Speech Sound Disorders Evidence Map for summaries of the available research on this topic.
The scope of this page is speech sound disorders with no known cause—historically called articulation and phonological disorders—in preschool and school-age children (ages 3–21).
Information about speech sound problems related to motor/neurological disorders, structural abnormalities, and sensory/perceptual disorders (e.g., hearing impairment) is not addressed in this page.
See ASHA's Practice Portal pages on
Childhood Apraxia of Speech and
Cleft Lip and Palate for information about speech sound problems associated with these two disorders. A Practice Portal page on dysarthria in children will be developed in the future.
Speech Sound Disorders
Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segments—including phonotactic rules governing permissible speech sound sequences in a language.
Speech sound disorders can be organic or functional in nature. Organic speech sound disorders result from an underlying motor/neurological, structural, or sensory/perceptual cause. Functional speech sound disorders are idiopathic—they have no known cause. See figure below.
Organic Speech Sound Disorders
Organic speech sound disorders include those resulting from motor/neurological disorders (e.g., childhood apraxia of speech and dysarthria), structural abnormalities (e.g.,
cleft lip/palate and other structural deficits or anomalies), and sensory/perceptual disorders (e.g., hearing impairment).
Functional Speech Sound Disorders
Functional speech sound disorders include those related to the motor production of speech sounds and those related to the linguistic aspects of speech production. Historically, these disorders are referred to as articulation disorders and phonological disorders, respectively. Articulation disorders focus on errors (e.g., distortions and substitutions) in production of individual speech sounds. Phonological disorders focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound. It is often difficult to cleanly differentiate between articulation and phonological disorders; therefore, many researchers and clinicians prefer to use the broader term, "speech sound disorder," when referring to speech errors of unknown cause. See Bernthal, Bankson, and Flipsen (2017) and Peña-Brooks and Hegde (2015) for relevant discussions.
This Practice Portal page focuses on functional speech sound disorders. The broad term, "speech sound disorder(s)," is used throughout; articulation error types and phonological error patterns within this diagnostic category are described as needed for clarity.
Procedures and approaches detailed in this page may also be appropriate for assessing and treating organic speech sound disorders. See
Speech Characteristics: Selected Populations [PDF] for a brief summary of selected populations and characteristic speech problems.