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Speech-Language Impairment

Accommodation and Compliance: Speech-Language Impairment

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About Speech-Language Impairment

Limitations in speech and language may result from a number of different impairments and disorders. An individual may be limited due to problems with articulation, voice strength, language expression, or may be non-vocal. Following is a list of speech and language disorders including information from the American Speech-Language, Hearing Association (ASHA).

  •  Aphasia is impaired expression or comprehension of written or spoken language. Aphasia is often caused by stroke, brain injury or Alzheimer's dementia.
  • Dysarthria results in difficulty pronouncing words like "cat" or sounds like "sh" and "ba." Dysarthria may be caused by a degenerative neurological disorder or alcohol intoxication.
  • Dysphonias can be present in one of two forms, adductor or abductor. The adductor type produces a strained or strangled voice quality. Abductor sounds like chronic hoarseness or breathy and effortful speech. 
  • Esophageal speech is a technique whereby a person takes air in through the mouth, traps it in the throat, and then releases it. As the air is released, it makes the upper parts of the throat/esophagus vibrate and produces sound. This sound is still shaped into words with the lips, tongue, teeth, and other mouth parts.
  • Stuttering results in repetition, blocks or inability to say certain words, and/or the prolonging of words. An individual who stutters may also have distorted movements and facial expressions when trying to speak.
  • Nodules are most frequently caused by vocal abuse or misuse. Polyps may be caused by prolonged vocal abuse, but may also occur after a single, traumatic event to the vocal folds. Speech may be hoarse, breathy, and painful to produce. 

Additionally, speech and language limitations might occur due to stroke, cerebral palsy, amyotrophic lateral sclerosis (ALS), Huntington’s Disease, oral and laryngeal cancer, hearing impairment, traumatic brain injury, dementia, chronic laryngitis, and vocal cord paralysis.

Speech-Language Impairment and the Americans with Disabilities Act

The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).

Accommodating Employees with Speech-Language Impairment

People with speech-language impairments may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people who are aging will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist

Questions to Consider:

  1. What limitations is the employee experiencing?
  2. How do these limitations affect the employee and the employee’s job performance?
  3. What specific job tasks are problematic as a result of these limitations?
  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
  5. Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
  6. Do supervisory personnel and employees need training?

Accommodation Ideas:

Situations and Solutions:

The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.

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