When a child says their first word, it brings incomparable joy to their parents. Then comes the mimicking of word sounds and attempts to say two-words at a time. Most children acquire spoken language quickly, although they make some very predictable, but cute mistakes.
A child trying to say a big word will often jumble up the consonants. They may say /w/ in place of /r/. Hearing your child say “wabbit” for the first time is indeed cute. Nonetheless, if your 5-year old keeps mispronouncing words and jumbling up word sounds, it may be a sign of a speech sound disorder.
By the age of 5 years, almost 100% of your child’s speech should be understandable, even to strangers. We can understand the anguish and stress you must feel as you watch your little one struggle with their speech.
Not just young children, adults can also have speech sound disorders; they may have never been diagnosed as children. If you are an adult who never received a formal consultation with a speech-language pathologist for your speech problems, it’s never too late to take the right step now.
Do you want to learn more about speech sound disorders (SSDs) today? Here’s everything you need to know about SSDs, the causes of speech sound disorders, the common signs and symptoms of speech sound disorders, and the possible treatment options for all ages.
- What Is A Speech Sound Disorder?
- What Are The Different Types Of Speech Sound Disorders?
- Articulation Disorders vs. Phonological Disorders
- Are Speech Sound Disorders Common?
- What Are The Signs and Symptoms Of Speech Sound Disorder In Children?
- Why Do Most Children Struggle With The /R/ Sound?
- What Can Cause A Speech Sound Disorder?
- Who Are At Risk Of Developing Speech Sound Disorders?
- How Is A Speech Sound Disorder Diagnosed?
- What Is The Treatment For Speech Sound Disorders?
- How Can Stamurai Help With The Diagnosis and Treatment of Speech Sound Disorders?
- How Can Parents Help A Child With Speech Sound Disorder At Home?
1. What Is A Speech Sound Disorder?
Speech sound disorder (SSD) is a broad term that covers the difficulties in the perception, phonological representation, and production of speech sounds.
Producing coherent speech involves perceiving the target speech sound and the ability to coordinate tongue, lip, and jaw movements. It also involves coordinated breathing and vocalization.
Children pick up spoken language naturally and produce more complex speech sounds as they grow older. Children who cannot produce specific sounds by a certain age may have a speech sound disorder.
While it is difficult to understand a person with a speech sound disorder, the inability to express oneself may also cause that person to have low self-esteem. SSDs can affect a person's personal, social, academic, and professional aspects of life.
2. What Are The Different Types Of Speech Sound Disorders?
According to ASHA, there are two different types of speech sound disorders – functional and organic.
Functional speech sound disorders – the cause of these speech sound disorders is not known
To correctly produce speech sounds, we need to make coordinated movements of the tongue, lip, teeth, soft palate, and jaws. We also need to time our breathing. If you or your loved one has an articulation disorder, they may have trouble coordinating these motor functions. That can result in the inability to produce legible speech sounds.
The causes of articulation disorders are not always known. Since there are multiple types of articulation disorders, each with their own set of signs and symptoms, you should always consult a licensed SLP for diagnosis and treatment.
Phonological patterns typically follow a pattern – the person with a phonological disorder can produce individual sounds correctly. However, they cannot put these sounds together to form coherent words. Typical patterns of speech sound errors are common in children up to a certain age, but when these errors persist beyond that age, it's a sign of speech sound disorder.
Refer to this speech checklist to ensure that your child is producing the speech sounds correctly as per their age.
Distinguishing between articulation and phonological disorders can be challenging, especially in the case of young children. Moreover, speech sound disorders may have the characteristics of both articulation disorders and phonological disorders. As a result, clinicians and researchers prefer to use the umbrella term "speech sound disorder" to refer to errors due to unknown cause(s).
Organic Speech Sound Disorders – these speech sound disorders have a known cause
Neurological/Motor Speech Sound Disorders
Motor or neurological speech disorders are caused by a lack of muscle coordination or strength. Motor speech sound disorders can be developmental or acquired. Individuals of any age can acquire a neurological speech disorder after a stroke, traumatic brain injury, or brain (neurological) damage.
Structural Speech Sound Disorders
Anomalies in the structure of the oral or facial features necessary for speech production can result in structural speech sound disorders. It can be a result of surgery or an accident.
Sensory/Perceptual Speech Sound Disorders
Recurring ear infections in children may lead to hearing loss. Hearing impairment can result in speech sound disorders since the individual is unable to hear the speech sounds. The severity of speech sound deficits will vary depending upon the extent of hearing loss.
3. Articulation Disorders vs. Phonological Disorders
Articulation disorders occur at the phonetic level. The phonetic level is the single sound level, and it's related to the act of producing vowels and consonants individually.
Phonological disorders occur at the phonemic level. The phonemic level is the sound patterns that come together to make a coherent speech. The brain plays a key role in the organization of these sound patterns to create spoken language. Therefore, you could say that phonological disorders occur at the brain level.
Clinicians often state that it is more difficult to understand someone with a phonological disorder as compared to an individual with an articulation disorder. Several children with phonological disorders have trouble with language. It affects their academic performance as well.
You need to consult an SLP for the proper diagnosis of speech sound disorders. Telling two SSDs apart is not easy and a thorough evaluation by a certified SLP is always necessary before beginning any treatment or therapy.
4. Are Speech Sound Disorders Common?
Speech sound disorders are quite common among children. As many as 8 to 9% of young children have articulation or phonological disorders. Around 5% of school-aged children (first graders) have varying speech disorders, including speech sound disorders, stuttering, and dysarthria.
The prevalence rates of speech sound disorders vary largely due to the inconsistencies in the classification of the disorders and age groups studied.
Between 11% and 40% of all children with speech sound disorders also had language problems. Poor language and speech sound production skills in preschool-aged children are associated with low literacy outcomes. (Overby, Trainin, Smit, Bernthal, & Nelson, 2012)
5. What Are The Signs and Symptoms Of Speech Sound Disorders In Children?
It is common for children to make mistakes during the acquisition of spoken language. However, if your child has a speech sound disorder, they may not be able to meet the speech milestones on time! Check this speech milestone checklist to ensure that your child's speech is developing as expected.
When a child has a speech sound disorder, you can expect them to repeatedly substitute one sound for another, add sounds, or omit sounds.
If your child says /w/ instead of /r/ when they are between 2 and 3 years old or says "monkey cheese" in place of "mac 'n' cheese" and "ear" instead of "hear," it is quite normal. Children often need time to learn the exact pronunciation and speech sounds.
However, if your child keeps making the same mistakes even when they are between 5 and 6 years old, they may have a speech sound disorder.
It is challenging for a parent or caregiver to understand if a child truly has a speech sound disorder or is simply going through a “phase.” Nonetheless, according to Stanford Children’s Health, here are a few signs and symptoms that you should watch out for to know if your child has a speech sound disorder.
Signs of an Articulation Disorder in Children
The child may have trouble saying sounds correctly even when they are old enough. That is a sign of articulation disorder.
- Mispronunciations due to differences in oral or facial structures, such as saying “wip” instead of “lip.”
- Recurring distortion of speech sounds. For example, a child may keep saying “fith” instead of “fish.”
- Changing or swapping sounds in a consistent pattern. For example, saying “Wabbit” instead of “Rabbit” and “woar” instead of “roar.”
Signs of Phonological Disorders in Children
A child with phonological process disorder makes word speech mistakes even when they are old enough to talk intelligibly.
- They may say only one syllable of a multisyllabic word such as “bay” instead of “baby.”
- The child can simplify a word by using two syllables instead of saying the complete word. For example, saying "popo" instead of "lollipop."
- They can omit consonant sounds from words, such as saying "ai" instead of "bye."
- They can change or swap consonant sounds. For example, they can say "peapop" instead of "teapot."
6. Why Do Most Children Struggle With The /R/ Sound?
Even 4-year olds may sometimes struggle with the /r/ sound along with the /s/, /sh/, /ch/, /th/, /z/ and /l/ sounds. The /r/ sound is not easy for kids to produce. The /r/ sound changes depending on the position of the 'R' relative to the other consonants and vowels in the word. For example, consider the varying pronunciations of R in the following words – are, air, ear, error, or, and ire.
The /r/ sound is different in each of the six instances. The R sounds different in the simple monosyllabic words like bar, for, and gear. The vowel preceding and succeeding the R determines the nature of the /r/ sound. According to linguists, there can be as many as 30 different R sounds.
A child who is still acquiring spoken language and trying to grasp the syntaxes of speech can find the varying /r/ sounds confusing. Therefore, if your preschooler is having trouble with the /r/ sound, but strangers manage to understand their speech more than 75% of the time, it's alright. With some practice at home, they can master pronouncing the more difficult set of speech sounds we have mentioned above.
If your child is of school-age already, but still can’t pronounce their /r/ sounds clearly, it may be time for an intervention. The longer they mispronounce a speech sound, the more difficult it can become to correct them.
7. What Can Cause A Speech Sound Disorder?
Sometimes, a speech sound disorder has no known cause. For example, phonological and articulation disorders rarely have any discernible cause.
In the case of an organic speech sound disorder, multiple factors can be at play. Some of these factors are –
- Traumatic brain injury or brain damage
- Intellectual disability or global developmental delay
- Genetic disorders such as Down syndrome
- A history of ear infections leading to partial or complete hearing loss
- Differences in Oro-facial structures, such as a cleft palate
- Disorder(s) that affect the nerves involved in speech production
Motor speech disorders in children include apraxia and dysarthria. These are conditions that affect the muscles involved in the production of speech.
Although apraxia can be of two types, the most common one observed in children is childhood apraxia of speech (CAS). It is a neurological condition that impacts the flow of messages from the brain to the muscles involved in speech production. Due to CAS, the signals between the brain and the muscles involved in speech production are interrupted. Therefore, the individual cannot move the muscles in a coordinated way necessary for producing speech.
You can learn more about apraxia right here.
Dysarthria is a speech disorder caused by weakness in the muscles involved in speaking. Muscle weakness can be due to traumatic brain injury (TBI) or other forms of brain damage. Dysarthria can happen immediately after birth (Cerebral Palsy) or after a stroke. Several individuals with Parkinson's, ALS, Huntington's, or Multiple Sclerosis (MS) also present with symptoms of dysarthria. Someone with dysarthria may have a hoarse or choppy voice or slow and slurred speech.
You can read more about dysarthria here.
8. Who Are At Risk Of Developing Speech Sound Disorders?
In most cases, the causes of speech sound disorders are unknown. However, studies show that certain risk factors increase the likelihood of speech sound disorders in a child. As per data from Stanford Children’s Health, these factors include –
- The presence of congenital conditions such as Cerebral Palsy
- Developmental conditions such as autism spectrum disorder
- Frequent ear infections and subsequent loss of hearing
- Genetic conditions such as Down syndrome
- Oro-facial anomalies such as cleft lips and cleft palates
Other controversial but observed factors that increase the risk of speech sound disorders in children include a low level of education of the parent(s) and a lack of a supportive learning environment at home.
Additionally, the following may add to the risk of developing speech sound disorders –
The chance of a male child developing SSD is significantly higher than a female child.
Pre- and Perinatal Issues
Infections during pregnancy, premature birth, low birth weight, and complications during birth can contribute to a higher possibility of speech sound disorders in the child.
Children with a family history of speech sound disorders and language disorders suffer a higher risk of SSDs.
9. How Is A Speech Sound Disorder Diagnosed?
If your child has been showing signs of a speech sound disorder, you should talk to a speech-language pathologist (SLP). The diagnosis of speech sound disorders requires close observation, noting the family history, and testing the child for other conditions that may better explain their symptoms.
The professional will recommend testing your child for hearing-related problems and other physiological issues. They will see how your child moves their lips, jaws, tongue, and other muscles to rule out any weakness-related issues. The SLP may also suggest tests for assessing your child's language skills.
Always remember, some families talk with an accent. Children automatically adopt accents, but speaking with an unfamiliar or foreign accent is NOT a speech sound disorder. Therefore, the SLP will also determine if your child is simply talking with an accent. They will also consider if your child's speech issues are a normal part of their speech and language acquisition journey.
10. What Is The Treatment For Speech Sound Disorders in Children?
Speech sound disorders are of different types, and they can affect children with varying severity. A licensed speech-language pathologist can recommend the proper course of therapy after a thorough assessment and evaluation.
The SLP will work with you and your child to tailor a treatment plan to overcome their speech sound-related challenges. There is no one-treatment-fits-all approach for speech sound disorders.
Here’s what you can expect during the treatment of speech-sound disorders in children –
- Practicing preventative activities and exercises so that the problem doesn’t worsen.
- The precise identification and correction of the sounds your child says incorrectly.
- Continued practice and repetition of the target sound in different words to familiarize the child with the correct speech sound.
- Learning at-home strategies and activities to continue your child’s improvement outside the sessions.
In addition to these, you will also receive updated and factual material from the SLP on speech sound disorders and their treatment. Educating yourself about the disorder will help you understand your child’s emotions and trysts.
11. How Can Stamurai Help With The Diagnosis and Treatment of Speech Sound Disorders?
Stamurai has a team of certified and trained SLPs who have been working with children with varying speech sound disorders. You or your child can receive online speech therapy for speech-sound disorders via one-on-one video sessions.
The nature of the therapy and the interactions during the video sessions will depend on the age and developmental levels of the client.
Speech Sound Disorder Therapy for Children between the Ages of 0 and 3-Years
Parents of very young children will work with the SLP during the video sessions to learn at-home exercises for speech sound disorder treatment. You will practice these speech therapy exercises and activities with your child and give your feedback directly to the SLP.
Speech Sound Disorder Therapy for Children between the Ages of 4 and 6-Years
You can attend the video sessions with your child. You will learn the cues and speech therapy exercises the SLP practices with your child during the session. You can promote at-home skill-building after each session.
Speech Sound Disorder Therapy for Children Older Than 7-Years
Older children can attend the therapy via video-conferencing for kids all by themselves. However, you can sit in with them or choose to receive feedback from the SLP after each session.
Speech Sound Disorder Therapy for Adults
Adults can always attend the therapy sessions alone. You can also invite your loved one(s) to sit with you during a session.
12. How Can Parents Help A Child With Speech Sound Disorder At Home?
A child's speech and language therapy is incomplete without complete parental involvement. Since your child spends most of their time at home with you, you can continue your child's speech and language therapy at home.
Your SLP will show you how to help a child with speech articulation problems. You can learn new activities and fun games for at-home practice.
Here are a few tips for all parents from our SLP –
- Listen to your child's speech carefully and note every word or sound they repeatedly mispronounce.
- Learn new and fun speech therapy activities for speech sound disorders so your child does not lose interest in at-home therapy.
- Make flashcards and cue cards for your child to practice specific words and word sounds.
- Provide natural modeling for your child if they mispronounce words.
- Do not reprimand your child or interrupt them everytime they mispronounce a word or word sound.
- Stay in touch with your SLP and offer them feedback on how your child is doing at home!