speech defect, any condition that interferes with the mental formation of words or their physical production. Speech defects in children generally become apparent in the early school years. Speech problems may arise from organic or functional abnormalities, but in practice the two are often hard to differentiate. Organic defects include deafness, cleft palate, dental abnormalities, and brain damage; most functional problems are basically psychological. Speech defects are generally categorized as disorders of sound production; disorders of voicing, e.g., loudness, pitch, and quality deviations; disorders of rhythm, such as stuttering and stammering; and disorders of language formulation and expression, including aphasia, the inability to use words as symbols of ideas. Treatment of a speech defect may include correction of organic conditions, psychotherapy, and training in proper articulation; it is rarely limited to a single type of therapy.

Congenital defect of the brain or spinal cord from abnormal growth of their precursor, the neural tube (see embryology), usually with spine or skull defects. The tube may fail to close properly, have parts missing, or have a blockage (see hydrocephalus). In spina bifida, vertebrae are open over the back of the spinal cord, usually at the base. This may not affect function if no further defects (local absence of skin or meninges, protrusion of tissue, defect opening into the spinal cord) exist. The more serious forms can cause paralysis and impair bladder and bowel function. In encephalocele, a meningeal sac containing brain tissue protrudes from the skull. The effects depend on the amount of tissue involved. Adequate folic-acid intake by women of childbearing age reduces the risk of neural tube defects. Early surgery can prevent or minimize disability.

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A large group of disorders arising during development that cause abnormality of the human body. Most are due to genetic factors such as inherited or spontaneous mutations, whereas others are caused by environmental influences during pregnancy such as exposure to harmful chemicals. The most severe and lethal disorders arise during the first 28 days of development and include gross brain anomalies and heart defects. The mildest malformations occur in the late stages of development and are often the result of dominant inheritance, whereas complex congenital syndromes are often the result of recessive inheritance. Seealso birth defect; Down syndrome.

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