Speech Sound Disorder

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Articulation Disorder Speech Therapist teaching child

Articulation Disorder Speech Therapist

What is speech sound disorder?

Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segments—including phonotactic rules governing permissible speech sound sequences in a language.

speech sound disorder chart

What causes speech sound disorder?

There are two main categories of speech sound disorders: organic and functional. Organic disorders stem from issues related to motor/neurological, structural, or sensory/perceptual functions. On the other hand, functional disorders, which are idiopathic, have unknown causes.

Organic Speech Sound Disorders

Organic speech disorders can stem from a variety of causes, such as motor or neurological issues (like childhood apraxia of speech and dysarthria), structural abnormalities (such as cleft lip/palate or other physical deficits), and sensory issues (like hearing loss).

 

Functional Speech Sound Disorders

Speech sound disorders can be classified as either motor or linguistic in nature. Articulation disorders are concerned with the physical production of speech sounds, while phonological disorders involve errors in the rules governing speech sound patterns. Articulation disorders involve mistakes like distortions or substitutions of individual sounds, while phonological disorders involve errors that follow predictable patterns of sound errors (such as fronting, stopping, and final consonant deletion) that impact multiple sounds. Distinguishing between articulation and phonological disorders can be challenging, leading many researchers and clinicians to use the general term speech sound disorder for speech errors with unknown origins.

The root of functional speech sound disorders remains a mystery, yet researchers have explored various potential risk factors.

Some common risk factors include:

  • Speech sound disorders are more prevalent in males than in females when considering gender differences.
  • Issues during pregnancy and childbirth, including maternal stress, infections, premature delivery, and low birth weight, have been linked to delays in acquiring speech sounds and speech disorders.
  • A strong family link has been found between speech disorders in children and a history of speech and language issues in their parents or siblings.
  • Chronic fluid buildup in the middle ear, known as persistent otitis media with effusion, has been linked to delayed speech development due to potential hearing loss.

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What are some signs and symptoms of speech sound disorder?

A child suffering from a speech disorder might face challenges in terms of comprehensibility. They demonstrate a range of articulation errors, which can be categorized into four distinct types:

  • Addition: Including unnecessary sounds or syllables into words that don’t naturally have them, like saying “puh-lay” instead of “play.”
  • Distortion: Modifying an audio event that can create the perception of a speech impediment, specifically when the “s” sound is pronounced as “th”.
  • Omission: Some people exclude specific sounds, like “sc,” from their speech when pronouncing words such as “school” or “scratch.”
  • Substitution: The act of regularly exchanging one sound for another, such as replacing “s” with “th” or using “w” instead of “r”.

If a child begins to feel self-conscious due to an articulation disorder, they may display certain behaviors:

  • Do not speak or interact with others verbally.
  • Be silent or show shyness.
  • Discomfort can arise during verbal communication.
  • Stop using specific terms completely.
  • Struggling with insecurities and self-doubt.

 

How is speech sound disorder diagnosed?

To rule out other potential causes, your healthcare provider will conduct a physical examination and hearing test if your child is experiencing a speech disorder.

If a medical condition is not the underlying cause of the speech disorder, your healthcare professional will refer you to us, a speech-language pathologist (SLP). 

We will evaluate your child using different methods:

  • Evaluate your child’s ability to speak fluidly by engaging in meaningful conversations with them.
  • Conduct diagnostic testing in accordance with established standards to identify issues.
  • Please review your child’s medical history, including factors such as premature birth, previous instances of ear infections, and any other relevant information.
  • Investigate the occurrence of speech disorders in the family history.
  • An examination of the dental and palatal conditions is necessary to assess any potential impacts on the structure of the mouth.
  • Take into consideration your child’s accent and dialect.
  • Observe the movements of your child’s mouth while they speak.

Medications are not usually prescribed for direct treatment of stuttering. However, medications can be used to effectively treat mental health issues such as anxiety or depression, which often occur alongside and worsen stuttering.

Treatment for speech sound disorder?

The broad term “speech sound disorder(s)” is used to refer to functional speech sound disorders, including those related to the motor production of speech sounds (articulation) and those related to the linguistic aspects of speech production (phonological).

It is often difficult to cleanly differentiate between articulation and phonological errors or to differentially diagnose these two separate disorders. Nevertheless, we often talk about articulation error types and phonological error types within the broad diagnostic category of speech sound disorder(s). A single child might show both error types, and those specific errors might need different treatment approaches.

Historically, treatments that focus on motor production of speech sounds are called articulation approaches; treatments that focus on the linguistic aspects of speech production are called phonological/language-based approaches.

Articulation approaches target each sound deviation and are often selected by the clinician when the child’s errors are assumed to be motor based; the aim is correct production of the target sound(s).

Phonological/language-based approaches target a group of sounds with similar error patterns, although the actual treatment of exemplars of the error pattern may target individual sounds. Phonological approaches are often selected in an effort to help the child internalize phonological rules and generalize these rules to other sounds within the pattern (e.g., final consonant deletion, cluster reduction).

Articulation and phonological/language-based approaches might both be used in therapy with the same individual at different times or for different reasons.

Both approaches for the treatment of speech sound disorders typically involve the following sequence of steps:

  • Establishment—eliciting target sounds and stabilizing production on a voluntary level.
  • Generalization—facilitating carry-over of sound productions at increasingly challenging levels (e.g., syllables, words, phrases/sentences, conversational speaking).

Maintenance—stabilizing target sound production and making it more automatic; encouraging self-monitoring of speech and self-correction of errors.

During speech therapy, we use various tasks and drills to help your child improve their communication skills:

  • Identify the sounds beyond their abilities.
  • Enhance their sound production techniques.
  • Explore various methods for controlling speech motor functions, such as tongue manipulation and lip shaping.
  • Improve the muscles involved in verbal communication.
  • Improve your sound formation skills at home.

If your child has a speech disorder, parents are advised to support their child to:

  • Try not to focus too much on your concerns about the issue, as it may make it worse and increase the child’s self-consciousness.
  • Avoid situations that may lead to stress in social settings, if possible.
  • Pay careful attention when the child is speaking, maintain a sincere gaze, avoid interrupting, and show affection and acknowledge their presence. It is advisable not to finish their sentences.
  • Set aside a specific time for engaging in conversation.

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