What is the medical term for difficulty with speech?

Medical Terms for Speech and Language Difficulties

The primary medical terms for difficulty with speech and finding problems with words are aphasia, dysarthria, and dysphonia, depending on the underlying cause and specific symptoms.

Types of Speech and Language Disorders

Aphasia

• Aphasia is an acquired language impairment following brain damage that affects some or all language modalities including expression and understanding of speech, reading, and writing 1
• It is commonly caused by stroke, affecting approximately one-third of stroke patients in the acute phase 1
• Aphasia impacts multiple linguistic domains including word finding, comprehension, expression, reading, and writing 2

Types of Aphasia

• Semantic aphasia: Characterized by difficulties in word retrieval and understanding word meanings 2
• Non-fluent/agrammatic aphasia: Features apraxia of speech and grammatical difficulties 2
• Logopenic aphasia: Results in word-finding difficulties and phonological working memory issues 2
• Broca's aphasia: A non-fluent aphasia affecting speech production 1
• Wernicke's aphasia: A fluent aphasia affecting comprehension 1

Dysarthria

• Dysarthria is a motor speech disorder associated with disturbances of respiration, laryngeal function, airflow direction, and articulation 3
• It results in difficulties with speech quality and intelligibility 3
• Occurs in 60% of patients with neurological conditions according to some studies 4

Types of Dysarthria

• Flaccid dysarthria: Associated with lower motor neuron impairment 3
• Spastic dysarthria: Associated with upper motor neuron damage 3
• Ataxic dysarthria: Primarily caused by cerebellar dysfunction 3
• Hyperkinetic dysarthria: Related to extrapyramidal system disorders 3
• Hypokinetic dysarthria: Related to extrapyramidal system disorders 3
• Mixed dysarthria: Associated with damage in multiple areas 3

Dysphonia

• Dysphonia refers to impaired voice production as recognized by a clinician 5
• Often used interchangeably with hoarseness, though hoarseness is specifically the symptom reported by patients 5
• Affects nearly one-third of the population at some point in their lives 5

Assessment and Diagnosis

Communication Assessment

• Motor speech evaluations establish the presence and severity of speech disorders by examining components including respiration, phonation, resonance, articulation, prosody, and overall intelligibility 5
• Language assessment procedures vary depending on whether aphasia or cognitive-communicative problems are suspected 5
• All language modalities should be assessed, including auditory comprehension, reading, spoken language, writing, and other communication modes 5

Diagnostic Approaches

• Diagnosis of functional communication disorders is made based on internal inconsistency in performance compared with well-described lesion-based patterns 5
• Laryngoscopy is recommended when dysphonia fails to resolve within 4 weeks or if a serious underlying cause is suspected 5
• Comprehensive assessment should include evaluation of multiple domains of language including comprehension, expression, repetition, reading, and writing 2

Treatment Options

Speech and Language Therapy

• Speech and language therapy (SLT) has been shown to improve functional communication, reading, writing, and expressive language in people with aphasia 6
• High-intensity, high-dose, or longer duration therapy may be more beneficial, though dropout rates may be higher 6
• Treatment approaches include encouraging effective use of available speech, increasing range and consistency of sound production, and teaching strategies for improving intelligibility 3

Multidisciplinary Approach

• Speech language pathologists play an important role as members of rehabilitation teams in neurological settings 4
• Early intervention is necessary despite the fact that many speech impairments have a tendency for spontaneous recovery 1
• For functional communication disorders, treatment should include explanation of the diagnosis, symptomatic interventions, behavioral approaches, and psychological support 5

Prognosis and Recovery

• Spontaneous recovery is most remarkable in the first three months after stroke onset 1
• Recovery of aphasias caused by ischemic stroke occurs earlier and is most intensive in the first two weeks 1
• In aphasias caused by hemorrhagic stroke, spontaneous recovery is slower and occurs from the fourth to the eighth week after stroke 1
• The course and outcome of aphasia depend greatly on the type of aphasia 1

Special Considerations

• For bilingual and multilingual patients, communication assessment of each language is recommended 5
• There is a need to expand normative data for communication tests to include individuals over 90 years of age, broader education levels, and individuals from minority and bilingual populations 5
• Speech and language disorders have profound effects on patients and their families as communication is integral to expressing personality and maintaining social relationships 3
• Dentists and healthcare providers should be aware that after a stroke, some people may have limited powers of expression or comprehension difficulties 7