Speech impairments may be developmental or be the result of illness or injury.  They may be found alone or in combination with other disabilities.  Impairments range from problems with articulation or vocal quality to being totally non-verbal.  They include stuttering, chronic hoarseness, difficulty in evoking an appropriate word or term, and esophageal speech (resulting from a laryngectomy).  Students with these impairments may require some minor adaptations in courses that rely on class discussions, questions/answer sessions, or student presentations.