SPEECH SOUND AND ARTICULATION DISORDERS

-By Mrs. Anjali Maratt

We use our tongue, lips, teeth, jaw, and vocal folds to make speech sounds. Children may face various challenges that impact how they produce these sounds. Speech sound delays include problems with making specific sounds (articulation errors) and difficulties with sound patterns (phonological process errors).

Articulation is how we make speech sounds. Some children struggle with placing their articulators correctly for certain sounds, like having a lisp, which is known as an articulation disorder. This difficulty can result from issues like muscle weakness, structural problems, tongue thrust posture, etc., and sometimes the cause is unknown. Speech therapy can effectively treat these disorders once diagnosed, by using the correct approach or combination of methods.

As children learn to talk, they often make typical errors that naturally improve with age. For instance:

• They may leave out ending sounds in words (e.g., "bus" becomes "bu_").
• They might simplify multisyllable words (e.g., "tomato" becomes "mato").
• Some may replace sounds made at the back of the mouth with those made at the front (e.g., "car" becomes "tar," "goat" becomes "doat").
• Difficulty contrasting long and short sounds may lead to errors like replacing the long /s/ with the short /d/ (e.g., "sun" becomes "dun").

These errors are common in typical speech development. However, some children don’t naturally outgrow these patterns, leading to phonological delay. Others may exhibit unusual speech error patterns not typically seen in development, known as phonological disorder. Some children may display features of both delay and disorder in their speech development.

Articulation disorder and phonological disorder are similar and often confused. But it’s important to differentiate between the two because treatments vary.

Children with articulation disorder have trouble with the motor functions required to make certain speech sounds. They can’t coordinate their lips, tongue, teeth, palate (roof of their mouth) and lungs to produce certain sounds. They may form distorted speech sounds or swap out sounds they can’t make. Articulation disorder examples include not forming the sound “th” and always using “f” instead.

Phonology refers to the pattern in which sounds are put together to make words. If your child has a phonological disorder, they are able to make the sounds correctly, but they may use it in the wrong position in a word, or in the wrong word, e.g. a child may use the d sound instead of the g sound, and so they say doe instead of go. They also make mistakes with the particular sounds in words, e.g. they can say k in kite but with certain words, will leave it out e.g. lie instead of like.

Phonological disorders and phonemic awareness disorders (the understanding of sounds and sound rules in words) have been linked to ongoing problems with language and literacy. It is therefore important to make sure that your child gets the most appropriate treatment.

 

It can be much more difficult to understand children with phonological disorders compared to children with pure articulation disorders. Children with phonological disorders often have problems with many different sounds, not just one.

Who might get articulation disorder?

Articulation disorder occurs in children. If it’s not treated, the disorder may last into adulthood. If an adult develops a speech sound disorder, it’s due to another reason (traumatic brain injury or stroke).

Articulation disorders are more common in boys than girls for unknown reasons. A child is more likely to have a speech sound disorder if the mother had complications during pregnancy or delivery. A speech sound disorder is also more likely in a child whose family has a history of the condition.

How common are speech sound disorders?

Speech sound disorders are common, affecting 8% to 9% of children.

Symptoms and Causes

What causes articulation disorder?

Articulation disorder has no known cause. It doesn’t mean something is wrong with your child’s brain, nerves, lips, tongue, teeth, jaw, lungs or hearing.

There are other types of speech disorders, including organic, developmental or acquired. These are due to other conditions, such as structural abnormalities or hearing impairment.

Articulation or phonological difficulties are generally not a direct result of brain injury. Children with an acquired brain injury may have different difficulties with their speech patterns. These are generally caused by dyspraxia or dysarthria. Some children with acquired brain injuries may also have difficulties with literacy and language.

What are some signs and symptoms of articulation disorder?

A child with articulation disorder exhibit one or more of four types of articulation errors:

Addition: Adding sounds or syllables to words that don’t belong there (for example, “puh-lay” instead of “play”).

Distortion: Changing a sound, which might seem like a lisp (when “s” sounds like “th”).

Omission: Leaving certain sounds out of their speech altogether (for example, never using “sc” in “school or “scratch”).

Substitution: Always substituting one sound for another (for example, using “s” instead of “th” or “w” in place of “r”).

If child becomes self-conscious of articulation disorder, they may display certain behaviours:

• Avoid reading aloud or speaking to other people.
• Become quiet or seem excessively shy.
• Get frustrated when speaking.
• Stop saying certain words altogether.
• Struggle with confidence and self-esteem.

Early diagnosis and therapy can help to prevent speech problems from worsening or affecting learning and socialization. A qualified speech pathologist will assess the child if there are any concerns about the quality of the sounds they make, the way they talk, or their ability to be understood.

A Speech language pathologist (SLP) will evaluate your child in several ways:

1. They will ask the child to make certain sounds and form specific words.
2. Assess child to assess connected speech during conversation.
3. Perform standardized diagnostic testing.
4. Consider your child’s medical history, such as premature birth, previous ear infections and more.
5. Discuss any family history of speech disorders.
6. Look at the mouth’s structure for any issues that may be contributing (for example, with their teeth and palate).
7. Take your child’s accent and dialect into consideration.
8. Watch the movement of your child’s mouth during speech.
9. They do the observations and perform various diagnostic test to diagnose articulation disorder or another type of speech disorder.
10. Based on the assessment they will be rating the severity of the articulation disorder from mild to severe.

With appropriate speech therapy, many children with articulation or phonological disorders will have significant improvement in their speech.

Speech therapy for phonological delay typically involves targeted activities to improve the child’s phonological awareness and sound production. In the case of phonological disorder, therapy may focus on addressing specific atypical speech error patterns through structured interventions and practice. Individualized approaches, consistent practice, and ongoing assessment are key components in managing both phonological delay and disorder effectively.

During speech therapy, your child’s SLP uses a variety of activities and exercises to help them:

• Identify the sounds they can’t make.
• Correct the way they create sounds.
• Re-learn ways to control the motor parts of speech (for example, moving their tongue, shaping their lips).
• Strengthen the muscles involved in speech.
• Practice sound formation at home.