Speech Sound Disorders
What are speech sound disorders in children?
It’s normal for young children learning language skills to have some trouble saying
words the right way. That’s part of the learning process. Their speech skills develop
over time. They master certain sounds and words at each age. By age 8, most children
have learned how to master all word sounds.
But some children have speech sound disorders. This means they have trouble saying
certain sounds and words past the expected age. This can make it hard to understand
what a child is trying to say.
Speech sound problems include articulation disorder and phonological process disorder.
Articulation disorder is a problem with making certain sounds, such as “sh.”
Phonological process disorder is a pattern of sound mistakes. This includes not pronouncing
What causes speech sound disorders in a child?
Often, a speech sound disorder has no known cause. But some speech sound errors may
be caused by:
Injury to the brain
Thinking or development disability
Problems with hearing or hearing loss, such as past ear infections
Physical problems that affect speech, such cleft palate or cleft lip
Disorders affecting the nerves involved in speech
Which children are at risk for speech sound disorders?
The cause often is not known, but children at risk for a speech sound disorder include
Developmental disorders such as autism
Genetic disorders such as Down syndrome
Nervous system disorders such as cerebral palsy
Illnesses such as frequent ear infections
Physical problems such as a cleft lip or palate
Too much thumb-sucking or pacifier use
Low education level of the parent
Lack of support for learning in the home
What are the symptoms of speech sound disorders in a child?
Your child’s symptoms depend on what type of speech sound disorder your child has.
He or she may have trouble forming some word sounds correctly past a certain age.
This is called articulation disorder. Your child may drop, add, distort, or swap word
sounds. Keep in mind that some sound changes may be part of an accent. They are not
speech errors. Signs of this problem can include:
Leaving off sounds from words (example: saying “coo” instead of “school”)
Adding sounds to words (example: saying “puhlay” instead of “play”)
Distorting sounds in words (example: saying “thith” instead of “this”)
Swapping sounds in words (example: saying “wadio” instead of “radio”)
If your child often makes certain word speech mistakes, he or she may have phonological
process disorder. The mistakes may be common in young children learning speech skills.
But when they last past a certain age, it may be a disorder. Signs of this problem
Saying only 1 syllable in a word (example: “bay” instead of “baby”)
Simplifying a word by repeating 2 syllables (example: “baba” instead of “bottle”)
Leaving out a consonant sound (example: “at” or “ba” instead of “bat”)
Changing certain consonant sounds (example: “tat” instead of “cat”)
How are speech sound disorders diagnosed in a child?
First, your child’s healthcare provider will check his or her hearing. This is to
make sure that your child isn’t simply hearing words and sounds incorrectly.
If your child’s healthcare provider rules out hearing loss, you may want to talk with
a speech-language pathologist. This is a speech expert who evaluates and treats children
who are having problems with speech-language and communication.
By watching and listening to your child speak, a speech-language pathologist can
determine whether your child has a speech sound disorder. The pathologist will evaluate
your child’s speech and language skills. He or she will keep in mind accents and dialect.
He or she can also find out if a physical problem in the mouth is affecting your child’s
ability to speak. Finding the problem and getting help early are important to treat
speech sound disorders.
How are speech sound disorders treated in a child?
The speech-language pathologist can put together a therapy plan to help your child
with his or her disorder. These healthcare providers work with children to help them:
Notice and fix sounds that they are making wrong
Learn how to correctly form their problem sound
Practice saying certain words and making certain sounds
The pathologist can also give you activities and strategies to help your child practice
at home. If your child has a physical problem in the mouth, the pathologist can refer
your child to an ear, nose, throat healthcare provider or orthodontist if needed.
Spotting a speech sound disorder early can help your child overcome any speech problems.
He or she can learn how to speak well and comfortably.
How can I help my child live with a speech sound disorder?
You can do things to take care of your child with a speech sound disorder:
Keep all appointments with your child’s healthcare provider.
Talk with your healthcare provider about other providers who will be involved in your
child’s care. Your child may get care from a team that may include experts such as
speech-language pathologists and counselors. Your child’s care team will depend on
your child’s needs and the severity of the speech sound disorder.
Tell others of your child’s disorder. Work with your child’s healthcare provider and
schools to develop a treatment plan.
Reach out for support from local community services. Being in touch with other parents
who have a child with a speech sound disorder may be helpful.
When should I call my child’s healthcare provider?
Call your child’s healthcare provider if your child has:
Key points about speech sound disorders in children
A speech sound disorder means a child has trouble saying certain sounds and words
past the expected age.
A child with an articulation disorder has problems making certain sounds the right
A child with phonological process disorder regularly makes certain word speech mistakes.
The cause of this problem is often unknown.
A speech-language pathologist can help diagnose and treat a speech sound disorder.
Tips to help you get the most from a visit to your child’s healthcare provider:
Know the reason for the visit and what you want to happen.
Before your visit, write down questions you want answered.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
Ask if your child’s condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if your child does not take the medicine or have the test or procedure.
If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.
Online Medical Reviewers:
- Ashutosh Kacker MD
- Daphne Pierce-Smith RN MSN CCRC
- Raymond Kent Turley BSN MSN RN
We do not treat children with a speech sound disorder as their main diagnosis; however, we do treat children who have developmental disabilities as well as a speech sound disorder.
- Physical Medicine and Rehabilitation - Provides outpatient evaluation and intense and targeted therapy programs for children and teens.
- Speech Pathology - Meets the needs of children who have difficulties with speech, communication, oral-motor control, and feeding/swallowing.
You can find resources for speech sound disorders in our Resource Directory!