Which of the following is an example of a speech impairment?

Problems with pronunciation and sound production represent a clear example of a speech impairment. Speech impairments specifically relate to difficulties in the physical production of sounds during verbal communication. This can include issues such as misarticulation, where a child may substitute sounds or have trouble making specific phonetic sounds accurately.

Such impairments affect how clearly a person can express themselves verbally, making it challenging for others to understand them, even if their understanding of language is intact. By contrast, the other options pertain to different aspects of communication: understanding spoken language relates to language processing issues; word choice in written language speaks to language expression; and challenges in conversation initiation involve social communication skills rather than the mechanics of speech itself.