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Speech Sound (Articulation) Disorders (Children)

What Are Speech Sound (Articulation) Disorders

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.

Causes Of Speech Sound (Articulation) Disorders

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.

Signs And Symptoms Of Speech Sound (Articulation) Disorders

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.
Diagnosis And Treatment Options For Speech Sound (Articulation) Disorders

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.

Tips For Taking Care Of Children With Speech Sound (Articulation) Disorders

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
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