate of speech).

Resonance disorders are related to voice quality that is impacted by the shape of the nose, throat, and/or mouth. Examples of resonance disorders include hyponasality and cul-de-sac resonance.

Articulation disorders occur when a patient has difficulty producing speech sounds. These disorders may stem from physical or anatomical limitations such as muscular, neuromuscular, or skeletal support. Examples of articulation speech impairments include sound omissions, substitutions, and distortions.

Phonological disorders result in the misuse of certain speech sounds to form words. Conditions include fronting, stopping, and the omission of final consonants.

Voice disorders are the result of problems in the larynx that harm the quality or use of an individual’s voice. This can impact pitch, resonance, and loudness.

Impact of Speech Disorders

Some speech disorders have little impact on socialization and daily activities, but other conditions can make some tasks difficult for individuals. Following are a few of the impacts of speech impediments.

• Poor communication — Children may be unable to participate in certain learning activities, such as answering questions or reading out loud, due to communication difficulties. Adults may avoid work or social activities such as giving speeches or attending parties.
• Mental health and confidence — Speech disorders may cause children or adults to feel different from peers, leading to a lack of self-confidence and, potentially, self-isolation.

Resources on Speech Disorders

The following resources may help those who are seeking more information about speech impediments.

Health Information : Information and statistics on common voice and speech disorders from the NIDCD

Speech Disorders : Information on childhood speech disorders from Cincinnati Children’s Hospital Medical Center

Speech, Language, and Swallowing : Resources about speech and language development from the ASHA

Children and adults can suffer from a variety of speech impairments that may have mild to severe impacts on their ability to communicate. The following 10 conditions are examples of specific types of speech disorders and voice disorders.

1. Stuttering

This condition is one of the most common speech disorders. Stuttering is the repetition of syllables or words, interruptions in speech, or prolonged use of a sound.

This organic speech disorder is a result of damage to the neural pathways that connect the brain to speech-producing muscles. This results in a person knowing what they want to say, but being unable to speak the words.

This consists of the lost ability to speak, understand, or write languages. It is common in stroke, brain tumor, or traumatic brain injury patients.

4. Dysarthria

This condition is an organic speech sound disorder that involves difficulty expressing certain noises. This may involve slurring, or poor pronunciation, and rhythm differences related to nerve or brain disorders.

The condition of lisping is the replacing of sounds in words, including “th” for “s.” Lisping is a functional speech impediment.

6. Hyponasality

This condition is a resonance disorder related to limited sound coming through the nose, causing a “stopped up” quality to speech.

7. Cul-de-sac resonance

This speech disorder is the result of blockage in the mouth, throat, or nose that results in quiet or muffled speech.

8. Orofacial myofunctional disorders

These conditions involve abnormal patterns of mouth and face movement. Conditions include tongue thrusting (fronting), where individuals push out their tongue while eating or talking.

9. Spasmodic Dysphonia

This condition is a voice disorder in which spasms in the vocal cords produce speech that is hoarse, strained, or jittery.

10. Other voice disorders

These conditions can include having a voice that sounds breathy, hoarse, or scratchy. Some disorders deal with vocal folds closing when they should open (paradoxical vocal fold movement) or the presence of polyps or nodules in the vocal folds.

Speech Disorders vs. Language Disorders

Speech disorders deal with difficulty in creating sounds due to articulation, fluency, phonology, and voice problems. These problems are typically related to physical, motor, sensory, neurological, or mental health issues.

Language disorders, on the other hand, occur when individuals have difficulty communicating the meaning of what they want to express. Common in children, these disorders may result in low vocabulary and difficulty saying complex sentences. Such a disorder may reflect difficulty in comprehending school lessons or adopting new words, or it may be related to a learning disability such as dyslexia. Language disorders can also involve receptive language difficulties, where individuals have trouble understanding the messages that others are trying to convey.  

Resources on Types of Speech Disorders

The following resources may provide additional information on the types of speech impediments.

Common Speech Disorders: A guide to the most common speech impediments from GreatSpeech

Speech impairment in adults: Descriptions of common adult speech issues from MedlinePlus

Stuttering Facts: Information on stuttering indications and causes from the Stuttering Foundation

Speech disorders may be caused by a variety of factors related to physical features, neurological ailments, or mental health conditions. In children, they may be related to developmental issues or unknown causes and may go away naturally over time.

Physical and neurological issues. Speech impediment causes related to physical characteristics may include:

• Brain damage
• Nervous system damage
• Respiratory system damage
• Hearing difficulties
• Cancerous or noncancerous growths
• Muscle and bone problems such as dental issues or cleft palate

Mental health issues. Some speech disorders are related to clinical conditions such as:

• Autism spectrum disorder
• Down syndrome or other genetic syndromes
• Cerebral palsy or other neurological disorders
• Multiple sclerosis

Some speech impairments may also have to do with family history, such as when parents or siblings have experienced language or speech difficulties. Other causes may include premature birth, pregnancy complications, or delivery difficulties. Voice overuse and chronic coughs can also cause speech issues.

The most common way that speech disorders are treated involves seeking professional help. If patients and families feel that symptoms warrant therapy, health professionals can help determine how to fix a speech impediment. Early treatment is best to curb speech disorders, but impairments can also be treated later in life.

Professionals in the speech therapy field include speech-language pathologists (SLPs) . These practitioners assess, diagnose, and treat communication disorders including speech, language, social, cognitive, and swallowing disorders in both adults and children. They may have an SLP assistant to help with diagnostic and therapy activities.

Speech-language pathologists may also share a practice with audiologists and audiology assistants. Audiologists help identify and treat hearing, balance, and other auditory disorders.

How Are Speech Disorders Diagnosed?

Typically, a pediatrician, social worker, teacher, or other concerned party will recognize the symptoms of a speech disorder in children. These individuals, who frequently deal with speech and language conditions and are more familiar with symptoms, will recommend that parents have their child evaluated. Adults who struggle with speech problems may seek direct guidance from a physician or speech evaluation specialist.

When evaluating a patient for a potential speech impediment, a physician will:

• Conduct hearing and vision tests
• Evaluate patient records
• Observe patient symptoms

A speech-language pathologist will conduct an initial screening that might include:

• An evaluation of speech sounds in words and sentences
• An evaluation of oral motor function
• An orofacial examination
• An assessment of language comprehension

The initial screening might result in no action if speech symptoms are determined to be developmentally appropriate. If a disorder is suspected, the initial screening might result in a referral for a comprehensive speech sound assessment, comprehensive language assessment, audiology evaluation, or other medical services.

Initial assessments and more in-depth screenings might occur in a private speech therapy practice, rehabilitation center, school, childcare program, or early intervention center. For older adults, skilled nursing centers and nursing homes may assess patients for speech, hearing, and language disorders.

How Are Speech Impediments Treated?

Once an evaluation determines precisely what type of speech sound disorder is present, patients can begin treatment. Speech-language pathologists use a combination of therapy, exercise, and assistive devices to treat speech disorders.

Speech therapy might focus on motor production (articulation) or linguistic (phonological or language-based) elements of speech, according to ASHA. There are various types of speech therapy available to patients.

Contextual Utilization  — This therapeutic approach teaches methods for producing sounds consistently in different syllable-based contexts, such as phonemic or phonetic contexts. These methods are helpful for patients who produce sounds inconsistently.

Phonological Contrast — This approach focuses on improving speech through emphasis of phonemic contrasts that serve to differentiate words. Examples might include minimal opposition words (pot vs. spot) or maximal oppositions (mall vs. call). These therapy methods can help patients who use phonological error patterns.

Distinctive Feature — In this category of therapy, SLPs focus on elements that are missing in speech, such as articulation or nasality. This helps patients who substitute sounds by teaching them to distinguish target sounds from substituted sounds.

Core Vocabulary — This therapeutic approach involves practicing whole words that are commonly used in a specific patient’s communications. It is effective for patients with inconsistent sound production.

Metaphon — In this type of therapy, patients are taught to identify phonological language structures. The technique focuses on contrasting sound elements, such as loud vs. quiet, and helps patients with unintelligible speech issues.

Oral-Motor — This approach uses non-speech exercises to supplement sound therapies. This helps patients gain oral-motor strength and control to improve articulation.

Other methods professionals may use to help fix speech impediments include relaxation, breathing, muscle strengthening, and voice exercises. They may also recommend assistive devices, which may include:

• Radio transmission systems
• Personal amplifiers
• Picture boards
• Touch screens
• Text displays
• Speech-generating devices
• Hearing aids
• Cochlear implants

Resources for Professionals on How to Fix a Speech Impediment

The following resources provide information for speech therapists and other health professionals.

Assistive Devices: Information on hearing and speech aids from the NIDCD

Information for Audiologists: Publications, news, and practice aids for audiologists from ASHA

Information for Speech-Language Pathologists: Publications, news, and practice aids for SLPs from ASHA

Speech Disorder Tips for Families

For parents who are concerned that their child might have a speech disorder — or who want to prevent the development of a disorder — there are a number of activities that can help. The following are tasks that parents can engage in on a regular basis to develop literacy and speech skills.

• Introducing new vocabulary words
• Reading picture and story books with various sounds and patterns
• Talking to children about objects and events
• Answering children’s questions during routine activities
• Encouraging drawing and scribbling
• Pointing to words while reading books
• Pointing out words and sentences in objects and signs

Parents can take the following steps to make sure that potential speech impediments are identified early on.

• Discussing concerns with physicians
• Asking for hearing, vision, and speech screenings from doctors
• Requesting special education assessments from school officials
• Requesting a referral to a speech-language pathologist, audiologist, or other specialist

When a child is engaged in speech therapy, speech-language pathologists will typically establish collaborative relationships with families, sharing information and encouraging parents to participate in therapy decisions and practices.

SLPs will work with patients and their families to set goals for therapy outcomes. In addition to therapy sessions, they may develop activities and exercises for families to work on at home. It is important that caregivers are encouraging and patient with children during therapy.  

Resources for Parents on How to Fix a Speech Impediment

The following resources provide additional information on treatment options for speech disorders.

Speech, Language, and Swallowing Disorders Groups: Listing of self-help groups from ASHA

ProFind: Search tool for finding certified SLPs and audiologists from ASHA

Baby’s Hearing and Communication Development Checklist: Listing of milestones that children should meet by certain ages from the NIDCD

If identified during childhood, speech disorders can be corrected efficiently, giving children greater communication opportunities. If left untreated, speech impediments can cause a variety of problems in adulthood, and may be more difficult to diagnose and treat.

Parents, teachers, doctors, speech and language professionals, and other concerned parties all have unique responsibilities in recognizing and treating speech disorders. Through professional therapy, family engagement, positive encouragement and a strong support network, individuals with speech impediments can overcome their challenges and develop essential communication skills.

Additional Sources

American Speech-Language-Hearing Association, Speech Sound Disorders

Identify the Signs, Signs of Speech and Language Disorders

Intermountain Healthcare, Phonological Disorders

MedlinePlus, Speech disorders – children

National Institutes of Health, National Institutes on Deafness and Other Communication Disorders, “Quick Statistics About Voice, Speech, Language”

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Overcoming Speech Impediment: Symptoms to Treatment

There are many causes and solutions for impaired speech

• Types and Symptoms
• Speech Therapy
• Building Confidence

Speech impediments are conditions that can cause a variety of symptoms, such as an inability to understand language or speak with a stable sense of tone, speed, or fluidity. There are many different types of speech impediments, and they can begin during childhood or develop during adulthood.

Common causes include physical trauma, neurological disorders, or anxiety. If you or your child is experiencing signs of a speech impediment, you need to know that these conditions can be diagnosed and treated with professional speech therapy.

This article will discuss what you can do if you are concerned about a speech impediment and what you can expect during your diagnostic process and therapy.

FG Trade / Getty Images

Types and Symptoms of Speech Impediment

People can have speech problems due to developmental conditions that begin to show symptoms during early childhood or as a result of conditions that may occur during adulthood. 

The main classifications of speech impairment are aphasia (difficulty understanding or producing the correct words or phrases) or dysarthria (difficulty enunciating words).

Often, speech problems can be part of neurological or neurodevelopmental disorders that also cause other symptoms, such as multiple sclerosis (MS) or autism spectrum disorder .

There are several different symptoms of speech impediments, and you may experience one or more.

Can Symptoms Worsen?

Most speech disorders cause persistent symptoms and can temporarily get worse when you are tired, anxious, or sick.

Symptoms of dysarthria can include:

• Slurred speech
• Slow speech
• Choppy speech
• Hesitant speech
• Inability to control the volume of your speech
• Shaking or tremulous speech pattern
• Inability to pronounce certain sounds

Symptoms of aphasia may involve:

• Speech apraxia (difficulty coordinating speech)
• Difficulty understanding the meaning of what other people are saying
• Inability to use the correct words
• Inability to repeat words or phases
• Speech that has an irregular rhythm

You can have one or more of these speech patterns as part of your speech impediment, and their combination and frequency will help determine the type and cause of your speech problem.

Causes of Speech Impediment

The conditions that cause speech impediments can include developmental problems that are present from birth, neurological diseases such as Parkinson’s disease , or sudden neurological events, such as a stroke .

Some people can also experience temporary speech impairment due to anxiety, intoxication, medication side effects, postictal state (the time immediately after a seizure), or a change of consciousness.

Speech Impairment in Children

Children can have speech disorders associated with neurodevelopmental problems, which can interfere with speech development. Some childhood neurological or neurodevelopmental disorders may cause a regression (backsliding) of speech skills.

Common causes of childhood speech impediments include:

• Autism spectrum disorder : A neurodevelopmental disorder that affects social and interactive development
• Cerebral palsy :  A congenital (from birth) disorder that affects learning and control of physical movement
• Hearing loss : Can affect the way children hear and imitate speech
• Rett syndrome : A genetic neurodevelopmental condition that causes regression of physical and social skills beginning during the early school-age years.
• Adrenoleukodystrophy : A genetic disorder that causes a decline in motor and cognitive skills beginning during early childhood
• Childhood metabolic disorders : A group of conditions that affects the way children break down nutrients, often resulting in toxic damage to organs
• Brain tumor : A growth that may damage areas of the brain, including those that control speech or language
• Encephalitis : Brain inflammation or infection that may affect the way regions in the brain function
• Hydrocephalus : Excess fluid within the skull, which may develop after brain surgery and can cause brain damage

Do Childhood Speech Disorders Persist?

Speech disorders during childhood can have persistent effects throughout life. Therapy can often help improve speech skills.

Speech Impairment in Adulthood

Adult speech disorders develop due to conditions that damage the speech areas of the brain.

Common causes of adult speech impairment include:

• Head trauma 
• Nerve injury
• Throat tumor
• Stroke 
• Parkinson’s disease 
• Essential tremor
• Brain tumor
• Brain infection

Additionally, people may develop changes in speech with advancing age, even without a specific neurological cause. This can happen due to presbyphonia , which is a change in the volume and control of speech due to declining hormone levels and reduced elasticity and movement of the vocal cords.

Do Speech Disorders Resolve on Their Own?

Children and adults who have persistent speech disorders are unlikely to experience spontaneous improvement without therapy and should seek professional attention.

Steps to Treating Speech Impediment 

If you or your child has a speech impediment, your healthcare providers will work to diagnose the type of speech impediment as well as the underlying condition that caused it. Defining the cause and type of speech impediment will help determine your prognosis and treatment plan.

Sometimes the cause is known before symptoms begin, as is the case with trauma or MS. Impaired speech may first be a symptom of a condition, such as a stroke that causes aphasia as the primary symptom.

The diagnosis will include a comprehensive medical history, physical examination, and a thorough evaluation of speech and language. Diagnostic testing is directed by the medical history and clinical evaluation.

Diagnostic testing may include:

• Brain imaging , such as brain computerized tomography (CT) or magnetic residence imaging (MRI), if there’s concern about a disease process in the brain
• Swallowing evaluation if there’s concern about dysfunction of the muscles in the throat
• Electromyography (EMG) and nerve conduction studies (aka nerve conduction velocity, or NCV) if there’s concern about nerve and muscle damage
• Blood tests, which can help in diagnosing inflammatory disorders or infections

Your diagnostic tests will help pinpoint the cause of your speech problem. Your treatment will include specific therapy to help improve your speech, as well as medication or other interventions to treat the underlying disorder.

For example, if you are diagnosed with MS, you would likely receive disease-modifying therapy to help prevent MS progression. And if you are diagnosed with a brain tumor, you may need surgery, chemotherapy, or radiation to treat the tumor.

Therapy to Address Speech Impediment

Therapy for speech impairment is interactive and directed by a specialist who is experienced in treating speech problems . Sometimes, children receive speech therapy as part of a specialized learning program at school.

The duration and frequency of your speech therapy program depend on the underlying cause of your impediment, your improvement, and approval from your health insurance.

If you or your child has a serious speech problem, you may qualify for speech therapy. Working with your therapist can help you build confidence, particularly as you begin to see improvement.

Exercises during speech therapy may include:

• Pronouncing individual sounds, such as la la la or da da da
• Practicing pronunciation of words that you have trouble pronouncing
• Adjusting the rate or volume of your speech
• Mouth exercises
• Practicing language skills by naming objects or repeating what the therapist is saying

These therapies are meant to help achieve more fluent and understandable speech as well as an increased comfort level with speech and language.

Building Confidence With Speech Problems 

Some types of speech impairment might not qualify for therapy. If you have speech difficulties due to anxiety or a social phobia or if you don’t have access to therapy, you might benefit from activities that can help you practice your speech. 

You might consider one or more of the following for you or your child:

• Joining a local theater group
• Volunteering in a school or community activity that involves interaction with the public
• Signing up for a class that requires a significant amount of class participation
• Joining a support group for people who have problems with speech

Activities that you do on your own to improve your confidence with speaking can be most beneficial when you are in a non-judgmental and safe space.

Many different types of speech problems can affect children and adults. Some of these are congenital (present from birth), while others are acquired due to health conditions, medication side effects, substances, or mood and anxiety disorders. Because there are so many different types of speech problems, seeking a medical diagnosis so you can get the right therapy for your specific disorder is crucial.

Centers for Disease Control and Prevention. Language and speech disorders in children .

Han C, Tang J, Tang B, et al. The effectiveness and safety of noninvasive brain stimulation technology combined with speech training on aphasia after stroke: a systematic review and meta-analysis . Medicine (Baltimore). 2024;103(2):e36880. doi:10.1097/MD.0000000000036880

National Institute on Deafness and Other Communication Disorders. Quick statistics about voice, speech, language .

Mackey J, McCulloch H, Scheiner G, et al. Speech pathologists' perspectives on the use of augmentative and alternative communication devices with people with acquired brain injury and reflections from lived experience . Brain Impair. 2023;24(2):168-184. doi:10.1017/BrImp.2023.9

Allison KM, Doherty KM. Relation of speech-language profile and communication modality to participation of children with cerebral palsy . Am J Speech Lang Pathol . 2024:1-11. doi:10.1044/2023_AJSLP-23-00267

Saccente-Kennedy B, Gillies F, Desjardins M, et al. A systematic review of speech-language pathology interventions for presbyphonia using the rehabilitation treatment specification system . J Voice. 2024:S0892-1997(23)00396-X. doi:10.1016/j.jvoice.2023.12.010

By Heidi Moawad, MD Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.

What Is A Speech Impediment?

Communicating with the people around us is a fundamental part of human interaction and connection. For some people, this communication can be difficult. Speech impediments can affect our ability to converse effectively with others and cause feelings of low self-confidence. 

A speech impediment is a disruption in normal speech. 1 It affects a person’s ability to produce the correct sounds and movements required for speech. Some examples of speech impediments are stuttering and apraxia . Speech impediments can affect both adults and children. They can impact learning, reading and social interaction. 2 Early treatment, often with speech therapy , can increase the chances of speech improvement. 

Common examples of speech disorders include:

• Verbal dyspraxia  

Dysarthria 

Dysarthria is a speaking difficulty due to weakness in the muscles used for speech. It results in slow, slurred, or unclear speech. It is a motor speech disorder usually caused by nervous system disorders or damage to the brain. Some conditions that can lead to dysarthria are Parkinson’s disease , multiple sclerosis , stroke and cerebral palsy . Dysarthria can also happen as a side-effect of certain medicines. 

Other symptoms include:

• Monotone speech 
• Nasal, raspy, or strained voice 
• Difficulty moving your tongue, mouth, or lips
• Speaking too loudly or too quietly 
• Speaking too slowly or too fast

A person with dysarthria will usually be referred to a speech and language therapist (SLT). A therapist may help you practice slowing down your speech or use techniques to improve your breathing to facilitate clear, loud speech.

Verbal dyspraxia 

Verbal dyspraxia, also known as apraxia or childhood apraxia of speech ( CAS ), affects physical coordination. People with verbal dyspraxia have difficulty coordinating the muscles needed to produce clear speech. To speak correctly, the brain has to send messages to the speech muscles to move. In verbal dyspraxia, this communication is affected.  

Symptoms of verbal dyspraxia are:

• Struggling to pronounce words correctly
• Using a limited range of consonants and vowels
• Pausing or hesitating during a speech 
• Pronouncing the same word correctly and then incorrectly

A person with verbal dyspraxia will usually be referred to as SLT. Verbal dyspraxia can occur alone but is often associated with other speech disorders like dysarthria and aphasia.

Aphasia disrupts speech due to damage in the brain areas involved in language, usually after a stroke or brain injury. People with aphasia can have trouble with reading, listening, speaking, and writing. Aphasia doesn’t impact intelligence, but it can affect a person’s ability to communicate their thoughts well. It can affect people of all ages but is more common in those over the age of 65. This is because strokes tend to affect older people. 

A person with aphasia may:

• Put words together incorrectly 
• Use the wrong sounds in a word
• Not understanding other people’s conversations
• Speak in sentences that don’t make sense

Stammering 

Stammering, also known as stuttering, affects the flow of speech. People who stammer repeat sounds, syllables, or words. Stammering usually starts in early childhood, when it is called developmental stammering. The exact cause of developmental stammering is not yet known; however, there is a genetic link. Studies indicate that around 60% who have a stammer also have a family member who stammers or used to stammer. In some, it may start later in adulthood, which is when it is referred to as acquired or late-onset stammering. 

Stammering is more common in people assigned male at birth (AMAB) than people assigned female at birth (AFAB). Approximately 75% of people with a stammer are AMAB. The severity of a stammer can change over the course of life. Some may find they have periods where they stammer more often and periods where they stammer less. Some people may stammer less as they get older as well.

Stammering is when a child or adult:

• Repeats sounds or syllables 
• Makes sounds longer
• Has words that get stuck or don’t come out 

Types of speech impediments

Speech impediments can affect voice, fluency and articulation. The main categories of speech impediments are:

• Articulation disorders: These occur when a person has difficulty producing the motor movements required for speech. They typically affect children but can impact adults who have suffered from brain injury or stroke. Individuals with articulation disorders may show omissions, substitutions, or additions of sound in their speech. These disorders tend to be more common in children AMAB than children AFAB.
• Fluency disorders: These interrupt the continuous flow of speech. The most common examples of fluency disorders are stuttering and cluttering . Cluttering is when a person speaks fast and merges their words together. They may also say ‘uh’ often.
• Voice disorders: These change how the voice sounds. They affect the larynx . With voice disorders, the voice may be hoarse, raspy, or suddenly change in pitch. They may be caused by vocal nodules or cysts, or weakness of the vocal folds .
• Resonance disorders: These are when too much air goes through the nose when speaking. This makes the voice sound more nasal. Common types of resonance disorders include hypernasality, hyponasality and cul-de-sac resonance. 

Causes of speech impediments

Understanding the cause of an impediment can help identify the best treatment for it. Sometimes, speech impediments may have an unknown cause. Some known causes include:

• Children are more likely to develop speech disorders if they have a parent who currently is, or has experienced one. 3 Some language disorders can also be genetic, like hereditary ataxia , which can cause slow and unclear speech. 
• Sometimes, children can show delays in reaching developmental milestones. These developmental delays can affect motor skills, cognitive abilities, or speech.  
• Traumatic brain injury or stroke can impact the brain’s ability to control the muscles required for speech, resulting in impediments. 4 People with conditions like autism or dementia may also develop speech impediments.
• Hearing sounds is an important part of learning to speak. People with hearing loss may find it difficult to produce different speech sounds and learn new words.
• Some people develop impediments like a stammer in response to trauma. Adults can develop a stammer after periods of intense stress.

Emotional impact of speech impediments  

Communicating skills is essential for self-expression and building healthy relationships. Often, people with speech impediments can have feelings of low self-esteem . 5 They may withdraw and speak less often. Issues of socialising can lead to feelings of loneliness and isolation. 

People with speech impediments know what they want to say, but have a struggle forming the speech sounds to say the words and sentences. As a result, speech impediments can be incredibly frustrating. 

Diagnosis and assessment 

Diagnosis usually involves a referral to a speech and language therapist (SLT). SLTs will review a patient's medical and family history. They will check for other underlying conditions, like autism, that may result in an impediment. A hearing test might also be carried out to rule out hearing loss as a cause. 

Tools and techniques SLTs may use to inform a diagnosis are:

• The Leiter International Performance scale-3 is a nonverbal test that measures cognitive ability. 
• The Goldman-Fristoe Test of Articulation 3 (GFTA-3) which tests consonant sound articulation. It uses engaging images to prompt responses that include the major speech sounds.  
• The Arizona Articulation and Phonology Scale 4th Revision (Arizona-4) is a test that evaluates articulatory and phonological skills.

Researchers emphasise the impact of early intervention on improving the outcome for people with speech impediments. Treatment methods will depend on the type and severity of the speech impediment. For those with impediments caused by cleft lip and palate , surgery might also be a treatment option. Some impediments may not require treatment, as some children can outgrow them. Speech therapy involves exercises that allow patients to practice producing certain sounds or to help find alternative ways of communication for people with severe impediments. 

Some treatment therapies used by SLTs include: 

• Target selection: Practicing specific speech sounds or words chosen by an SLT. These can vary and may be based on how frequent the sounds are in the patient’s language or the patient’s general speaking ability. 
• Contextual utilisation: This approach focuses on understanding how sounds are produced in different syllables.
• Contrast therapy: Uses contrasting word pairs to emphasise the different sounds that need to be produced to differentiate the words from each other. An example of a word pair can be “pot” vs “spot” or “tea” vs “key.”
• Oral-motor therapy: Weakness in the oral-motor muscles may cause poor articulation, so this therapy focuses on strengthening and improving the control of oral muscles.  

Summary 

Speech impediments, like dysarthria and stammering, affect how a person is able to produce the sounds needed for speech. They can be caused by many factors, such as neurological conditions or hearing loss, though sometimes the cause is not always known. Children can grow out of milder speech impediments. Speech therapy can help improve speech for some, while individuals with a cleft lip and palate may benefit from surgery. Early diagnosis and intervention are crucial and can have a big impact on improving communication, learning and overall quality of life. 

References:

• Sheikh SA, Sahidullah M, Hirsch F, Ouni S. Machine learning for stuttering identification: review, challenges and future directions [Internet]. arXiv; 2022 [cited 2023 Oct 13]. Available from:  http://arxiv.org/abs/2107.04057
• Feldman HM. Evaluation and management of language and speech disorders in preschool children. Pediatrics In Review [Internet]. 2005 Apr 1 [cited 2023 Oct 13];26(4):131–42. Available from:  https://publications.aap.org/pediatricsinreview/article/26/4/131/61533/Evaluation-and-Management-of-Language-and-Speech
• Kang C, Drayna D. Genetics of speech and language disorders. Annu Rev Genom Hum Genet [Internet]. 2011 Sep 22 [cited 2023 Oct 13];12(1):145–64. Available from:  https://www.annualreviews.org/doi/10.1146/annurev-genom-090810-183119
• Basilakos A, Fridriksson J. Types of motor speech impairments associated with neurologic diseases. In: Handbook of Clinical Neurology [Internet]. Elsevier; 2022 [cited 2024 Feb 2]. p. 71–9. Available from:  https://linkinghub.elsevier.com/retrieve/pii/B9780128233849000049
• Krueger BI. Eligibility and speech sound disorders: assessment of social impact. Perspect ASHA SIGs [Internet]. 2019 Feb 26 [cited 2023 Oct 13];4(1):85–90. Available from:  http://pubs.asha.org/doi/10.1044/2018_PERS-SIG1-2018-0016

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Speech impairment in adults

Speech and language impairment may be any of several problems that make it difficult to communicate.

Considerations

The following are common speech and language disorders.

Aphasia is loss of the ability to understand or express spoken or written language. It commonly occurs after strokes or traumatic brain injuries. It can also occur in people with brain tumors or degenerative diseases that affect the language areas of the brain. This term does not apply to children who have never developed communication skills. There are many different types of aphasia.

In some cases of aphasia, the problem eventually corrects itself, but in others, it doesn't get better.

With dysarthria , the person has problems expressing certain sounds or words. They have poorly pronounced speech (such as slurring) and the rhythm or speed of speech is changed. Usually, a nerve or brain disorder has made it difficult to control the tongue, lips, larynx, or vocal cords, which make speech.

Dysarthria, which is difficulty pronouncing words, is sometimes confused with aphasia, which is difficulty producing language. They have different causes.

People with dysarthria may also have problems swallowing.

VOICE DISTURBANCES

Anything that changes the shape of the vocal cords or the way they work will cause a voice disturbance. Lump-like growths such as nodules, polyps, cysts, papillomas, granulomas, and cancers can be to blame. These changes cause the voice to sound different from the way it normally sounds.

Some of these disorders develop gradually, but anyone can develop a speech and language impairment suddenly, usually due to a stroke or trauma.

• Alzheimer disease
• Brain tumor (more common in aphasia than dysarthria)
• Head trauma
• Transient ischemic attack (TIA)
• Alcohol intoxication
• Diseases that affect nerves and muscles (neuromuscular diseases), such as amyotrophic lateral sclerosis (ALS or Lou Gehrig disease), cerebral palsy, myasthenia gravis, or multiple sclerosis (MS)
• Facial trauma
• Facial weakness, such as Bell's palsy or tongue weakness
• Head and neck cancer surgery
• Nervous system (neurological) disorders that affect the brain, such as Parkinson disease or Huntington disease (more common in dysarthria than aphasia)
• Poorly fitting dentures
• Side effects of medicines that act on the central nervous system, such as narcotics, phenytoin, or carbamazepine
• Growths or nodules on the vocal cords
• People who use their voice heavily (teachers, coaches, vocal performers) are more likely to develop voice disorders.

For dysarthria, ways to help improve communication include speaking slowly and using hand gestures. Family and friends need to provide plenty of time for those with the disorder to express themselves. Typing on an electronic device or using pen and paper can also help with communication.

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.Using nonverbal ways of communicating may also help.

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 person understands.
• Provide communication aids, if possible, depending on the person and condition.

Mental health counseling may help with depression or frustration that many people with speech impairment have.

When to Contact a Medical Professional

Contact the provider if:

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

What to Expect at Your Office Visit

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

The provider will likely ask about the speech impairment. Questions may include when the problem developed, whether there was an injury, and what medicines the person takes.

Diagnostic tests that may be performed include the following:

• Blood tests
• Cerebral angiography to check blood flow in the brain
• CT or MRI scan of the head to check for problems such as tumor
• Electroencephalogram (EEG) to measure electrical activity of the brain
• Electromyography ( EMG ) to check the health of the muscles and the nerves that control the muscles
• Lumbar puncture to check the cerebrospinal fluid that surrounds the brain and spinal cord
• Urine tests
• X-rays of the skull

If the tests find other medical problems, other specialist doctors will need to be consulted.

For help with the speech problem, a speech and language therapist or social worker will likely need to be consulted.

Alternative Names

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

Kirshner HS. Dysarthria and apraxia of speech. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 14.

Kirshner HS, Wilson SM. Aphasia and aphasic syndromes. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice.  8th ed. Philadelphia, PA: Elsevier; 2022:chap 13.

Rossi RP, Kortte JH, Palmer JB. Speech and language disorders. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation . 4th ed. Philadelphia, PA: Elsevier; 2019:chap 155.

Review Date 5/2/2022

Updated by: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Targeted Word Lists for Speech Therapy Practice

The speech therapy word lists are perfect for anyone who needs practice with speech and language concepts . For any type of practice...

...you need words to get started .

Now I don't know about you, but when I need to think of targeted words to use...

...I suffer from spontaneous memory loss , or SML.

It's more common than you might think ;)

This page has words for anyone to practice articulation, apraxia, language, phonology, or stuttering principles . They will help children and adults be successful meeting their goals. 

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Each list of articulation sounds contains words with the target sound in the beginning, middle, and end position, including blends when applicable, as well as words that...

• are common and functional (words we use all day...everyday)
• are mostly 1 syllable (multi-syllabic words are more difficult)
• have a phonemic context that don't interfere with production of the target sound (most words)

If "R" is the problem sound using the word "Rope" makes saying the "R" sound harder because the "O" sound is considered a round vowel.

A round vowel is one where you round your lips to say it. Go ahead...try it by saying "O" as in "boat". You rounded your lips didn't you? I thought you might.

Children who have difficulty with the "R" sound tend to say the "W" sound...they say "Wabbit" instead of "Rabbit".

The "W" sound is considered a rounded sound too. Try saying the "W" sound without rounding your lips...you can't because that is how the sound is made.

So by pairing the "R" sound with the "O" sound like in the word "Rope", this makes the word extra difficult for a child who has a problem saying the "R" sound because the "O" that follows the "R" will naturally make them want to round there lips.

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How to Get Rid of a Speech Disorder

Last Updated: December 4, 2023 Fact Checked

This article was co-authored by Devin Fisher, CCC-SLP . Devin Fisher is a Speech-Language Pathologist based in Las Vegas, Nevada. Devin specializes in speech and language therapy for individuals with aphasia, swallowing, voice, articulation, phonological social-pragmatic, motor speech, and fluency disorders. Furthermore, Devin treats cognitive-communication impairment, language delay, and Parkinson's Disease. He holds a BS and MS in Speech-Language Pathology from Fontbonne University. Devin also runs a related website and blog that offers speech-language therapy resources and information for clinicians and clients. There are 13 references cited in this article, which can be found at the bottom of the page. This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources. This article has been viewed 330,132 times.

Many people feel insecure about their speech impediments, whether they're dealing with a lisp or an inability to articulate words. Although it may not seem like it—particularly if you have been dealing with this problem for years—you may be able to get rid of or improve your speech impediment with a few speech-training practices and some major confidence-boosters. And don't forget to seek out the professional opinion of a speech and language therapist/pathologist for more information.

Helping Yourself with a Speech Disorder

• One modern approach is to use technology. There are apps that can run on smartphones and tablets that listen to what you say and then give you feedback. For example, on Android there is the free app "Talking English." You can also find similar apps in the Apple App Store.

Stephanie Jeret

Cues and picture boards can help those with aphasia find words and express thoughts. For aphasia or trouble finding words, cues like the first sound can help jog your memory. Picture boards are great too, especially if speaking is very difficult. These tools allow people to communicate their needs and thoughts through other means.

Using Your Body to Improve Speech

• Shoulders relaxed
• Back straight
• Feet steady

• Sit comfortably and with an erect posture. Breathe in deeply through your nose. You should use your hand to feel your stomach expanding like a balloon being inflated. Hold the breath and then release it slowly, feeling your stomach deflating beneath your hand. Repeat this exercise before you have to speak publicly to relieve stress.

Getting Professional Help

• Speech therapy is helpful for correcting your impediment. The therapist will point out the part of speech where you're having problems, and will work with you to correct it. Private speech therapy sessions do not come cheap, although most insurance policies will fund services needed to treat speech disorders.
• There's no substitute for learning and practice when it comes to the proper and effective use of language. Take every opportunity to speak, to practice and brush up on the correct pronunciation and enunciation provided to you by a professional.

• Every time the dentist adjusts your braces (or even dentures), you need to train yourself to talk and to eat properly. It may be quite painful at first, but remember not to go too far, lest you end up with a mouth injury.
• Most braces are used for orthodontic purposes, although some braces can be used as decorations. Braces are rather expensive, and you may need to take out a dental plan or cash in on dental insurance to pay for them.
• Kids and teenagers don't like to wear braces because they're often teased as “metal mouths” or “railroad faces.” The fact is that braces are still the best way to correct a lisp caused by misaligned teeth.

Assessing Your Speech Disorder

• Cleft lips and palates were a major cause of speech impediments until surgery became affordable. Now, children born with clefts can have reconstructive surgery and a multidisciplinary team of providers that help with feeding and speech and language development. [14] X Research source
• Malocclusion is when the teeth do not have the proper normal bite. Malocclusions are usually corrected through braces, although orthodontic surgery is necessary in some cases. Individuals with this condition may talk with a lisp, make a whistle sound when certain words are spoken, or mumble.
• Neurological disorders caused by accidents or brain and nerve tumors can cause a speech disorder called dysprosody. Dysprosody involves difficulty in expressing the tonal and emotional qualities of speech such as inflection and emphasis.

Expert Q&A

• Welcome good speech. Look forward to it, and accept and celebrate even little improvements. Thanks Helpful 0 Not Helpful 0
• Try to slow down and pronounce each word properly, as this can also help when trying to overcome a speech problem. Thanks Helpful 0 Not Helpful 0

• See a Speech Pathologist who maintains their Certification of Clinical Competence from the American Speech and Hearing Association. These professionals are able to evaluate, diagnose and treat speech impairments. Nothing replaces sound medical advice from a specialist. Thanks Helpful 11 Not Helpful 14

You Might Also Like

• ↑ https://www.uts.edu.au/sites/default/files/2018-10/Camperdown%20Program%20Treatment%20Guide%20June%202018.pdf
• ↑ Devin Fisher, CCC-SLP. Speech Language Pathologist. Expert Interview. 15 January 2021.
• ↑ https://www.stutteringhelp.org/sites/default/files/Migrate/Book_0012_tenth_ed.pdf
• ↑ http://www.coli.uni-saarland.de/~steiner/publications/ISSP2014.pdf
• ↑ https://sps.columbia.edu/news/five-ways-improve-your-body-language-during-speech
• ↑ https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/breathing-exercises-for-stress/
• ↑ http://kidshealth.org/teen/diseases_conditions/sight/speech_disorders.html#
• ↑ https://www.nidcd.nih.gov/health/stuttering
• ↑ https://medlineplus.gov/ency/article/001058.htm
• ↑ http://www.asha.org/public/speech/disorders/CleftLip/
• ↑ https://www.cdc.gov/ncbddd/developmentaldisabilities/language-disorders.html
• ↑ https://www.stanfordchildrens.org/en/topic/default?id=stuttering-90-P02290
• ↑ https://raisingchildren.net.au/preschoolers/development/language-development/stuttering

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100+ fun activities for kids that will keep them entertained for hours! Target speech development through play and games. They won’t even know they are learning!

Learn about your baby and toddler developmental milestones! Check if you are on track, when to worry, and how to work on skills like language, potty training, and feeding!

Every child is different! Here are speech and language tips and tools for kids with learning differences, alongside information for parents provided by speech therapists.

Parenting starts with your well-being! Here is some advice on how to teach life skills, work from home, distance learning, along with tips for developing parenting coping skills.

We help kids speak no matter their speech challenges! Speech therapists advise parents about late talkers, speech delay, stuttering, apraxia, articulation, and other speech impediments.

From your first worry to your first appointment, and your last speech therapy session – find the information you need to help your child thrive and gain necessary speech skills.

Parent's Academy › Speech Disorders › Speech Impediments › 6 Types of Speech Impediments

6 Types of Speech Impediments

Stacie bennett.

Speech-Language Pathologist , Trenton , New Jersey

Jan 28, 2022 ‘Speech and language impediment’ is a very broad term that refers to a communication disorder in an individual that has depressed social, language, communication, hearing, or fluency skills.

In This Article

Speech therapy exercises with speech blubs, apraxia of speech, speech sound disorder, specific language impairment, language-based learning disabilities, key takeaways about speech impediments.

A speech impediment relates to the way an individual produces or articulates specific sounds. One example of this is stuttering. Under the umbrella of a speech impairment lies several different types of disorders with which a child or adult can be diagnosed.

A language impairment involves understanding and sharing thoughts and ideas. For example, this person may not have adequate or “age-appropriate” vocabulary and grammar skills. Again, there are several different language disorders that fall under this category that will be addressed in this blog.

Speech Blubs  is a language therapy app with a vast library of more than 1,500 activities, face filters, voice-activated activities, and educational bonus videos. 

The more you practice, the more it carries over! Try the Speech Blubs app for fun and engaging therapy sessions with your little one.

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3 Types of Speech Disorders

Apraxia of speech is a neurogenic (starts in the nervous system) communication disorder that involves the planning system for speech.

Individuals with Apraxia know what they want to say, but there is a disconnect in the part of the brain that tells a specific muscle to move. When someone is diagnosed with  apraxia of speech , they may have signs of groping, which is where the mouth searches for the position to create the sound.

When this occurs, it affects how long or short the sounds are, and could lead to odd pitch or volume issues and to sounds being distorted or substituted. A tell-tale sign of someone who has apraxia is that they lose the ability to produce sounds that they previously could say.

For instance, if you ask a child to say the word “dog,” which they do successfully and then ask them to say the same word again 10 minutes later, they will not be able to do it. 

Speech sound disorders may be of two varieties: articulation (the production of sounds) or phonological processes (sound patterns).

An articulation disorder  may take the form of substitution, omission, addition, or distortion of normal speech sounds.

Phonological process disorders  may involve more systematic difficulties with the production of particular types of sounds, such as those made in the back of the mouth, like “k” and “g” (ASHA 2018).

Educating a child on the appropriate ways to produce a speech sound and encouraging the child to practice this articulation over time may produce natural speech.

For additional reading on articulation and phonological disorders, check these blogs:

• What Are Phonological Processes
• Process of Articulation Therapy

Stuttering  is a disruption in the fluency of an individual’s speech, which begins in childhood and may persist over a lifetime.

Stuttering is a form of disfluency (an inability to produce fluent speech). Disfluency becomes a problem because it impedes successful communication between two parties. Disfluencies may be due to unwanted repetitions of sounds (e.g., “I-I-I want ice cream”), or the extension of speech sounds (e.g., “S——tart the wash”), syllables (e.g., “Na-na-na nasty”), or words (e.g., “go-go-go to the store”). Disfluencies also incorporate unintentional pauses in speech, in which the individual is unable to produce speech sounds (ASHA 2016).

Unfortunately, the cause of stuttering is unknown, which makes it more difficult to treat. Treatment can vary from person to person depending on the severity and type of stuttering that is occurring. 

Read more on  how to distinguish stuttering as a part of typical speech development from stuttering as a speech disorder!

3 Types of Language Disorders

Specific Learning Impairment (SLI) is diagnosed when a child’s language is not developing as rapidly or as typically as other children. In order for a child to be diagnosed with SLI, they cannot have Autism Spectrum Disorder, Apraxia, hearing loss, or an abnormality of the speech mechanisms. If those disorders are present, they do not have SLI and are exhibiting speech patterns typical of those diagnoses. Usually, the first indication of SLI is that the child is later than usual in starting to speak and subsequently is delayed in putting words together to form sentences.  Spoken language  may be immature. In many children with SLI, understanding of  language , or  receptive  language, is also impaired, though this may not be obvious unless the child is given a formal assessment. This diagnosis is reserved for children whose language difficulties persist into school age, not for children who are speech delayed and eventually catch up to their peers. 

Aphasia  is an inability to comprehend or formulate language because of damage to specific brain regions.

The major causes are a cerebral vascular accident (stroke), or head trauma, but aphasia can also be the result of brain tumors, brain infections, or neurodegenerative diseases such as dementia (ASHA 2017).

The difficulties of people with aphasia can range from occasional trouble finding words, to losing the ability to speak, read, or write; intelligence, however, is unaffected. Any person of any age can develop aphasia, given that it is often caused by a traumatic injury. However, people who are middle-aged and older are the most likely to experience the problem. 

Language-based learning disabilities occur in children who are falling behind their same-aged peers. These children will have difficulties with spelling, reading, and/or writing, but have normal intelligence levels. This is a common source of academic struggles in young children and can often be misdiagnosed or missed in typical assessments.

The key to supporting students with LBLD is knowing how to adjust curriculum and instruction to ensure they develop  proficient language and literacy skills . Most individuals with LBLD need instruction that is specialized, explicit, structured, and multisensory, as well as ongoing, guided practice aimed at remediating their specific areas of weakness.

There are a lot of speech and language impediments that can occur in children and adults. This blog only scratches the surface of these disorders, so please stay tuned and check out Speech Blubs regularly for more in-depth blogs regarding these subjects.

If there’s a topic you’d like to know more about, please reach out to us and we will get working on it! As always, if you feel like your child is exhibiting any signs or symptoms of these disorders, it’s important that you make an appointment with a speech-language pathologist as soon as possible to get a full evaluation.

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The author’s views are entirely his or her own and may not necessarily reflect the views of Blub Blub Inc. All content provided on this website is for informational purposes only and is not intended to be a substitute for independent professional medical judgement, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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252 of the hardest English words to pronounce and spell

Karolina Assi

Are you tired of stumbling over hard English words to pronounce? From common words with silent letters to tongue twisters that leave you tongue-tied, we delve into the nuances of English pronunciation to help you master the trickiest ones.

Without a doubt, pronunciation is one of the most important aspects of learning a new language. Mispronouncing words may lead to many misunderstandings… sometimes funny or even embarrassing. Which is why it makes total sense that, as an English learner , you most likely aim to master your pronunciation to sound as close to a native speaker as possible.

But while English may not seem like the most difficult language to pronounce, it has its fair share of words that can be hard to get your tongue around. This is mainly because the English language is a mishmash of words borrowed from other languages. Or inspired by other languages.

To give you some extra value, we’ve compiled a list of more than 250 hardest words to pronounce in English. Even if you don’t master them immediately, simply having a go at the pronunciation and having fun with them will make you a more confident English speaker. So buckle up for an ephemeral, eclectic vocabulary explosion that will test your equanimity.

What makes English words difficult to pronounce and spell?

As an English learner, you may have noticed a disconnect between the pronunciation and spelling of certain words in English. Sometimes, how you spell a word has nothing to do with how you pronounce it or vice versa.

Linguistically speaking, the graphemes (the written words) and the phonemes (sounds) do not always coincide in English.

This happens mainly because the English language uses many words borrowed from other languages, such as French , Latin, Greek , or German . For example, the word “vacuum” comes from the Latin word “vacuus,” which means “empty.” That’s why it’s spelled with a double “u.”

To make things even more confusing, in English, one letter can make different sounds, and the same combination of letters can be pronounced differently in different words. There’s no better way to illustrate this than this funny TikTok sketch . Or this one .

10 of the hardest words in English to pronounce

The pronunciation of some English words can leave even the most eloquent wordsmiths perplexed. Here are the top 10 hardest English words to pronounce, even for native speakers. Test your English knowledge and see whether you can pronounce these words correctly. We’re curious to know how many you got right!

There’s no way you can pronounce this word without twisting your tongue! The double “r” followed by a contradictory “l” makes this seemingly innocent word one of the hardest ones to pronounce in English.

2. Mischievous

[ˈmɪsʧəvəs]

To be mischievous means “to cause or show a fondness for causing trouble in a playful way.” And indeed, this word causes us a lot of trouble when it comes to its correct pronunciation. Most people pronounce it as “mis-chee-vee-us”, adding an extra “i.” But no, it’s actually “mis-chee-vus.”

This seemingly simple word is actually one of the most mispronounced words in English, even by native speakers. We bet you read it the way it’s written (“co-lo-nel”), right? Well, we’re sorry to break it to you, but it’s actually pronounced: “ker-nel.” Yes, it makes no sense.

This seemingly innocent word is another one that causes a lot of confusion. We’re sure you read it as “epi-tom.” But no, the correct pronunciation of this word is “epi-toh-mee” Yes, despite what your intuition is telling you, the “e” isn’t silent.

This one is probably the most counter-intuitive English word to pronounce. Its correct pronunciation still has me bewildered, no matter how many times I’ve said it. However you think it’s pronounced - believe me, it isn’t. No, it’s not “drot.” It’s “draft.” As in “laugh,” but with a “t” at the end.

6. Hyperbole

[haɪˈpɜrbəˌli]

This word, likely familiar to you from your mathematics classes, is a word of Greek origin. And just like with many other words of Greek origin in English, the “e” at the end isn’t silent. Although most people mispronounce it as “hahy-pur-bohl,” it’s actually pronounced “hahy-per-buh-lee.”

7. Nauseous

If you’re pronouncing this word as “naw-zee-us,” then you’re pronouncing it wrong! While this pronunciation may seem intuitive, it’s actually pronounced “naw-shus.” Yes, we agree, the English spelling-to-pronunciation relationship doesn’t make sense sometimes.

While this is such as basic word, it’s actually one of the hardest to pronounce. Because of how challenging it is to correctly pronounce the combination of “x” and “th,” most people just mispronounce it as “siks.”

9. Thorough

As an English learner, you may find it confusing to differentiate between the words “thorough” and “through.” In writing, they are very similar, but their pronunciation differs significantly. Contrary to what you may think, “thorough” isn’t pronounced as “threw.” The correct pronunciation is “thuh-ruh.”

10. Worcestershire sauce

[ˈwʊstəʃər sɔs]

And the winner is… Worcestershire sauce. We’re ready to bet that you’re pronouncing it “Wor-cest-er-shi-er.” However, the correct pronunciation is “Woo-ster-sher.” Just forget about the “ces” syllable.

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The top 250+ hardest English words to spell and pronounce

Did you think that there were only 10 super-complicated words to pronounce in English? Oh no, the list doesn’t end there! In fact, it goes on and on… Well, in this article, it goes up to 252 of the hardest English words to pronounce and spell. Let’s dive in.

Hardest words to spell that have won a Spelling Bee

The words “Spelling Bee” probably make you remember your English classes from kindergarten and primary school. But, achieving spelling mastery goes beyond passing all your Spelling Bees with an A at school.

Spelling Bee is also a contest for language enthusiasts. Here are the top 10 most brutal words to spell and pronounce that appeared in the Spelling Bee contest over the years.

Twisted your tongue?

Phew! Some of these words are true tongue twisters, even for spelling bee champions. Aside from the tricky spelling of words like abeyance, accent, and exercise, there are also common words we use daily that are difficult to say and even harder to spell. The words such as “epitome” and “colonel” confuse even the best of us.

But whether you're learning English for personal or professional reasons, learning how to pronounce these challenging words will help you impress native speakers and take your English to the next level. So keep at it!

If you love this article, check out more challenges with the longest words in English , or keep up the vocab fun on our English blog .

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English pronunciation of speech impediment

Speech impediment.

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(English pronunciations of speech impediment from the Cambridge Advanced Learner's Dictionary & Thesaurus and from the Cambridge Academic Content Dictionary , both sources © Cambridge University Press)

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Our 6 Favorite Apps for Kids with Speech Impediments

Boys playing apps for speech impediments

One comment

Thanks for commenting Elaine. Currently Articulation Games is the most expensive on this list, but the others are more affordable. You might check out an app like “App Shopper” which will notify you when apps that you’re interested in go on sale. Otherwise I might ask a local SLP if they have any recommendations about appropriate apps, or check out youtube to see demonstrations of games you’re considering.

Then let us know what works! Best of Luck.

Comments are closed.

English pronunciation practice: Difficult words with R

Pronunciation & Shadowing Courses

Hi students! It’s Shayna, your teacher from EspressoEnglish.net and today we’re going to practice pronouncing some difficult English words that feature the letter R.

The letter R may be pronounced differently in your native language, but in English it sounds like R. Let’s warm up by practicing some simple words with the R sound:

OK, now let’s move on to some of our more difficult words! I’m going to explain them and help you pronounce them correctly.

Before we get started, I’d like to invite you to check out my courses called American English Pronunciation and Shadowing with Shayna . These courses will help you learn to pronounce English words and sentences more clearly and naturally.

All right, are you ready?

How to pronounce “choir”

Our first word is choir , referring to a singing group – this one is tricky because the CH sounds like a K, and the O sounds more like an U. So all together it’s like “KWI-er.”

Rhymes with fire – choir.

How to pronounce “drawer”

Next we have an everyday object in the house, and that is a drawer . The initial D sounds like a J, and we have two R sounds. The “aw” in the middle actually sounds more like an “o”

So drawer rhymes with store

Try saying it really slowly: ddddrrrraaawwweeerrr

And then at a more normal speed: drawer

How to pronounce “rural”

Another word a lot of English students have trouble with is rural . Your tongue might get mixed up between the two Rs and the L. So try saying just the “rur” part and then adding “al”

rur – al

It’s not easy!

How to pronounce “rarely”

Another word with two Rs and an L is rarely. Again, let’s first say “rare” and then add “ly”:

rare – ly

How to pronounce “jewelry”

Next there’s the word jewelry – and what’s crazy about this word is that some people pronounce it with three syllables, like JOO-ler-y, and others say it more like JOOL-ry with two syllables.

The joo-ler-y pronunciation seems contrary to the spelling, but you will sometimes hear it. I think the JOOL-ry pronunciation is easier and makes more sense, so let’s work on that:

JOOL – ry

How to pronounce “library”

Next we have library. Some people mistakenly pronounce this liberry, forgetting the BR in the middle. But the correct pronunciation is: LI-brer-y

LI – brer – y

How to pronounce “February”

The month of February looks similar, but most people actually do NOT pronounce the R after the B. Instead, we say: FEB-you-er-y

Repeat after me, once slow, once fast:

FEB – you – er – y

How to pronounce “regularly”

Another difficult 4-syllable word with R is regularly. To master the pronunciation, it’s best to break it up into parts:

REG – you – lar – ly

REG-you-lar-ly

Just keep practicing, and eventually your tongue will master the pattern of these Rs and Ls!

How to pronounce “temperature”

Finally we have the word temperature. Let’s start with just the first two syllables:

Easy, right?

Now the -ature part actually just sounds like “chur” in fast spoken English. So we have:

TEM – per – chur

TEM-per-chur

tem-per-chur

Do you have a difficult word that you want to know how to pronounce correctly in English? If so, tell me about it, and I’ll add it to my list for future videos!

If you want to continue learning pronunciation and practicing with me, come check out my pronunciation and shadowing courses – I think you’ll really enjoy them.

Keep on practicing and with time, you will be able to pronounce these difficult R words well. See you in the next video!

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• 50 hard words to pronounce in English

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About the author.

Shayna Oliveira

Shayna Oliveira is the founder of Espresso English, where you can improve your English fast - even if you don’t have much time to study. Millions of students are learning English from her clear, friendly, and practical lessons! Shayna is a CELTA-certified teacher with 10+ years of experience helping English learners become more fluent in her English courses.