Speech-Sound Disorders Explained

What is Speech Sound Disorder

Speech sound disorder is a type of communication disorder which is characterised by difficulty with production or phonological representation of speech sounds.

Children are able to produce almost all speech sounds by the age of 4-6 years. However, after that any persistent difficulty in producing specific sounds or words correctly experienced may be a result of Speech Sound Disorder. Developmental effects and influence of accent or dialect on speech are not to be characterised as language or speech-sound disorders.

Speech sound disorder is an umbrella term that includes articulation and phonological disorder:

  • Articulation disorder is characterised by inability to produce speech sounds e.g. distortions and substitutions. 
  • Phonological disorder is characterised by a child’s difficulty in understanding the sound system and speech rules of their language.

Speech sound disorders are considered to be idiopathic i.e. there are no known causes for them. However, some experts believe that speech sound disorders can be a result of an underlying:

  • Motor-neurological disorders e.g. apraxia
  • Structural abnormalities e.g. cleft lip or other orofacial anomalies 
  • Sensory/perceptual disorders e.g. hearing impairment 
Risk factors

 The following factors may put a child at a greater risk for developing speech sound disorders

  1. Family history: A child is at a greater risk to develop a speech sound disorder if they have one or more family members with speech and/or language difficulties
  1. Gender: According to studies prevalence of Speech sound disorders is higher in males than in females.
  1. Prenatal/perinatal problems: Complications during pregnancy and during delivery may lead to speech sound disorders

Signs and symptoms of Speech Sound Disorders include the following:

  • Certain speech sounds are omitted or deleted (e.g. Saying "poon" for "spoon").
  • One or more sounds are substituted (e.g. Saying “wadio” instead of “radio”).
  • Extra sounds are added into a word (e.g. Saying “puhlay” instead of “play”.
  • Sounds are altered or distorted (e.g. Saying “thith” instead of “this”).
  • Weak syllables are deleted from a word (e.g. “bay” instead of “baby”).
  • Simplifying a word by repeating 2 syllables (example: “bobo” instead of “bottle”).

Additional symptoms include a hoarse, raspy or nasal voice, abrupt changes in the pitch or volume of speech, and shortness of breath while speaking.  


Those diagnosed with Speech sound disorders usually require speech therapy for alleviating symptoms. The earlier the intervention in the form of therapy starts the better are the results. The treatment plan usually depends on a child’s age and type and severity of the disorder. 

A comprehensive treatment plan is designed after assessments and evaluations by a speech-language pathologist. An SLP selects appropriate targets for therapy and treatment strategies based on the intervention goals to be addressed during sessions. An SLP usually aims to achieve the following goals when it comes to speech sound disorders:

  • Notice and fix speech sounds produced incorrectly.
  • Learn the correct way to speak. 
  • Practice speech (especially words and sounds articulated incorrectly).
  • Stabilising production of target sounds.
  • Encouraging self-monitoring of speech and self-correction of errors.

They may achieve these goals through therapy with different activities or playing games. In addition to that an SLP might collaborate with teachers and parents of the child to facilitate the child's learning progress.

In addition to speech therapy an SLP might refer your child to a health-care provider if the disorder is caused by some structural deficits that require surgical intervention. 

Lastly mental-health counselling may also help with building self-esteem and reducing anxiety associated with speaking.

How can I help my child?
  • Ask questions from an SLP in order to understand the problems your child has.
  • Accompany your child during treatment.
  • Follow the suggestions your SLP makes.
  • Discuss your child’s situation at their school and with family members. 
  • Discuss your child’s progress with the SLP.

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