Speech Sound (Articulation) Disorders (Children)

Speech sound disorders occur when a child's articulation or pronunciation is delayed or deviates from normal speech sound development. These disorders can be categorised into five types:

Organic speech sound disorder
Articulation problems related to structural abnormalities or known impairments, such as cleft lip and palate, hearing impairment or brain injury.

Functional speech disorder
Difficulties in learning to produce specific speech sounds.

Developmental phonological disorder
Difficulties in using appropriate speech patterns. E.g. "tar" for "car" or "dock" for "sock"

Developmental apraxia of speech
Difficulties in planning and coordinating the movements of lips, tongue, and jaw for speech production.

Developmental dysarthria
A motor speech disorder affecting the strength and control of speech muscles, often seen in children with cerebral palsy and traumatic brain injury.

The exact causes of functional speech disorders, developmental phonological disorders and developmental apraxia of speech are often unclear. Developmental dysarthria results from impaired nerve and muscle function. Conditions such as cleft palate, hearing impairment, tongue-tie, paediatric stroke and certain syndromes can impact speech clarity.

A child with a speech sound disorder may exhibit:

Omissions or deletions

Omitting certain sounds in words.
Examples: "boo" for "book" and "soon" for "spoon"

Substitutions

Replacing sounds with different ones.
Examples: "bat" for "pat", "dood" for "good" and "wabbit" for "rabbit"

Additions

Inserting extra sounds into words.
Examples: "buhlack" for "black" or "doguh" for "dog"

Distortions

Altering sounds.
Examples: An interdental "s" produced with the tongue between teeth

Syllable-level errors

Repeating or deleting syllables.
Examples: "dada" for "dad" or "te_phone" for "telephone"

Prosody errors

Inappropriate use of stress, rhythm and intonation in speech.

Assessment by a speech therapist is crucial to identify the specific speech disorder. The treatment plan is tailored to the individual child’s needs and may involve medical or allied health professionals. Parents play an important role in therapy, practising speech strategies with the child at home and adhering to therapy schedules.

Children typically acquire different speech sounds gradually. Here is a general guide to speech sound development:

• By two years: p, m, h, n, b, w, y, d
• By three years: t, k, g, f, ng
• By four to five: sh, s, j, ch, l, r, z
• By six years and above: v, th, st, sp, sl, and other groups of consonant blends

A child's speech clarity progresses with age:

• 25% clear by 18 months
• 50–75% clear by 24 months
• 75–100% clear by 36 months