Can not Say Big Words

"Bob" (not his real name) is a salesman who has had difficulty all his life in saying long words. Unfortunately, many of the products he sells are multi-syllabic. A technical expert by training, Bob creatively came up with short nick-names for each product, and a sales pitch of one syllable words that he practiced until it was fluent. When he left a telephone message asking me to contact him to help him with his speech, I was puzzled; his speech on the message sounded fine to me. When I returned his call, however, Bob's speech sounded "mangled". Unprepared for my call, he could not pronounce common two syllable words correctly. When he tried to correct his speech, it sounded worse, and the variations were never the same. After a speech assessment, Bob was diagnosed with a little-known impairment called "verbal apraxia".

Verbal apraxia is a neurological impairment in which the signals from the brain to the mouth get out of sequence.

When there are two or three consonants together, such as "str" ​​in "strong", one or two consonants may be omitted, or they may be in the wrong order. Sometimes entire syllables in the middle are omitted. While a one syllable word such as "ban" may be spoken easily, a longer word such as "bannister" is very hard to say. Each time the same longer word is spoken, the variations may be different. It may be difficult for someone to start speaking; however, this is definitely not stuttering. People are acutely aware that they have difficulty speaking, and are often quite frustrated.

Verbal apraxia can be congenital, occurring from early childhood when it is often called "childhood apraxia of speech", or it can occur later. Often it occurs after a head injury or a stroke. It has nothing to do with how smart a person is. Many people try to compensate for it by speaking as little as possible, and then only in short words.

Poor speech can impact self-esteem, career growth, and happiness. People with poor communication skills often withdraw, and may become depressed due to social isolation.

There is no cure yet for verbal apraxia. However, there are some techniques that can help. People who can not speak at all can be provided with special devices that can talk for them, called Assistive and Augmentative Communication devices (AAC). A speech pathologist or augmentative communications specialist needs to assess a person for the correct device, as there are over 100 possibilities. The device, ranging from very simple to highly complex, can be programmed to speak for a person. There are also some speaking techniques that help many people.

A person with this problem needs to be acutely aware of safety issues. When stressed by an accident or other emergency, his speech could be worse. First, the person should carry a card with his ID that explains he has difficulty speaking, and gives his basic identification information. It should also list his medical information, such as any medical conditions, medication he is taking and his healthcare provider's name and phone number. Second, he should have a script written in words of one syllable if possible, and kept by his telephone for use in emergencies. If his telephone is a cell phone, the script could be kept in his wallet.

There are two strategies people with difficulty speaking can try. First, write out a word that is hard to say. While looking at it, say each sound individually. Then very slowly, try to say them together. Do this a total of three times.

Then try saying the word at a faster pace. This rehearsal strategy should be started with two syllable words, and then expanded for three syllable words. A second approach is to note which words are especially hard to say. Then go to a thesaurus, often found online at sites such as, to find synonyms. These other words that have the same meaning, such as talk for speak, may be easier to say.

If these strategies are not sufficient, people should go to a certified speech pathologist for a speech evaluation. More can be done by an expert in many cases to improve communication skills. Great speech makes business sense!