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When children are first referred to a speech-language pathologist, it is typically because they are not easily understood by their parents, close family members or teachers.

It’s important to realize that there are many reasons why a child isn’t talking or why their intelligibility (what is understood by the listener) is poor. 

Speech sound disorders can be broken down into phonological disorders and articulation disorders. It is very important that speech sound disorders be diagnosed appropriately, as treatment for phonological and articulation disorders differ. 

Articulation disorders happen when a child has difficulty producing a specific sound (or sounds) and are fixed by addressing the sound(s) in error. For example, a child may put their tongue in the wrong spot when creating the /r/ sound, which makes the /r/ sound different than it should.

If your child has an articulation disorder, they:

  • have problems making sounds and forming particular speech sounds properly (e.g. they may lisp, so that s sounds like th)
  • may not be able to produce a particular sound (e.g. they can’t make the r sound, and say ‘wabbit’ instead of ‘rabbit’). 

You can target specific sounds with articulation therapy:

Phonological disorders are more complex, as they are patterns in a child’s speech used to simplify speech sound production.  An example of this is when a child deletes the last sound off of a word. They might say /ca/ for /cat/ or /si/ for /sit/. The majority of children with highly unintelligible speech present with a phonological disorder, as their speech is characterized by repeating patterns of incorrect productions.

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 dsound instead of the g sound, and so they say ‘doe’ instead of ‘go’
  • 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’. 

The following are examples of phonological process disorders:

Phonological ProcessDescriptionExample
Frontingreplacement of a sound typically produced in the back of the oral cavity with a front sound “tar” for “car”, “tandy” for “candy”
Backingreplacement of a sound typically produced in the front of the oral cavity with a back sound “gog” for “dog”
Final Consonant Deletionomission/deleting of final consonant“cu” for “cup”
Cluster Reductionsimplification of a cluster (two letter sound) into single sound“poon” for “spoon”
Weak syllable deletiondeletion of weak syllable in word“tefone” for “telephone”
Glidingsound /r/ and /l/ replaced by /w/ and “j”“wadder” for “ladder”
Stoppingreplacement of sounds“too” for “shoe”
Reduplicationrepetition of syllables“wawa” for “water”
Prevocalic Voicingreplacement of voiceless consonant with a voiced consonant“vone” for “phone”
Initial Consonant Deletiondeletion of initial consonant“ose” for “nose”
Epenthesisaddition of “uh” sound in between two consonants“puh-lane” for “plane”

It’s important to know that children’s speech goes through normal articulation and phonological errors. By 2 years of age, a child’s speech should be 50% intelligible to an unfamiliar listener, by 3 years of age 75% intelligible to an unfamiliar listener and by 4 years of age 100% intelligible to an unfamiliar listener (ASHA).

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