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The importance of the use of narrow phonetic transcription in transcribing a variety of speech disorders is emphasized. This point is illustrated with clinical data from the authors’ own research. The examples used are the transcription of a severely disfluent client, a child with progressive hearing loss, repair sequences in dysarthric speakers, a child with idiosyncratic velar articulations, and an adult with progressive speech degeneration. The use of the extended International Phonetic Alphabet (IPA) for the transcription of disordered speech and the Voice Quality Symbols (VoQS) system for transcribing voice quality is introduced and illustrated in the examples provided. The need for training in narrow transcription is discussed as part of a combination of impressionistic and instrumental description techniques.