Speech Sounds Disorders

Children can have trouble saying sounds clearly. It may be hard to understand what they say. Speech-language pathologists, or SLPs, can help!

A child who does not say sounds by the expected ages may have a speech sound disorder. You may hear the terms "articulation disorder" and "phonological disorder" to describe speech sound disorders like this.

Signs and Symptoms

Your child may substitute one sound for another, leave sounds out, add sounds, or change a sound. It can affect their intelligibility (how easily others understand him).

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.

Below are examples of signs and symptoms of speech sound disorders:

omissions/deletions—certain sounds are omitted or deleted (e.g., "cu" for "cup" and "poon" for "spoon")
substitutions—one or more sounds are substituted, which may result in loss of phonemic contrast (e.g., "thing" for "sing" and "wabbit" for "rabbit")
additions—one or more extra sounds are added or inserted into a word (e.g., "buhlack" for "black")
distortions—sounds are altered or changed (e.g., a lateral "s")
syllable-level errors—weak syllables are deleted (e.g., "tephone" for "telephone")

Causes

Many children learn to say speech sounds over time, but some do not. You may not know why your child has difficulty speaking. Some children have speech difficulty because the brain has trouble sending messages to the speech muscles telling them how and when to move; called apraxia. Some children have speech difficulty because the muscles needed to make speech sounds are weak; called dysarthria.

Your child may have speech difficulty if he has:

a developmental disorder, like autism;
a genetic syndrome, like Down syndrome;
hearing loss, from ear infections or other causes;
brain damage, like cerebral palsy or a head injury.

Treatment for Speech Sound Disorders

A speech-language pathologist (SLP) can assess your child's speech. The SLP will listen to your child to hear how he says sounds. The SLP will look at how your child moves his lips, jaw, and tongue. The SLP may also test your child’s language skills. Many children with speech sound disorders also have language disorders. For example, your child may have trouble following directions or telling stories.

SLPs can help you or your child say sounds correctly and clearly. Treatment may include the following: