Speech and Voice Disorders

Disorders of speech, language, or voice are defined as conditions that call attention to themselves in a way that interrupts the normal flow of communication, or that limit a person’s ability to perform the normal tasks and social roles of daily life. (See World Health Organization classifications below.)

Disorders of communication may be congenital, developmental, or acquired later in life. Causes may be structural (such as cleft palate), neurological (such as stroke or Parkinson’s Disease), traumatic (such as a head injury), usage-related (vocal nodules), or may include a mixture of physiological and psycho-social influences (stuttering or  spasmodic dysphonia).

Characters in dramatic works of fiction may have a speech disorder specified by the playwright, or a medical condition that is described as affecting their communication ability. An actor may independently choose to portray a disability for artistic reasons.

In all such cases, the actor’s research into actual conditions/disorders, and how they sound, shows respect for people with true disabilities. Real-time interactions with real speech-disordered people will provide the best insight into the varied presentations of disordered speech; one individual’s lisp, stroke, hoarseness, stuttering, or wheezing may not sound like anyone else’s. The samples here are offered as a beginning, not an end, of research by the actor, director, and/or speech coach.

As outlined in the World Health Organization classifications, a loss of function leads to restrictions on personal activity, which in turn can bring a change in social or community role. The individual may experience psychological distress at any of these levels of difficulty, showing responses such as denial, depression, grief, anger, anxiety, or a shifting combination of feelings.  These reactions may make the disorder appear to be more or less serious, or may influence how the person is treated by others. Attention to a character’s relationship with their disability adds nuance and credibility to the work.

Careful attention should be paid to unrelated assumptions made by or about a character because of her/his disabled status. Unless linked to a brain condition impacting intellect or mood, speech disturbances do not automatically confer lack of intelligence; nor are disordered speakers more likely to have psychiatric problems than the general population.

In the search for appropriate samples for this collection, false presentations created as humor could not be avoided (such as videos edited to present a non-stutterer stuttering). Such laughing-at-disability should be avoided on stage as scrupulously as other negative stereotypes, unless the character overtly invites humor as part of his/her coping style (e.g., Cyrano).

To further minimize voyeurism and stereotyping, an actor or speech coach might determine how the voice or speech disorder contributes to the characterization or script, and apply the mildest possible sound distortion to serve that artistic goal.  This optimizes intelligibility to the audience and minimizes distraction from the core meaning of the production.

Joanna Cazden  for IDEA, 2011
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INTERNATIONAL CLASSIFICATION OF IMPAIRMENTS, DISABILITES AND HANDICAPS (ICIDH), WORLD HEALTH ORGANIZATION, Geneva, 1980

The following distinctions are made by the World Health Organization, in the context of health experience, between impairment, disability and handicap:
·  “Impairment: Any loss or abnormality of psychological, physiological, or anatomical structure or function.
·  “Disability: Any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.
·  “Handicap: A disadvantage for a given individual, resulting from an impairment or disability, that limits or prevents the fulfillment of a role that is normal, depending on age, sex, social, and cultural factors, for that individual.”

Click here for an Excel spreadsheet containing IDEA’s updated collection of voice and speech disorder samples. If clicking the link on the spreadsheet doesn’t produce results, copy and paste the link directly into your browser.