The term “Speech Sound Disorders” is used to describe any difficulty or combination of difficulties with producing sounds. There are three different types of speech sound disorders. It’s important to know the difference between these types because they all have different treatment approaches and possible causes.
While it is normal for young children learning language skills to have some trouble saying words correctly, their speech skills should develop over time mastering certain sounds and words at each age. New research demonstrates that children should have all sounds mastered by age six and have the majority mastered by age 4 (McLeod, S. & Crowe, K., 2018). But some children have speech sound disorders. This means they have trouble saying certain sounds and words by the appropriate age. This can make it hard to understand what a child is trying to say. 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.
An articulation disorder is a problem forming certain sounds correctly by a given age, such as difficulty producing the ‘r’ sound or having a frontal lisp. The child may drop, add, distort, or swap word sounds.
On the other hand, if your child often makes certain word speech mistakes, he or she may have a phonological process disorder. While speech and language mistakes are common in young children learning speech skills, when they last past a certain age it may be a disorder. Signs of this problem are:
Saying only 1 syllable in a word (example: “fant” instead of “elephant”);
Changing certain consonant sounds (example: “tar” instead of “car”)
Thus, phonological disorders focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound. Because it is often difficult to clearly differentiate between articulation and phonological disorders, many researchers and clinicians prefer to use the broader term, "speech sound disorder," when referring to speech errors of an unknown cause.
Finally, motor speech disorders involve difficulty with the motor movements of speech and can include Childhood Apraxia of Speech and Dysarthria.
So, what causes speech sound disorders in a child?
Sometimes there really isn’t a known cause. But some common speech sound disorder causes may be due to:
Injury to the brain;
Cognitive or developmental disability;
Problems with hearing or hearing loss, such as past ear infections;
Physical problems that affect speech, such as cleft palate or cleft lip; and
Disorders affecting the nerves involved in speech.
In addition to these causes, children more at risk for a speech sound disorder include those with:
Developmental disorders such as autism;
Genetic disorders such as Down Syndrome;
Nervous system disorders such as cerebral palsy; and
Too much thumb-sucking or pacifier use.
How are speech sound disorders diagnosed in a child?
First, your child’s healthcare provider will check his or her hearing. This is to make sure that your child isn’t simply hearing words and sounds incorrectly. If your child’s healthcare provider rules out hearing loss, you may want to talk with a speech-language pathologist. This is a speech expert who evaluates and treats children who are having problems with speech/ language and communication. By watching and listening to your child speak, a speech-language pathologist can determine whether your child has a speech sound disorder. The pathologist will evaluate your child’s speech and language skills keeping in mind accents and dialect. The speech-language pathologist can also find out if a physical problem in the mouth is affecting your child’s ability to speak. Finding the problem and getting help early are important to treat speech sound disorders.
Are you concerned about your child’s speech skills? Contact us!
Marissa Doletzky, MS, CCC-SLP