Alexis Irazoque, M.S., CCC-SLP
If you have a young child, it’s likely you've heard them mispronounce words. How cute is it when your toddler says “Let’s pway outside!”?
As adorable as it is, there does come a point where, clinically, these speech mispronunciations are classified as an articulation disorder. But how do you know if your child has speech articulation problems? Let’s explore the causes and signs of this speech sound disorder so you can feel confident spotting possible problems in your child’s speech. We’ll also explain how speech therapy helps improve articulation.
What is an articulation disorder?
“Articulation” refers to how we make speech sounds. We produce sounds using the coordinated movements of our lips, tongue, teeth, palate (top of the mouth), and respiratory system (lungs).
Children with articulation disorders have difficulty using these motor functions to physically produce the correct speech sounds. As a result, they’re unable to form clear, legible words past a certain age. This makes their speech hard to understand.
The prevalence of speech sound disorders in young children is about 8% to 9%. By first grade, about 5% of children have noticeable speech problems.
How do you know if your child has an articulation disorder?
As we mentioned, it’s completely normal for toddlers and young children to pronounce sounds wrong as they’re growing! However, while all children develop at different speeds, there are certain sounds they should be able to make correctly by certain ages. If a child can’t pronounce certain sounds by an expected age, you may hear these errors in their speech:
Errors due to differences in their orofacial structures, such as in their mouth, tongue, or teeth (saying “hip” instead of “ship”)
Distorting or mispronouncing sounds in words (saying "thith" instead of "this")
Swapping sounds in words (saying "wadio" instead of "radio")
What causes speech articulation problems?
Parents and caregivers often want to know what’s causing problems with their child’s speech. Often, a speech sound disorder has no known cause.
In other cases, several factors could be involved. They include differences in orofacial structures, hearing problems, and genetic disorders such as Down syndrome.
According to the American Speech-Language-Hearing Association (ASHA), some things may increase a child’s likelihood of developing a speech sound disorder. These risk factors include:
Gender: Speech sound disorders are more common in males than in females.
Pre- and perinatal problems: Maternal stress or infections during pregnancy, complications during birth, preterm delivery, and low birthweight are associated with speech sound problems.
Family history: Children who have parents or siblings with speech or language difficulties may be more likely to have a speech disorder.
Why is clear speech so important?
Clear, developmentally appropriate articulation is important because it helps people communicate as best as they possibly can. Children with speech sound problems may not always be understood by other people, especially unfamiliar listeners who don’t know them well. These children may feel self-conscious and struggle socially and academically once they begin school.
In addition, studies have shown that children with poor speech sound skills may have difficulty with reading and other literacy tasks as they get older. This is another huge reason to identify and treat any issues with articulation as soon as possible.
How does speech therapy work for articulation problems?
Speech therapists work with children to correct speech articulation problems. With speech therapy, many children see major improvement in their ability to speak clearly. A speech therapist will identify your child’s articulation problems, develop an individualized treatment plan, and work with you to improve your child’s speech articulation.
Speech therapy for articulation involves working through something called a “speech sound hierarchy.” This is how your child will learn to say each sound correctly. Here’s what a speech sound hierarchy looks like, using the /s/ sound as an example:
Isolation level: Saying the sound by itself (sssssssss)
Syllable level: Combining the sound with a vowel (say, see, sigh, so, sue)
Word level: Using the sound within a word (sun, dinosaur, house)
Phrase level: Stringing several /s/ words together into short two- or three-word phrases (hot soup, sit down)
Sentence level: Saying longer, more complex sentences that include /s/ words (The sun sets at 6 pm)
Conversation level: The ability to use /s/ words in connected speech in conversation, 100% accurately
To move through this hierarchy, your speech therapist will first teach your child articulatory placement. This includes things like tongue placement, lip shape, voice use, and tongue tension. The goal is for your child to learn the correct “motor pattern” for accurately saying the sound. When the child can say the sound correctly in isolation (for example, “sss”), it lays the foundation for saying the sound correctly at more complex levels (“hot soup”).
In some cases, your speech therapist may begin to practice at a higher level, such as the word level rather than in isolation. And as your child shows readiness, your speech therapist will guide them to practice a variety of words with the sound in different positions (such as sun, dinosaur, or house). Your therapist will use their clinical judgment to achieve the quickest progress for your child.
Regardless of the level, your speech therapist will give your child “multimodal cues” to help them learn correct articulation. Multimodal cues include helpful prompts such as:
Talking about how to shape your mouth, lips, and tongue
Modeling, or demonstrating, tongue placement
Using a gesture to represent the sound
Asking you or your child to touch certain parts of the mouth to show the tongue where to go
How do you find a speech therapist for articulation?
If your child’s speech is hard to understand, talk with your pediatrician to get a referral for speech therapy. They will likely have some recommendations for speech therapists.
You can also talk with friends or family with children who have received speech therapy. There’s nothing like getting a recommendation from someone you know!
If you choose to use insurance, talk with your insurance company for a list of speech therapists who are in-network with your plan.
Ideally, you want a speech therapist who will work well with your child–and you. Your speech therapist should be focused on making therapy fun and engaging for kids. They should also keep you updated on your child’s progress and provide weekly practice activities you can do at home. So spend some time researching and finding the best speech therapist for your child. If you’d like to talk with an Expressable speech therapist, please get in touch for a free consultation call!
