Speech sound disorder

In order to produce speech sounds, one needs the ability to coordinate the jaw, tongue, and lips with breathing and vocalizing.

The phonological awareness of speech is also crucial. Children need to understand and differentiate the various sounds, and grasp the rules for putting these sounds together.

Children with speech sound disorder typically have trouble pronouncing the sounds in words.They may leave certain sounds out, add sounds, change a sound or substitute one sound for another. For instance, saying “wadio” instead of “radio”, or “coo” instead of “school”. The terms articulation disorder and phonological disorder may also be used to describe speech sound disorder.

It’s important to note that the acquisition of speech sounds is a developmental process, and children often demonstrate "typical" errors and phonological patterns during this acquisition period.

Young children may say some sounds incorrectly as they learn to speak, and this shouldn’t be considered a speech sound disorder. For instance, mistaking a "w" sound for an "r" and saying "wabbit" for "rabbit." They may typically leave sounds out of words too, like saying "nana" instead of "banana." Some children also learn certain sounds earlier, such as “p”, “m” or “w”. Sounds like “z”, “v” or “th” may take longer to learn.

As a general guide, children master most speech sounds correctly by the age of 4. If they do not say sounds by then, they may have a speech sound disorder.

Some children may grow out of articulation difficulties without intervention. However, articulation problems can continue beyond the age of six, with some not being able to close the gap on their own without any specific intervention.

It’s hard to determine specific causes for speech sound disorder. Myriad factors may contribute, including a developmental disability, hearing problems, injury to the brain, disorders affecting the nerves connected to speech or physical defects like a cleft palate or cleft lip. There is some evidence that speech sound disorder runs in families too.

Some common symptoms of speech sound disorder include:

• Repeating or prolonging sounds
• Distorting sounds. E.g. saying “thith” instead of “this”
• Adding sounds or syllables to words. E.g. saying “puhlay” instead of “play”
• Leaving out sounds from words
• Rearranging syllables
• Difficulty pronouncing words correctly
• Speaking very softly, or with a hoarse or raspy voice

Speech difficulties can limit a child’s ability to effectively participate in academic, social and eventually occupational environments.

As learning occurs through the process of communication, being unable to communicate well with classmates and teachers in an educational setting may impede their success in school.

The persistence of speech sound disorder into one’s early school years impacts literacy development too. This is seen as phonological skills, and spoken language in general, form a pivotal foundation for learning to read and write. Spoken and written language are intertwined – each builds on the other to result in language and literacy competence.

Studies also back up the fact that children who entered school with speech sound disorder usually have poorer emergent literacy skills. Additionally, they experience less self-confidence and a reduced engagement in learning activities involving speaking. Understandably, presentations in class are especially challenging.

Children with speech sound disorder may also get frustrated about speaking when they aren't understood. This can lead to a withdrawal from interactions with others, or even a reluctance to attend school or be immersed in other social environments.

Our speech therapist will assess your child in the following areas: 

• Individual speech sounds in single words and in connected speech (using formal and or informal screening measures)
• Screening of oral motor functioning (e.g.. strength and range of motion of oral musculature)
• Orofacial examination to assess facial symmetry and identify possible structural bases for speech sound disorders (e.g. submucous cleft palate, malocclusion)
• Informal assessment of language comprehension and production

If needed, your child will be referred to other professionals. For example, an audiologist if hearing loss is suspected, or a psychologist if other learning difficulties are suspected. Once an official diagnosis is made, our speech therapist will devise an intervention plan.

Getting assessed and having early intervention provides children with the best opportunities for normalising their speech. A close monitoring of their functional improvement also helps refine management strategies. 

With the support of a speech therapist, children with speech sound disorder can build the appropriate skills they need to succeed in school and in life. Treatment also helps them boost their self-esteem and self-confidence, which is key to improving their quality of life. 

In many cases, children with speech difficulties do respond well to treatment, and show marked improvements in their speech over time.