Learning About Speech Sound Disorders in Children

What is a speech sound disorder?

Children learn to make speech sounds over time. For example, they may be able to make "b," "m," "d," and "n" sounds as early as 6 months of age. It may take them until they are 6 years old to make "r" and "l" sounds. But when children aren't able to make the sounds that are expected for their age, they may have a speech sound disorder. These are sometimes called articulation (say "ar-TIK-yoo-LAY-shun") disorders.

Children with a speech sound disorder usually know what they want to say. But they have trouble moving their mouth, lips, and tongue correctly to make the sounds that become words. This makes their speech hard to understand.

Speech problems can have many causes. These can include hearing problems, cleft palate or other problems with the mouth, or issues with the brain. Sometimes the cause isn't known.

If your child doesn't speak as expected for their age, it may not mean that your child has a disorder. But if your child is having trouble with speech, talk with your doctor.

What happens when your child has a speech sound disorder?

Children with speech sound disorders can be very frustrated when others don't understand them. They can also become shy about speaking.

You may hear your child make errors that other children the same age don't make. For example, your child may leave out sounds. Your child might say "cu" instead of "cup" or "poon" instead of "spoon." Or your child may use one sound instead of another sound. They might say "dood" instead of "good." You child may leave a syllable out of a word. An example of this is saying "tephone" for "telephone."

Children may have other speech sound problems, such as a lisp. With one type of lisp, the child makes a "th" sound instead of "s," "sh," "ch" and "j" sounds. Some children have problems making the "r" sound. For example, a child may say "teachuh" instead of "teacher" or "wabbit" instead of "rabbit."

How are they diagnosed?

The doctor will do a physical exam and ask questions about your child's past health. The doctor will also ask if your child has reached speech milestones for their age.

If the doctor thinks your child has a speech problem, they will refer your child to a speech-language pathologist (SLP). SLPs diagnose and treat speech and language problems. The SLP will listen to and watch your child talk. They will also ask your child to say certain sounds, words, and sentences.

Tests may be suggested to:

• Look for other conditions. For example, your child may get a hearing test to rule out hearing loss.
• Find out what speech sounds your child can say and how well they put speech sounds together to form words and sentences.
• Check how well your child is developing speech, language, and motor skills.
• Find out if your child is having other problems, such as behavior issues. This could also include having trouble with common skills, such as sucking, chewing, or swallowing.

How are they treated?

A child's speech can often improve with treatment such as speech therapy. To help your child speak better, the speech-language pathologist (SLP) may:

• Help your child learn to make the right speech sounds and combination of sounds. The SLP does this by correcting certain movements of your child's mouth and tongue. This can make your child's speech more clear.
• Help your child to learn when sounds are right or wrong so they can correct themselves.

Treatment works best when problems are caught early. Your child's health care team will help you decide on the best schedule for treatment.

The SLP may suggest that your child practice every day between treatment sessions. If so, the SLP will teach you how to help your child do this at home.