A speech sound (articulation) disorder happens when a child has problems making some speech sounds correctly compared with most children of the same age. Articulation is how people make clear speech sounds (pronounce words) by moving the tongue, lips, jaw, and soft palate (the soft back part of the roof of the mouth).
A speech sound disorder may involve replacing, leaving out, or saying sounds incorrectly. It can make it hard for people to understand your child when they speak. This may be frustrating for your child. They may get embarrassed or worried about how they sound or avoid situations where they need to speak.
Many children improve their speech with therapy and practice. A speech-language pathologist (SLP), sometimes called a speech therapist, is a licensed professional who helps children with speech challenges. Getting help as early as possible can lead to better results.
How speech develops
Young children learn speech by copying the sounds they hear as caregivers talk about what they are doing during the day, sing songs, and read books out loud.
Children begin developing speech as infants. By 6 months of age, babies coo and play with their voices, making sounds like ”oo,” ”da,” ”ma,” and ”goo.” As babies grow, they begin to babble, using more consonant sounds like "b" and "k" with vowel sounds.
Children do not learn all speech sounds at the same time. Your child will listen to and copy sounds and word patterns. Over time, these sounds will become part of your child’s everyday speech.
General articulation milestones
Children usually learn each sound at a certain age range. But each child develops at their own pace. These are general milestones for making clear speech sounds:
By age 3: People should understand your child about 80% of the time.
By age 4: People should understand your child almost all of the time, but your child may still make mistakes.
By age 8: Your child should be able to say all speech sounds correctly.
Mistakes are a normal part of speech development. Most children will make errors as they learn to say new words. Some children may develop sounds earlier or later.
This chart gives a general guideline for speech sound development by age.
Signs of an articulation disorder
An articulation delay or disorder happens when errors continue past typical age ranges. These errors can occur at the beginning, middle, or end of a word. They make your child’s speech unclear or hard to understand. The 3 most common articulation errors are:
Replacing one sound for another, like “bacuum” for “vacuum.”
Leaving out a sound, like “bue” for “blue.”
Distorting a sound. This is when listeners can recognize the speech sound, but it is not correct. For example, a lisp is a distortion of the “s” sound and is caused when the tongue sticks out past the teeth (“thoap” instead of “soap”).
Causes of articulation disorders
For many children, the causes of articulation disorders are not known. Some children need extra support to learn how to make sounds correctly. In other cases, a medical condition or physical limitation could affect speech development. Causes of articulation disorders may include:
Illnesses that last a long time: Being in a hospital or having a serious illness may reduce the normal activities and interactions that help children learn speech and language.
Hearing loss: Children learn speech by listening. Hearing loss and ear problems, such as frequent ear infections, can slow speech development in young children.
Brain tumors: Tumors may affect the speech centers of the brain. They can also weaken muscles of the lips, palate, tongue, or vocal cords.
Structural differences: The physical structure of the jaw, tongue, lips, or palate can affect articulation. Structural differences from injuries or birth defects, such as a cleft lip or a cleft palate, can lead to speech delays or disorders.
Developmental or neurological disorders: Conditions such as stroke, cerebral palsy, autism, or brain injury can affect the brain or muscles involved in speech.
Diagnosis of articulation disorders
Speech evaluation
An SLP may listen to or record your child saying different words. They will examine how your child speaks and how well their mouth muscles work. The SLP will plan treatments based on your child’s needs.
Hearing test
An audiologist (hearing specialist) will check your child’s hearing. Hearing problems may cause your child to hear words incorrectly or only partially. This affects their speech development.
Treatment for articulation disorders
Speech therapy
An SLP can work with your child to:
Show them how to move their mouth, tongue, and lips to make speech sounds
Help them recognize which sounds are correct
Practice using the correct sounds in words, sentences, and stories
Practice at home
The SLP will give your child games and activities to do at home as part of a therapy plan. A speech therapy plan is tailored to your child’s age, needs, and goals. Activities may include repeating sounds and words. Work with your child on making speech sounds.
How you can help your child
You can help your child practice speech during daily activities.
Talk to your child during playtime. This is a chance to make talking fun and model correct speech sounds.
When talking, face your child and place yourself near their eye level. Speak clearly and at a natural pace.
Do not interrupt or constantly correct your child. This may frustrate them.
Do not reinforce errors by imitating them. Instead, model the correct way to make the sound. For example, if your child says, “That’s a wellow duck,” you say, “Yes, that is a yellow duck. A yellow baby duck. The sun is yellow, too.”
Praise your child for saying the sound correctly or for trying.
Read to your child. Use reading to surround your child with the targeted sound. For example, read Goodnight Moon if the child is working on the /g/ sound.
Use meals, bath time, bedtime, playtime, and other daily routines to work on speech. These activities can be great learning moments.
Other ways to help
Work with your child’s care team and school to make an individualized education program (IEP) or 504 plan if needed. This can give your child extra help at school to make sure they are learning speech sounds correctly.
Follow the SLP’s instructions for activities to do at home with your child. Make sure you know how often to practice.
Let others know about your child’s speech needs and simple ways they can help.
Join a local or online group of other caregivers of children with articulation disorders.
If you have concerns about your child’s speech, talk to your care team. It is important to find out and treat any physical conditions that may be contributing to articulation delays.
Questions to ask your care team
What are common articulation problems in children?
What causes speech delays?
What are the different types of speech disorders?
What type of speech disorder does my child have?
Does my child need speech-language therapy?
How will we track my child’s progress?
What can I do at home to help my child?
When should I ask for more help from the care team?
Key points about articulation disorders
Articulation is how people make speech sounds. Articulation errors are a normal part of speech development.
Speech sound errors or articulation disorders can happen for a variety of reasons. Often, the cause is not known.
There are ways you can help your child with speech sounds.
Your care team may refer you to a speech-language pathologist for speech therapy to help with an articulation delay or disorder.
Work with your child at home to practice speech sounds. Involve friends and family in helping your child.
If you are worried about your child’s speech, talk with your care team or a speech‑language pathologist.
Speech and language therapy helps children improve communication, language, and feeding skills. Learn how a speech-language pathologist (SLP) can help your child.
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