| Speech Sound Disorders - Speech language disorder - Bright Tots information on child development |
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| Speech Sound Disorders |
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Speech sound disorders (SSD) are complex conditions which affect the ability to communicate. They range from
saying sounds incorrectly to being completely unable to speak or understand speech. A speech sound disorder is an
impairment of voice, articulation of speech sounds, and/or fluency. These deficiencies are seen in communication and
use of oral coordination.
Speech sound disorders may be separated into two primary groups, articulation disorders (also called phonetic
disorders) problems with making sounds in alphabet, and phonological disorders (also called phonemic disorders)
problems with distinctive sounds in spoken language. Speech sound disorders are speech disorders in which some
speech sounds (phonemes) are either not produced, not produced correctly, or are mispronounced. However, some
children may have a mixed disorder in which both articulation and phonological difficulties exist. Though speech sound
disorders are associated with childhood, some effects may continue into adulthood.
Children with SSD’s make up for approximately 15% of children referred to speech and language therapy, usually at 3
years of age. It is likely that these children represent a diverse group, excluding children with disorders such as
pervasive developmental delay, and other neurological developmental disorders.
Characteristics found in SSD:
• Omissions: Certain sounds are not produced entire syllables or specific sounds may be deleted.
• Additions: An extra sound or sounds are added to the intended word.
• Distortions: Sounds are changed slightly so that the intended sound may be recognized but sound inaccurate or
may sound like any sound in the speaker’s fluent language. The best known example of distortion is a lisp.
• Substitutions: One or more sounds are substituted for another; e.g. twee instead of the tree.
Some distorted forms of /r/ may be mistaken for /w/ by a casual observer, yet may not actually be either sound but
somewhere in between. Further, children with severe speech sound disorders may be difficult to understand, making it
hard to recognize which word was actually intended.
The causes or origin of children with early speech sound disorders are unknown. The search for genetic influences is
difficult and has not been research thoroughly. It is likely that SSDs have more than a single set of causes that
contribute to the incidence of the disorder.
Phonological Disorders and Articulation Disorders
Both phonology and articulation refer to the structure of forming the individual sounds in speech. They do not relate to
producing or understanding the meaning or content of speech. A child with either a phonological disorder or an
articulation disorder is often difficult to understand.
The child incorrectly makes group of sounds, usually substituting earlier developing sounds for later-developing sounds
and consistently omitting sounds. Children with phonological deficits often substitute t/k and d/g. They frequently leave
out the letter s so stamp becomes tamp and snake, nake. Phonological deficits usually seriously affect fluency. Sounds
may be well articulated, but inappropriate for the context.
Diagnosis is normally made between 2 and 4 years of age. In terms of their sound structure, children with phonological
disorders produce, on average, 8 of the 24 letters in the English language. Most children respond well to intervention,
which can take several years. There is extensive research relating to phonological disorders and difficulty with learning
to read. Early intervention is important with these children. The cause is most frequently linked to temporary hearing
loss due to colds, ear infections, and allergies.
Children with severe phonological disorders present a particular medical and academic challenge. Their accumulation of
language might include nasals, stops and glides, but not at all places of verbalization and difficulty with speech sounds
produced, due to breath moving against a narrowing of the vocal tract. Some children also have poor or errors in vowel
capacity. Most notably, however, these disadvantages on the sound system come in the absence of any other obvious
deficits. These children’s prenatal and developmental histories are typical; they have normal hearing and intelligence;
other areas of the linguistic system are intact; and they do not commonly appear to have perceptual, processing, or oral-
motor deficiencies.
Possible Causes of Phonological Disorders
There is no known cause of phonological disorders in children. Primary and rising evidence points to possible genetic
origins for a limited number of children.
Still others have identified risk factors that increase the probability for developing the disorder as based on male gender,
an affected sibling, and low maternal education. Aside from these observations, little is else known about the underlying
cause of phonological disorders.
An important detail known is that there is a critical period for speech sound normalization. The most favorable window
of time in which to modify a child’s sound system with the target language is between the ages of 4 and 6. Moreover,
beyond age 8.5, there are level in learning, which limits the amount and degree of change in adjustment. These, in turn,
can further impact children’s ability to read, write, and perform academically. As a result, while there is no known
cause, there is a critical and early need for clinical treatment of phonological disorders. In particular, linguistic qualities
of sound systems can be used to enhance phonological learning in treatment.
Treatment Approaches for Phonological Disorders
Minimal pairs - This approach can be used with children with moderate to severe phonological disorders and poor
speech intelligibility. In this approach, the SLP selects words which differ by only one sound to draw the child's
attention to the fact that meanings are indicated by the difference between the chosen sounds.
Phonological cycle approach - This approach uses three key elements which include auditory overload of phonological
targets at the beginning and end of sessions, to teach formation and a series of the sound targets.
Articulation Disorders
Articulation is a general term which refers to the production of individual sounds. The production of sounds involves
the coordinated movements of the lips, tongue, teeth, palate (top of the mouth) and respiratory system (lungs). It also
includes many different nerves and muscles used for speech.
When young children are growing, they develop speech sounds in a predictable order. A child with an articulation
disorder has difficulty producing and forming particular speech sounds properly (an example 'lisp') or they may not be
able to produce a particular sound (for example the 'r' sound). These disorders are generally very specific and need
therapy from a trained speech pathologist.
An articulation disorder can co-occur with giftedness, language and learning disabilities, and retardation. The causes are
varied and may be linked to temporary hearing loss due to otitis media (frequent ear infections) or allergies; structural or
functional problems with the lips, teeth, tongue, or hard palate; or a medical condition such as cleft palate or cerebral
palsy.
Articulation errors are characterized by the omission, distortion, substitution, addition and/or incorrect sequencing of
speech sounds.
Causes of articulation disorders:
• Hearing Loss
• History of ear infections during the first few years of life
• Speech sound perception and ability to distinguish
• Tooth alignment and missing teeth
• Impaired oral-motor skills
• Eating problems
• Tongue thrust swallow after 6 years of age
• Neurological disorders
• Mental retardation
• Language problems
• Reading disorders
• Family history
Articulation Assessment / Articulation Test
Formal assessment should include both articulation and phonology. A speech-language pathologist (SLP) should use
caution in the interpretation of standardized scores to determine need for service. Although some assessments will
reveal standardized scores below the average range for single sound inaccuracy, services may not be necessary if there
is not a poor educational outcome. The standardized scores should be interpreted carefully, always taking into
consideration impact on educational performance.
A speech-language pathologist is the professional that evaluates children with speech and language difficulties. The SLP
listens to the child and may use a formal articulation test to record sound errors. An oral mechanism examination is also
done to determine whether the muscles of the mouth are working correctly. The SLP may recommend speech
treatment if the sound is not appropriate for the child's age or if it is not a trait of jargon or accent. For all children, the
SLP often also evaluates their language development to determine overall communication functioning.
saying sounds incorrectly to being completely unable to speak or understand speech. A speech sound disorder is an
impairment of voice, articulation of speech sounds, and/or fluency. These deficiencies are seen in communication and
use of oral coordination.
Speech sound disorders may be separated into two primary groups, articulation disorders (also called phonetic
disorders) problems with making sounds in alphabet, and phonological disorders (also called phonemic disorders)
problems with distinctive sounds in spoken language. Speech sound disorders are speech disorders in which some
speech sounds (phonemes) are either not produced, not produced correctly, or are mispronounced. However, some
children may have a mixed disorder in which both articulation and phonological difficulties exist. Though speech sound
disorders are associated with childhood, some effects may continue into adulthood.
Children with SSD’s make up for approximately 15% of children referred to speech and language therapy, usually at 3
years of age. It is likely that these children represent a diverse group, excluding children with disorders such as
pervasive developmental delay, and other neurological developmental disorders.
Characteristics found in SSD:
• Omissions: Certain sounds are not produced entire syllables or specific sounds may be deleted.
• Additions: An extra sound or sounds are added to the intended word.
• Distortions: Sounds are changed slightly so that the intended sound may be recognized but sound inaccurate or
may sound like any sound in the speaker’s fluent language. The best known example of distortion is a lisp.
• Substitutions: One or more sounds are substituted for another; e.g. twee instead of the tree.
Some distorted forms of /r/ may be mistaken for /w/ by a casual observer, yet may not actually be either sound but
somewhere in between. Further, children with severe speech sound disorders may be difficult to understand, making it
hard to recognize which word was actually intended.
The causes or origin of children with early speech sound disorders are unknown. The search for genetic influences is
difficult and has not been research thoroughly. It is likely that SSDs have more than a single set of causes that
contribute to the incidence of the disorder.
Phonological Disorders and Articulation Disorders
Both phonology and articulation refer to the structure of forming the individual sounds in speech. They do not relate to
producing or understanding the meaning or content of speech. A child with either a phonological disorder or an
articulation disorder is often difficult to understand.
The child incorrectly makes group of sounds, usually substituting earlier developing sounds for later-developing sounds
and consistently omitting sounds. Children with phonological deficits often substitute t/k and d/g. They frequently leave
out the letter s so stamp becomes tamp and snake, nake. Phonological deficits usually seriously affect fluency. Sounds
may be well articulated, but inappropriate for the context.
Diagnosis is normally made between 2 and 4 years of age. In terms of their sound structure, children with phonological
disorders produce, on average, 8 of the 24 letters in the English language. Most children respond well to intervention,
which can take several years. There is extensive research relating to phonological disorders and difficulty with learning
to read. Early intervention is important with these children. The cause is most frequently linked to temporary hearing
loss due to colds, ear infections, and allergies.
Children with severe phonological disorders present a particular medical and academic challenge. Their accumulation of
language might include nasals, stops and glides, but not at all places of verbalization and difficulty with speech sounds
produced, due to breath moving against a narrowing of the vocal tract. Some children also have poor or errors in vowel
capacity. Most notably, however, these disadvantages on the sound system come in the absence of any other obvious
deficits. These children’s prenatal and developmental histories are typical; they have normal hearing and intelligence;
other areas of the linguistic system are intact; and they do not commonly appear to have perceptual, processing, or oral-
motor deficiencies.
Possible Causes of Phonological Disorders
There is no known cause of phonological disorders in children. Primary and rising evidence points to possible genetic
origins for a limited number of children.
Still others have identified risk factors that increase the probability for developing the disorder as based on male gender,
an affected sibling, and low maternal education. Aside from these observations, little is else known about the underlying
cause of phonological disorders.
An important detail known is that there is a critical period for speech sound normalization. The most favorable window
of time in which to modify a child’s sound system with the target language is between the ages of 4 and 6. Moreover,
beyond age 8.5, there are level in learning, which limits the amount and degree of change in adjustment. These, in turn,
can further impact children’s ability to read, write, and perform academically. As a result, while there is no known
cause, there is a critical and early need for clinical treatment of phonological disorders. In particular, linguistic qualities
of sound systems can be used to enhance phonological learning in treatment.
Treatment Approaches for Phonological Disorders
Minimal pairs - This approach can be used with children with moderate to severe phonological disorders and poor
speech intelligibility. In this approach, the SLP selects words which differ by only one sound to draw the child's
attention to the fact that meanings are indicated by the difference between the chosen sounds.
Phonological cycle approach - This approach uses three key elements which include auditory overload of phonological
targets at the beginning and end of sessions, to teach formation and a series of the sound targets.
Articulation Disorders
Articulation is a general term which refers to the production of individual sounds. The production of sounds involves
the coordinated movements of the lips, tongue, teeth, palate (top of the mouth) and respiratory system (lungs). It also
includes many different nerves and muscles used for speech.
When young children are growing, they develop speech sounds in a predictable order. A child with an articulation
disorder has difficulty producing and forming particular speech sounds properly (an example 'lisp') or they may not be
able to produce a particular sound (for example the 'r' sound). These disorders are generally very specific and need
therapy from a trained speech pathologist.
An articulation disorder can co-occur with giftedness, language and learning disabilities, and retardation. The causes are
varied and may be linked to temporary hearing loss due to otitis media (frequent ear infections) or allergies; structural or
functional problems with the lips, teeth, tongue, or hard palate; or a medical condition such as cleft palate or cerebral
palsy.
Articulation errors are characterized by the omission, distortion, substitution, addition and/or incorrect sequencing of
speech sounds.
Causes of articulation disorders:
• Hearing Loss
• History of ear infections during the first few years of life
• Speech sound perception and ability to distinguish
• Tooth alignment and missing teeth
• Impaired oral-motor skills
• Eating problems
• Tongue thrust swallow after 6 years of age
• Neurological disorders
• Mental retardation
• Language problems
• Reading disorders
• Family history
Articulation Assessment / Articulation Test
Formal assessment should include both articulation and phonology. A speech-language pathologist (SLP) should use
caution in the interpretation of standardized scores to determine need for service. Although some assessments will
reveal standardized scores below the average range for single sound inaccuracy, services may not be necessary if there
is not a poor educational outcome. The standardized scores should be interpreted carefully, always taking into
consideration impact on educational performance.
A speech-language pathologist is the professional that evaluates children with speech and language difficulties. The SLP
listens to the child and may use a formal articulation test to record sound errors. An oral mechanism examination is also
done to determine whether the muscles of the mouth are working correctly. The SLP may recommend speech
treatment if the sound is not appropriate for the child's age or if it is not a trait of jargon or accent. For all children, the
SLP often also evaluates their language development to determine overall communication functioning.
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