Speech Sound Disorders
Children and adults can have trouble saying sounds clearly. It may be hard to understand what they say. Speech-language pathologists, or SLPs, can help.
On this page:
About Speech Sound Disorders
Children will say some sounds the wrong way as they learn to talk. They learn some sounds earlier, like p, m, or w. Other sounds take longer to learn, like z, v, or th. Most children will be able to say all sounds in English by 8 years old. A child who does not say sounds by the expected age may have a speech sound disorder.
Some children have trouble controlling their mouth muscles to make sounds.
Childhood apraxia of speech is not common but will cause speech problems.
To learn more about what you should expect your child to be able to say, see these resources:
Adults can also have speech sound disorders. Some adults have problems that started when they were children. Others may develop speech problems after a stroke or
brain injury. To learn more about adult speech disorders, see
apraxia of speech and
Signs of Speech Sound Disorders
Your child may have trouble making sounds. He may substitute another sound, leave sounds out, add sounds, or change the sound. It can be hard for others to understand him.
It is normal for young children to say the wrong sounds. For example, your child may make a "w" sound for an "r" and say "wabbit" for "rabbit." She may leave sounds out of words, such as "nana" for "banana." This is okay when she is young. It may be a problem if she keeps making these mistakes as she gets older.
Adults may have speech problems that started when they were children. They may start to have problems saying sounds as an adult. They also may substitute, add, leave off, or change sounds.
Not every speech error is a problem. You and your child may sound different because you have an accent or dialect. This is not a speech sound disorder.
The chart below shows the age range for each speech sound.
By 3 months:
By 5 months:
- Laughs and makes playful noises
By 6 months:
- Babbles with sounds like "puh," "mi," and "da"
By 1 year:
- Babbles longer strings of sounds, like “mimi,” “bababa,” and “upup”
By 3 years:
- Says m, h, w. p, b, t, d, k, g. and f in words
By 4 years:
- Says "y" and "v" in words
- May still have trouble with s, sh, ch, j, th, z, l, and r sounds
Causes of Speech Sound Disorders
You may not know why your child has problems speaking. Many children learn to say speech sounds over time, but some do not.
Your child may have speech problems if he has:
- A developmental disorder, like autism.
- A genetic syndrome, like Down syndrome.
- Hearing loss, from ear infections or other causes.
- Brain damage, like cerebral palsy or a head injury.
For adults, the cause may be:
- Brain damage, from a stroke or head injury.
- Diseases that get worse over time, like Amyotrophic Lateral Sclerosis or Parkinson's disease.
- Mouth cancers.
Testing for Speech Sound Disorders
A speech-language pathologist, or SLP, can test your child's speech. The SLP will listen to your child to hear how he says sounds. The SLP also will look at how your child moves his lips, jaw, and tongue. The SLP may also test your child's language skills. Many children with speech sound disorders also have language disorders. Your child may have trouble understanding words and telling stories.
Testing an adult is very similar. The SLP will talk to you about your speech and the problems you have. She will look at how your mouth muscles move and how well you say sounds.
The SLP can help decide if you have a speech problem or speak with an accent. An accent is the unique way that groups of people sound. Accents are NOT a speech or language disorder. An SLP can work on
accent modification if you want to change how you sound.
Treatment for Speech Sound Disorders
SLPs can help you or your child say sounds correctly and clearly. Treatment may include:
- Learning the correct way to make sounds.
- Learning to tell when sounds are right or wrong.
- Practicing sounds in different words.
- Practicing sounds in longer sentences.
See ASHA information for professionals on the Practice Portal’s
Speech Sound Disorders page.
To find a speech-language pathologist near you, visit