Speech Sound Disorders
Children can have trouble saying sounds clearly. It may be hard to understand what they say. Speech-language pathologists, or SLPs, can help. Visit ASHA ProFind to locate a professional in your area.
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About Speech Sound Disorders
Children may 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 can say almost all speech sounds correctly by 4 years old. A child who does not say sounds by the expected ages may have a speech sound disorder. You may hear the terms "articulation disorder" and "phonological disorder" to describe speech sound disorders like this.
To learn more about what you should expect your child to be able to say, see these two resources:
Adults can also have speech sound disorders. Some adults have problems that started when they were children. Others may have speech problems after a stroke or traumatic brain injury. To learn more about adult speech disorders after a stroke or traumatic brain injury, see apraxia of speech in adults and dysarthria.
Signs and Symptoms
Your child may substitute one sound for another, leave sounds out, add sounds, or change a sound. It can be hard for others to understand him.
It is normal for young children to say the wrong sounds sometimes. 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.
You and your child may also sound different because you have an accent or dialect. This is not a speech sound disorder.
The chart below shows the ages when most English-speaking children develop sounds. Children learning more than one language may develop some sounds earlier or later.
| By 3 months
|| Makes cooing sounds
| By 5 months
|| Laughs and makes playful sounds
| By 6 months
|| Makes speech-like babbling sounds like puh, ba, mi, da
| By 1 year
|| Babbles longer strings of sounds like mimi, upup, bababa
| By 3 years
Says m, n, h, w, p, b, t, d, k, g, and f in words
Familiar people understand the child's speech
| By 4 years
Says y and v in words
May still make mistakes on the s, sh, ch, j, ng, th, z, l, and r sounds
Most people understand the child’s speech
Many children learn to say speech sounds over time, but some do not. You may not know why your child has problems speaking.
Some children have speech problems because the brain has trouble sending messages to the speech muscles telling them how and when to move. This is called apraxia. Childhood apraxia of speech is not common but will cause speech problems.
Some children have speech problems because the muscles needed to make speech sounds are weak. This is called dysarthria.
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; or
- brain damage, like cerebral palsy or a head injury.
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 traumatic brain injury, or other trauma. To learn more about adult speech disorders, see apraxia of speech in adults, dysarthria, laryngeal cancer, and oral cancer.
Seeing a Professional
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. For example, your child may have trouble following directions or telling stories.
It is important to have your child’s hearing checked to make sure he does not have a hearing loss. A child with a hearing loss may have more trouble learning to talk.
The SLP can also 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.
Treatment for Speech Sound Disorders
SLPs can help you or your child say sounds correctly and clearly. Treatment may include the following:
- 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.