People with some leukodystrophies may struggle to learn language skills, or may lose these skills at any age as cognitive issues progress. Difficulty with speech as a child or adult will be frustrating for the affected person trying to communicate with those around them, and for carers trying to identify the needs of their loved one.

Speech difficulties have a variety of possible causes, including developmental delay, cognitive decline, brain damage, problems with the voice box or the muscles that create speech, and hearing problems.

Dysarthria is the name given to speaking difficulty caused by damage or changes to the brain. In some cases dysarthria is linked to problems with intelligence or understanding, but in others the person’s cognitive ability is unaffected. Speech may be slurred, nasal or breathy, making it difficult to understand. Some people with dysarthria are unable to produce any intelligible words, or may speak in short, disjointed phrases. Difficulty with swallowing (dysphagia) can be present alongside dysarthria and can make speaking more difficult. See more about speech and language therapy here.

• Speech difficulty caused by effects of physical disorders of the mouth, tongue, throat, or vocal cords on sound or voice production is called dysphonia. Dysphonia affects the quality of the voice, which may sound strained, strangulated or hoarse. Spasmodic dysphonia is caused by spasms in the muscles of the larynx (voice box). People with Alexander Disease type 2 may experience dysphonia.

Treatment of speech difficulties
For help with speech difficulties, you should ask your doctor to refer you or your child to a speech and language therapist. As well as helping with speech itself, they will be able to advise you about communication aids such as speech apps.