Articulation Disorder

Articulation disorder is a speech impairment. It makes it hard for your child to pronounce or use some sounds or words. Specialists may say your child has a functional speech disorder or an articulation delay.

Articulation disorder may make it hard for others to understand what your child is trying to say. It can affect your child’s ability to learn or develop relationships. Speech therapy may help your child speak more clearly.

Symptoms of articulation disorder

There are four types of articulation issues:

• Addition: Your child may add extra sounds or syllables to words. For example, the word “play” may sound like “puh-lay.”
• Distortion: A sound, like “th,” may come out sounding fuzzy. You may recognize it, but feel like it’s not quite right.
• Omission: They may not use certain sounds. For example, they may say “hool” instead of “school” because they don’t use the “sc” sound.
• Substitution: They may switch one sound for another. In this case, the term “rascally rabbit” would sound like “wascally wabbit.”

It’s normal for a young child to substitute words or change sounds. Most children stop doing this by the time they’re 4 or 5 years old.

Articulation disorder causes

Children often have this disorder for no obvious reason. But experts believe several factors may increase the risk, including:

• Biological family history: Having other family members with speech disorders may increase the chance that your child will, too.
• Chronic ear infections: Children with frequent middle ear infections are more likely to have articulation disorder.
• Pregnancy issues: Infections and stress during pregnancy, early delivery and low birth weight may increase the chance of articulation disorder.
• Sex: Males are more likely to have the disorder.

Less frequently, other medical issues can cause articulation disorder, including:

• Dysarthria: This is a motor speech disorder that can happen if something damages your child’s nervous system. Examples are cerebral palsy, stroke or traumatic brain injury.
• Hearing loss: Children learn to talk by listening to others and imitating them, which is why hearing loss may lead to speech issues.
• Genetic syndromes: Down syndrome and fragile X syndrome are examples of genetic issues that cause developmental delay issues, including articulation disorder.
• Orofacial myofunctional disorders (OMD): OMDs can occur when your child’s facial movements affect their speech. Dental issues like severe overbite or underbite may cause OMD. Children over 3 who use a pacifier or suck their thumbs may develop this condition.
• Physical differences: Having a cleft lip, cleft palate or a short soft palate can lead to articulation disorder.

Complications of articulation disorder

This condition can affect your child’s quality of life. As they get older, your child may become upset if people can’t understand them. They may feel self-conscious about speaking. They may avoid reading aloud, talking to others or saying certain words.

How doctors diagnose articulation disorder

Your child’s pediatrician will do a physical exam and hearing test. Depending on your child’s situation, their pediatrician may refer you to a speech-language pathologist (SLP). This is a specialist who diagnoses and treats speech, language and communication issues.

An SLP will check your child’s mouth for issues with their teeth or palate. They’ll ask about your child’s medical history, including risk factors like preterm birth or a family history of the condition. They may:

• Ask your child to make certain sounds and form specific words.
• Chat with your child to see if they can carry on a conversation. Their SPL may call this connected speech.
• Watch how your child moves their mouth when they speak.

Articulation disorder may be mild or severe. For example, the disorder may be mild if your child makes one or two sounds that are wrong. But they may have a severe form if they make many incorrect sounds. Specialists consider several factors to make a diagnosis, including:

• How much they’re able to understand what your child says
• The percentage of consonants your child can pronounce

They’ll also rate your child’s speech on an articulation disorder scale. The scale measures how children produce speech sounds, like how often a child substitutes words. Your child’s SLP will use one of several standard tools to evaluate your child’s speech. They’ll explain the testing process and what the results mean.

How is articulation disorder treated?

Your child’s speech-language pathologist will identify the sounds your child can’t make. They’ll develop exercises and activities that target your child’s issues. For example, your child’s SLP may:

• Correct how your child creates sounds.
• Show them how to practice making difficult sounds.
• Show your child how to move their tongue or shape their lips.

When should I talk to my child’s healthcare provider?

In general, you should be able to understand about 50% of what your child says by the time they’re 2. By age 4, you should understand most of your child’s speech.

What can I expect if my child has articulation disorder?

In general, speech therapy can help most children to speak more clearly. Your child’s speech may improve after a few sessions. Another child may need more intensive or long-term therapy. Ask your child’s speech-language pathologist to explain how speech therapy may help your child.

Can a child outgrow articulation disorder?

Some children will outgrow the condition. But the longer your child makes sound errors, the harder it can be to help them learn to speak correctly.

What’s the difference between articulation disorder and phonological disorder?

Children with articulation disorders have trouble pronouncing some words or making certain sounds. For example, your child may say “fink” when they mean to say “think” because they can’t pronounce the “th” sound.

With phonological disorder, your child has difficulty using sounds in patterns. This can affect entire categories of sounds. For example, they may not say any final consonants. So, the word “hat’ becomes “ha.” The word “bad” becomes “ba.”