Speech sound disorders are conditions where a child's articulation or pronunciation is delayed or deviant from normal speech sound development. There are five types of speech sound disorders:
Organic speech sound disorder
Articulation problems that are associated with structural abnormalities or known impairments such as cleft lip and palate, hearing impairment or brain injury.
Functional speech disorder
Difficulties in learning to make specific speech sounds.
Developmental phonological disorder
Difficulties using appropriate speech patterns. E.g. "tar" for "car" or "dock" for "sock"
Developmental apraxia of speech
Difficulties planning and coordinating lips, tongue, and jaw to produce speech sounds.
Developmental dysarthria
Motor speech disorder involving problems with strength and control of the speech musculature. Dysarthria is typically seen in children with cerebral palsy, traumatic brain injury, etc.
The precise causes for functional speech disorders, developmental phonological disorders and developmental apraxia of speech are unknown.
Developmental dysarthria is caused by impaired nerve and muscle function.
Some conditions such as cleft palate, hearing impairment, certain syndromes, tongue-tie, paediatric stroke will affect a child's clarity of speech.
A child with a speech disorder may have one or more of these signs and symptoms:
Omissions or deletions
Definition: Certain sounds are not produced but omitted or deleted.
Examples: "boo" for "book" and "soon" for "spoon"
Substitutions
Definition: One or more sounds are replaced with a different sound.
Examples: "bat" for "pat", "dood" for "good" and "wabbit" for "rabbit"
Additions
Definition: One or more sounds are added or inserted into a word.
Examples: "buhlack" for "black" or "doguh" for "dog"
Distortions
Definition: Sounds are altered or changed.
Examples: An interdental "s" whereby the "s" sound is being produced with the tongue sticking out in between teeth
Syllable-level errors
Definition: A syllable is repeated or deleted.
Examples: "dada" for "dad" or "te_phone" for "telephone"
Prosody errors
Definition: Inappropriate use of stress, intensity, rhythm, and intonation during speech
An assessment by a speech therapist is necessary to determine the type of speech disorder(s) a child with unclear speech has. Other medical or allied health professionals may also need to be involved in the assessment and management.
Each speech disorder requires a different type of treatment, and each treatment programme is individually tailored to the needs of the particular child.
Parents play an important role in their child's therapy which continues outside of the clinical setting. This includes practising the recommended speech strategies and activities with the child at home and following up on therapy visits regularly.
Children typically learn to produce different speech sounds gradually. Below is a general guide of speech sound development (consonant sounds):
All children make predictable pronunciation errors when they learn to speak like adults. A child will generally have speech that is normally clear:
Click here to access our Find A Doctor directory for a list of doctors treating this condition across our NUHS institutions.
