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.