Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor production,
or phonological representation of speech sounds and speech segments—including phonotactic rules governing permissible speech
sound sequences in a language.
Children may say some sounds the wrong way as they learn to talk. They learn some sounds earlier, like “p”, “m”, or “w”. Other
sounds take longer to learn, like “z”, “v”, or “th”. Most children can say almost all speech sounds correctly by 4 years old. A child who
does not say sounds by the expected ages may have a speech sound disorder.
Speech sound disorders can be organic or functional in nature. Organic speech sound disorders result from an underlying
motor/neurological, structural, or sensory/perceptual cause. Functional speech sound disorders are idiopathic—they have no known
cause (According to Bernthal, Bankson, and Flipsen (2017) and Peña-Brooks and Hegde (2015)).
Organic Speech Sound Disorders
Organic speech sound disorders include those resulting from motor/neurological disorders (e.g., childhood apraxia of speech and dysarthria), structural abnormalities (e.g., Cleft Lip/Palate and other structural deficits or anomalies), and sensory/perceptual disorders (e.g., hearing impairment).
Functional Speech Sound Disorders
Functional speech sound disorders include those related to the motor production of speech sounds and those related to the linguistic aspects of speech production. Historically, these disorders are referred to as articulation disorders and phonological disorders, respectively. Articulation disorders focus on errors (e.g., distortions and substitutions) in production of individual speech sounds. Phonological disorders focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound. It is often difficult to cleanly differentiate between articulation and phonological disorders; therefore, many researchers and clinicians prefer to use the broader term, "speech sound disorder," when referring to speech errors of unknown cause. Adults can also have speech sound disorders. Some adults have problems that started when they were children. Others may have speech problems after a Stroke or Traumatic brain injury or other Trauma.
Signs And Symptoms
The child may substitute one sound for another, leave sounds out, add sounds, or change a sound. It can be hard for others to
understand him. It is normal for young children to say the wrong sounds sometimes. For example, the child may make a "w" sound
for an "r" and say "wabbit" for "rabbit." He/ She may leave sounds out of words, such as "nana" for "banana." This is okay when she
is young. It may be a problem if she keeps making these mistakes as she gets older. There may also be difference in the sound of
two people because person have an accent or dialect. This is not a speech sound disorder.
The chart below shows the ages when most English-speaking children develop sounds. Children learning more than one language
may develop some sounds earlier or later.
By 3 months |
Makes cooing sounds |
By 5 months |
Laughs and makes playful sounds |
By 6 months |
Makes speech-like babbling sounds like puh, ba, mi, da |
By 1 year |
Babbles longer strings of sounds like mimi, upup, bababa |
By 3 year |
Says m, n, h, w, p, b, t, d, k, g, and f in words |
By 4 year |
Says y and v in words |
Causes
Many children learn to say speech sounds over time, but some do not. Some children have speech problems because the brain has trouble sending messages to the speech muscles telling them how and when to move. This is called apraxia. Childhood apraxia of speech is not common but will cause speech problems. Some children have speech problems because the muscles needed to make speech sounds are weak. This is called dysarthria. The child may have speech problems if he/she has
☺ A developmental disorder, like Autism Spectrum disorder;
☺ A genetic syndrome, like Down syndrome;
☺ Hearing loss, from ear infections or other causes; or
☺ Brain damage, like Cerebral palsy or a Head injury.
Testing For Speech Sound Disorders
A speech-language pathologist, or SLP, can test people speech. The SLP will listen to the people how he/she says sounds. The SLP also will look at how the people moves his/her lips, jaw, and tongue. The SLP may also test people language skills. Many people with speech sound disorders also have language disorders. For example, people may have trouble following directions or telling stories. It is important to have the person hearing checked to make sure he does not have a hearing loss. A person with a hearing loss may have more trouble learning to talk. The SLP can also help decide if person have a speech problem or speak with an accent. An accent is the unique way that groups of people sound. Accents are NOT a speech or language disorder.
Treatment For Speech Sound Disorders
SLPs can help you or your child say sounds correctly and clearly. Treatment may include the following:
- Learning the correct way to make sounds
- Learning to tell when sounds are right or wrong
- Practicing sounds in different words
- Practicing sounds in longer sentences