What’s the difference between a speech impairment and a language disorder?

ByEllen Koslo, AuD


What’s the difference between a speech impairment and a language disorder?


We often hear the words speech and language used interchangeably. They might mean the same thing when we’re talking casually about communication. But in the medical community, they have very different meanings.

Speech refers to the actual sound of spoken language. It’s the oral form of communicating. Speech is talking: using the muscles of the tongue, lips, jaw, and vocal tract in a very precise and coordinated way to produce the recognizable sounds that make up language.

Language refers to a whole system of words and symbols — written, spoken, or expressed with gestures and body language — that is used to communicate meaning.

Just as speech and language differ, there’s a difference between speech disorders and language disorders.

A speech disorder usually indicates that someone has trouble producing certain sounds accurately.

Young children who are learning how to speak will probably substitute, leave out, or distort normal speech sounds. For example, it’s not unusual for 3-year-olds to use the f sound for th in their speech: “I’m firsty (thirsty).” But that pronunciation would be considered an articulation error in a 5-year-old. This is a speech problem.

Language deals with meaning. Kids with a language disorder may have a difficult time understanding the meaning of what’s being said (receptive language issues). Or they may have trouble communicating their own thoughts (expressive language issues).

Imagine a child who has good speech and pronounces words correctly. This child can still have poor language — trouble putting words together to express thoughts or trouble understanding the meaning what’s being said by other.

Speech disorders and language disorders may occur separately. Or an individual may have both kinds of disorders at the same time.

There are milestones that can guide you when considering whether your child’s speech and language are developing typically. Most children, by their second birthday, have a vocabulary of about 50 words. By age 2 to 3 years, typical kids start understanding a lot more language than they can express.

Here are some signs that could cause concern:

  • Doesn’t understand name, the word no, or simple commands by age 1

  • Isn’t saying words by 14 to 16 months of age

  • Can’t answer basic “wh” questions (what, where, who) by age 3

  • Has difficulty being understood by people outside the family after age 3

  • Has noticeable hesitations or repetitions in speech past age 5

  • Can’t tell a sequential story (a story with a beginning, middle, and end) by age 5

  • Shows limited development of vocabulary

Children develop speech and language skills at their own individual paces. But if your child has any of the above problems, it’s a good idea to talk to your pediatrician. You can get a referral to a speech-language specialist to find out if a speech or language problem exists. Treatment options can be different for each child, so getting the right diagnosis is key.

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About the author

About the author

Ellen Koslo, AuD is an audiologist and associate professor of otolaryngology at Columbia University Medical Center.