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# JAN’S ACCOMMODATION FACT SHEET SERIES

**Job Accommodations for People with**

**Speech-Language Impairments**

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.

The following is a quick overview of some of the job accommodations that might be useful for employees with speech impairment.   For a more in depth discussion, access JAN's publications at http://askjan.org/media/atoz.htm.  To discuss an accommodation situation with a consultant, contact JAN directly.

**Communicating with the Person with the Speech or Language Impairment:**

· Be patient, do not complete words or phrases for the individual

· Concentrate on the content of the conversation not the delivery

· Communicate as naturally as possible 

**Communicating One-on-One or in Groups:**

· Provide pen and paper, chalk or dry-erase boards

· Allow the use of a computer with word processing software, word prediction software, and/or speech output software

· Provide a portable speech amplifier

· Provide, or allow the use of augmentative and alternative communication (AAC) devices ( AAC devices provide communication access through typed or pre-programmed words and sentences, or through pictorial symbols.)

· Provide a TTY (TTYs are traditionally used for text telephone communication for individuals who have no speech or speech that is difficult to understand, but can also be useful to communicate one-on-one through a TTY trainer device that connects TTYs together without a telephone line.)

· Allow the use of e-mail or instant messaging

**Communicating on the Telephone:**

· Provide telephone equipment that offers outgoing speech amplification

· Allow the use of AAC devices, or speech amplifiers with the telephone

· Provide a TTY

· Allow the use of Speech-to-Speech (SRS) relay services

**Resources Specifically For People with Speech-Language Impairments**

**American Speech Language Hearing Association**

2200 Research Boulevard

Rockville, MD 20850-3289

Toll Free: (800)638-8255

actioncenter@asha.org

http://www.asha.org

**National Institute of Neurological Disorders and Stroke**

P.O. Box 5801

Bethesda, MD 20824

Toll Free: (800)352-9424

Direct: (301)496-5751

TTY: (301)4965981

http://www.ninds.nih.gov/index.htm

Updated 3/23/10.

This document was developed by the Job Accommodation Network, funded by a contract agreement from the U.S. Department of Labor, Office of Disability Employment Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department of Labor. Nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Department of Labor.

Fact Sheet Series

Job Accommodations for People with Speech-Language Impairments