American Speech-Language-Hearing Association
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Speech Sound Disorders: Articulation and Phonological Processes

What are speech sound disorders?

Most children make some mistakes as they learn to say new words. A speech sound disorder occurs when mistakes continue past a certain age. Every sound has a different range of ages when the child should make the sound correctly. Speech sound disorders include problems with articulation (making sounds) and phonological processes (sound patterns).

To learn more about typical speech sound development, see How Does Your Child Hear and Talk? and Literacy and Communication: Expectations From Kindergarten Through Fifth Grade.

Can adults have speech sound disorders?

Adults can also have speech sound disorders. Some adults continue to have problems from childhood, while others may develop speech problems after a stroke or head injury. To learn more about adult speech disorders, see apraxia of speech and dysarthria.

What are some signs of an articulation disorder?

An articulation disorder involves problems making sounds. Sounds can be substituted, left off, added or changed. These errors may make it hard for people to understand you.

Young children often make speech errors. For instance, many young children sound like they are making a "w" sound for an "r" sound (e.g., "wabbit" for "rabbit") or may leave sounds out of words, such as "nana" for "banana." The child may have an articulation disorder if these errors continue past the expected age.

Not all sound substitutions and omissions are speech errors. Instead, they may be related to a feature of a dialect or accent. For example, speakers of African American Vernacular English (AAVE) may use a "d" sound for a "th" sound (e.g., "dis" for "this"). This is not a speech sound disorder, but rather one of the phonological features of AAVE.

To see the age range during which most children develop each sound, visit Talking Child's speech chart.

What are some signs of a phonological disorder?

A phonological process disorder involves patterns of sound errors. For example, substituting all sounds made in the back of the mouth like "k" and "g" for those in the front of the mouth like "t" and "d" (e.g., saying "tup" for "cup" or "das" for "gas").

Another rule of speech is that some words start with two consonants, such as broken or spoon. When children don't follow this rule and say only one of the sounds ("boken" for broken or "poon" for spoon), it is more difficult for the listener to understand the child. While it is common for young children learning speech to leave one of the sounds out of the word, it is not expected as a child gets older. If a child continues to demonstrate such cluster reduction, he or she may have a phonological process disorder.

To see the ages at which phonological processes should disappear, go to Elimination of Phonological Processes, and for descriptions of the common processes see Phonological Processes.

How are speech sound disorders diagnosed?

A speech-language pathologist (SLP) is the professional that evaluates children or adults with speech and language difficulties. The SLP listens to the person 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 feature of a dialect or accent. For children, the SLP often also evaluates their language development to determine overall communication functioning.

What if I speak more than one language? Is my accent a speech sound disorder?

An accent is the unique way that speech is pronounced by a group of people speaking the same language. Accents are a natural part of spoken languages. It is important to realize that no accent is better than another. Accents are NOT a speech or language disorder. An SLP can work on accent modification services if a client wishes to reduce or modify his or her accent.

What treatments are available for people with speech sound disorders?

SLPs provide treatment to improve articulation of individual sounds or reduce errors in production of sound patterns.

Articulation treatment may involve demonstrating how to produce the sound correctly, learning to recognize which sounds are correct and incorrect, and practicing sounds in different words. Phonological process treatment may involve teaching the rules of speech to individuals to help them say words correctly.

Learn more: Child speech intervention index

What causes speech sound disorders?

Many speech sound disorders occur without a known cause. A child may not learn how to produce sounds correctly or may not learn the rules of speech sounds on his or her own. These children may have a problem with speech development, which does not always mean that they will simply outgrow it by themselves. Many children do develop speech sounds over time but those who do not often need the services of an SLP to learn correct speech sounds.

Some speech sound errors can result from physical problems, such as:

  • developmental disorders (e.g.,autism)
  • genetic syndromes (e.g., Down syndrome)
  • hearing loss
  • illness
  • neurological disorders (e.g., cerebral palsy)

Children who experience frequent ear infections when they were young are at risk for speech sound disorders if the ear infections were accompanied by hearing loss.

Speaking with an accent and/or dialect is not a speech sound disorder.

How common are speech sound disorders?

In young children learning to speak, speech sound errors are quite common. In fact, very few children develop speech without producing errors early on. By the age of 8, children should be able to produce all sounds in English correctly.

Information about how many children have speech sound disorders is available in the ASHA report, Incidence and Prevalence of Communication Disorders and Hearing Loss in Children - 2007 Edition.

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How effective are treatments for speech sound disorders?

The following information on treatment efficacy for phonological process disorders is available at:

What do SLPs do when working with individuals with speech sound disorders?

The Preferred Practice Patterns for the Profession of Speech-Language Pathology includes sections on speech sound assessment (section 15) and speech sound intervention (section 16). These sections describe the typical clinical process followed by an SLP in these areas.

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