December 4, 2023
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The ABCs of Speech Sound Disorders in Children

Learning to talk is an exciting journey for children and parents.

In this short explainer, I'll talk about speech sound disorders in children.

What they are, some common errors, and a typical development timeline.

A 7 year old boy who Heather Zortman helped with speech a sound disorder
Bravo Speech Therapy
Speech Sounds
The ABCs of Speech Sound Disorders in Children

We’ll walk through:

  • What are Speech Sound Disorders?
  • How To Recognize The Signs
  • The impact on a child’s life
  • What are some causes?
  • Testing and Treatment

Let’s get started!

1. Basics of Speech Sound Disorders

A character representing a parent that is reading a paper on speech sound disorders in children

Having worked with numerous families over the years, I've seen firsthand the concerns my parents have about their child's speech clarity.

Let's uncover what Speech Sound Disorders are.

What are Speech Sound Disorders?


Speech Sound Disorder

This is a condition where a child has difficulty correctly saying certain speech sounds, affecting their clarity of speech and ability to be understood by others.

You may also hear the terms "articulation disorder" and "phonological disorder" to describe speech sound disorders.

Remember, it's perfectly normal for children to mispronounce sounds while they're learning. It's a part of their growth and learning curve.

However, when these challenges persist past the typical age of mastering those sounds, we may be looking at a speech sound disorder.

Common Speech Sound Errors

Does your child seem to stumble over some sounds more than others?

Children naturally gravitate towards certain sounds earlier on. Simpler sounds like 'p', 'm', and 'w' tend to be the initial favorites.

But as they grow, the more intricate sounds like 'z', 'v', and 'th' demand more practice.

What is a Normal Speech Development Timeline for Children?

By about the age of 4, I expect most children to be able to articulate nearly all speech sounds accurately. But keep in mind, every child is unique and learns at their own pace. 

If your young one isn't picking up on certain sounds as anticipated, they could potentially be grappling with a speech sound disorder.

Chart showing normal speech development timeline for children ages 3 months, 5 months, 6 months, 1 year, 3 years, and 4 year milestones

Information on this chart provided by the American Speech-Language-Hearing Association

To give you a clearer picture of speech development milestones, I'm in the process of creating comprehensive guides. Stay tuned for more insights that will help you navigate this journey with confidence!

2. Early Warning Signs of Speech Sound Difficulties

Characters representing a parent that is looking at their child through a magnifying glass attempting to recognize the signs of speech sound disorders in children

Let's put the subtleties in your child's speech under a magnifying glass for a moment.

It's always encouraging when I get to work with parents that are truly wanting to understand their child's speech journey better.

Spotting signs of communication disorders during those precious early years, from birth to age 4, can be SO IMPORTANT! Early intervention can make a huge impact on progress.

What does a Speech Sound Disorder look like?

For example:

  • Replacing certain sounds, such as saying 'wabbit' instead of 'rabbit.'
  • Skipping sounds or parts of words, saying 'nana' instead of 'banana' or ‘poon’ instead of ‘spoon’.
  • You may hear a distorted sound, such as a slushy /s/ (lateral airflow) instead of a crisp and clear sounding /s/ (forward airflow).

Your child's speech may be hard to understand, even for those who interact with them regularly, like family members or close friends. We call this 'speech intelligibility'. Speech intelligibility can be high (easy to understand) or low (hard to understand). Note: This has nothing to do with how intelligent your child is. This is only how understandable they are when they speak.

You might be thinking, "Well, this all seems pretty common for toddlers," and you're right. That's because they have a lot to express! Little ones are still exploring language, and this is a part of their learning process. But keep in mind - if these speech patterns continue as they grow older, it could be a sign of a speech sound disorder.

Key Sounds to Monitor

  • If your child cannot say or still has difficulty with the sounds, ‘p, b, m, h, w’ by age 2-3 years old, they may have a speech sound disorder.
  • If your child cannot say or has difficulty with the sounds, ‘k, g, t, d, f, n’ by age 4 years, it is likely your child has a speech sound disorder and consulting a speech therapist would be a great next step.
Infographic chart showing kids sounds that they may have trouble pronouncing if they have a speech sound disorder ages 2-3 years and 3-4 years old

‍While monitoring your child's speech, it's beneficial to:

  1. Model the correct sounds during conversations.
  2. Emphasize positive reinforcement over correction to foster confidence.
  3. Encourage communication, celebrating their efforts and successes.

Prioritize nurturing their self-confidence. You'll want to encourage their talking attempts, rather than just correcting them.

It's about keeping things positive, and looking for opportunities to tell them “Bravo!”

3. What Causes Speech Sound Disorders?

A graphic that represent different causes of speech sound disorders in children

There could be several reasons why a child might have a speech sound disorder. 
And sometimes there is no known cause. Some children have a family history of speech delay that plays a role.

Remember, each child's journey is unique, and pinpointing a single cause isn't always straightforward. But, having partnered with many parents, I can share with you some common factors we often encounter.

Let’s look at the different possibilities..

Neurological: Apraxia and Dysarthria

There is a speech sound disorder called Apraxia (Childhood Apraxia of Speech, or CAS). In this case, the brain has difficulty sending the correct messages to the muscles responsible for speech, affecting how and when they should move. Although childhood apraxia is not common, it will result in speech issues.

In other instances, the issue could be Dysarthria, where the muscles needed for creating speech sounds are weaker than usual.

If you've been introduced to these terms through a diagnosis, know that you're not alone, and there are pathways to support and improve.

Developmental and Genetic Influences

Conditions like Autism and Down syndrome might also affect your child's speech development.

Autism, for instance, can influence communication skills, while physical traits associated with Down syndrome may make forming certain sounds more challenging.

Hearing loss

Hearing plays a pivotal role in a child's speech development. It's through hearing that children learn to recognize, process, and reproduce sounds. Imagine attempting to mimic a tune or sound you've never clearly heard; that's the task some children with hearing challenges face.

Hearing loss can lead to a speech sound disorder.

Spotting Hearing Difficulties

Vigilance is essential. Here are some signs that might suggest hearing issues:

  • Lack of response to loud noises.
  • Not turning head/body toward the source of sound after six months of age.
  • Mumbled or delayed speech.
  • Regular requests for repetitions or frequent irrelevant answers.
  • Preference for unusually loud volumes on electronic devices.

A chart infographics showing causes of speech sound disorders in children. Apraxia, Dysarthria, Autism, Down Syndrome, Ear Infections, Loss of Hearing, Cerebral Palsy Brain Damage, Cleft Lip or Palate

Brain Injuries and Neurological Factors

Sometimes, brain damage due to conditions like cerebral palsy or from a head injury can disrupt the nerve pathways crucial for speech and language.

This, in turn, can manifest as speech sound disorders.

Physical Structural Causes

Occasionally, structural abnormalities or damage can play a role.

For instance, cleft lip or palate, or even subtle differences in the mouth's anatomy, might cause deviations in speech sounds.

Environment and Exposure

Our environment is our first classroom. Children soak up language from their surroundings. If they're exposed to limited spoken language or if they frequently hear speech modeled with deviations, they might adopt these patterns, which can contribute to speech sound disorders.

To emphasize, it's essential to remember: just because a child showcases one or more of these signs, it doesn't mean they definitively have a speech sound disorder. A thorough evaluation is the only way to get clarity on that front.

Always keep in mind, the root cause might remain elusive, and that's okay. Your commitment to understanding and supporting your child is already a tremendous step forward. Together, we can delve in, assess, and employ the best techniques to nurture and refine your little one's communication abilities.

4. The Impact: From a Child's View

Shapes that represent a child on a basketball court being outcast by other children for being different

Childhood is full rich experiences, all contributing to shaping who they'll become.

Among these experiences, the ability to communicate stands out as very important.

Social Impact

It's never easy to see our children face challenges, especially when those challenges might set them apart from their peers. Imagine your child's world, where expressing a feeling, a thought, or even sharing that new joke they heard, becomes a mountain to climb. It's more than just words; it's about connection, belonging, and feeling understood.

  1. Expressing Emotions: Feelings are often the first things children want to share, whether it's the excitement over a new toy or the sadness of a scraped knee. With a speech disorder, these simple, raw emotions can sometimes get trapped, leading to feelings of frustration.
  2. Forming Friendships: Playdates, school recesses, and birthday parties are where children gain their earliest friendships. Being unable to communicate clearly can sometimes hinder the forming of these bonds, potentially leading to feelings of isolation.
  3. Learning Through Interaction: Much of a child's learning in these formative years comes from interacting with peers: sharing toys, playing games, and countless other shared activities. A gap in communication can sometimes mean a gap in these shared learning experiences.

All that being said, children are masters of adaptability. They have an innate ability to find alternate ways to communicate, be it through gestures, expressions, or sheer persistence.

Academic Impact

The classroom is where children begin to understand the world around them, formulate opinions, and grow their individual identities. It's an environment for learning, experiencing, and expressing. And for a child with a speech sound disorder, navigating the academic world can be like running a race with invisible hurdles.

  1. Participation: Answering a question in class or reading aloud becomes more than just an academic exercise; it's a test of courage. The anxiety of mispronouncing a word or being misunderstood can cause frustration.
  2. Writing: Sometimes, speech difficulties can spill over into writing. If a child consistently hears and produces a sound incorrectly, they might replicate that error in their spelling, making written assignments a potential challenge.
  3. Feedback: While feedback is essential for growth, children with speech disorders might sometimes perceive it as criticism of their effort. This can be a delicate area where their self-worth gets intertwined with their academic performance. They will benefit from strong role-models and adults to encourage their efforts in a positive way! 
  4. Peer perceptions: Kids are observant, and they notice differences. For a child with a speech issue, there might be an underlying fear of being labeled or left out. This could sometimes hinder collaborative activities or group projects.

And yet, I've seen children turn these challenges into strengths, developing keen listening skills, a sharper focus, or even a liking for visual and creative expression.


Kai, a 7-year-old boy whose confidence I helped nurture as his speech pathologist

Kai's Transformation

Here is story about a boy I saw for therapy many years ago. He had perseverance and a strong desire to communicate. We'll call him Kai.

A sweet 7-year-old, Kai started to see me because his parents noticed that he had difficulty making certain sounds. He was having trouble with his ‘th’ sound, like saying “fing” instead of “thing”. This little hiccup impacted his confidence, especially around his peers.

As we started our sessions, my aim was not only to help him correct his speech sound but also to reinforce that it’s perfectly okay to make mistakes - that’s how we learn. With Kai, I used various activities that made our sessions feel more like play than work, such as fun games focusing on the ‘th’ sound, and movement activities to keep him motivated.

It wasn't a straight path to success. Some days were more challenging than others, and there were moments when Kai felt frustrated and didn't want to participate.

In the following weeks, he made slow, steady progress. Within a few months, Kai made significant progress with his ‘th’ sound.

I was able to collaborate with his teacher and she told me about his reading aloud in his classroom. During their parent-teacher conference, Kai's mother shared a precious moment. One evening, Kai was reading his younger sister a bedtime story. At the end, he turned to his mom with a smile and said, “Did you hear my ‘th’ sounds, Mom?!“

I share this because Kai's journey is a common one. There is effort, moments of doubt, but ultimately, growth and progress! His speech sound improved, but just as importantly, his confidence did too.

5. Inside the Toolbox: Professional Treatment

Two characters representing a pediatric Speech Language Therapist evaluating a child as he plays with a toy car

When you picture a Speech-Language Pathologist (SLP) working with a child, what comes to mind?

For many, it's a clinical setting, filled with charts and exercises, working while seated at a table.

In reality, it's carefully planned out activities that target the child's unique goals. It can look like moving around the room, sensory play, music, games, worksheets, and many combinations. Mix in expertise and patience.

Role of a Speech-Language Pathologist (SLP)

A speech-language pathologist or SLP, has the skills to evaluate your child's speech ability. They will closely observe your child's articulation and pronunciation, and analyze your child's facial movements (focusing on the strength and coordination of the lips, jaw, and tongue).

In addition, the SLP may want to evaluate your child’s language skills to get a better understanding of the whole picture of communication.

Testing for Speech Sound Disorders

Speech Testing
  • In a speech test, the SLP will engage your child in conversation, ask them to repeat words or read sentences, with the aim of understanding what sounds or words are most difficult for them. Through this, the SLP can identify specific speech sounds that your child needs help with. (also known as Articulation Testing).

Language Testing
  • This is a different part of the assessment. Language tests involve assessing your child's understanding and use of language, separate from speech. This can include comprehension (understanding spoken or written language), expressive language (ability to convey thoughts, ideas, and feelings), and pragmatic skills (social communication skills). This means checking if they can follow what's being said, express their own ideas clearly in various ways, and use language in a social situation.


Every child is unique, and so is their path to improving speech. After an SLP figures out what your child is struggling with, they will come up with a tailored plan to help your child communicate better.

This might involve fun activities and exercises to practice making specific sounds, or games that encourage language use.

Treatment may include the following:

  • Phonetic placement: Using tools and techniques, we emphasize the correct placement of the tongue, lips, and jaw for specific sounds.
  • Sound drills: These are engaging activities centered around specific sounds, ensuring practice doesn't feel like a chore.
  • Contrastive techniques: When certain sounds are confusing, we tackle them head-on, differentiating and practicing until they become clear.
  • Auditory familiarity: This is immersion in targeted sounds through stories or games, aiming for recognition and replication.

Collaboration is Key

While our sessions are pivotal, your involvement at home is crucial. Activities, tips, and strategies will be shared to ensure practice is both effective and engaging.

In the realm of speech sound disorders, understanding the journey and the techniques is the first step towards successful communication.

Wrap Up

I sincerely hope you found this guide to be a good starting point on Speech Sound Disorders.

There is much more to dive into, but hopefully now you have a good foundation of understanding!

See you in the next one!


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Frequently Asked Questions

Does my child's speech sounds disorder affect his/her reading and writing skills?

Speech sound disorders can impact reading and writing skills because they involve phonetic awareness, or the understanding that words are made up of individual sounds.

If a child has trouble with certain speech sounds, they may struggle to sound out words when reading or spell words correctly when writing. It’s important to address these issues as early as possible to support your child’s academic success.

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What are some techniques to help my child pronounce specific speech sounds correctly?

Techniques vary based on the specific sound and the child’s needs. Some strategies include auditory awareness (listening to sound differences), visual cues (like watching the therapist’s mouth or looking at picture cards), and tactile feedback (like feeling the throat vibrate for certain sounds).

They might find success with playful techniques too, like pretending to be animals or robots.

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How does a speech-language pathologist help with speech sounds disorders?

A Speech-Language Pathologist, or SLP, works with children to identify speech sound issues, develop a customized therapy plan, and provide targeted exercises to improve their speech.

The traditional articulation therapy approach may involve demonstrating how to make certain sounds, practicing syllables, words, and sentences, and conversational speech. They use games or activities to make the process fun!

The SLP will also provide you with education and guidance to  help your kiddo at home.

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What are some activities to help my child practice speech sounds at home?

Reading together, singing songs, and playing rhyming games are all excellent ways to help your child practice their speech sounds. You can also practice specific sounds using toys or pictures (”lets find all the toys that start with /s/”). Your therapist can provide you with specific ideas or worksheets to help at home.

Make it fun and part of your everyday activities. Remember, practice, patience, and positive reinforcement are key.

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How can I tell if my child has a speech sounds disorder?

If your child struggles to make certain sounds, is consistently difficult to understand compared to same aged peers, or has frustration when not understood, they may have a speech sound disorder.

For example, they might substitute one sound for another (”wabbit” for “rabbit”). It’s normal for children to mispronounce sounds as part of their development, but when these patterns persist past the typical age range, treatment may be necessary.

It’s important to get a speech evaluation to determine the need for therapy. Early intervention can make a big difference!

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What are the typical milestones for speech sounds development?

Speech sound development is a gradual process. Babies typically start by cooing and making gurgling sounds. By their first birthday, they can often say a few simple words.

During toddlerhood, vocabulary expands rapidly, and by age 3 or 4, most children can use sentences and understand most of what's said to them.

Mastering all speech sounds may take until they're 7 or 8. Remember, children develop at different rates, and that's okay.

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