Articulation Disorder

Articulation disorder is a common condition when your child can’t make specific sounds. For example, they may always replace “r” with “w” or “th” with “s.” The disorder isn’t related to any issues with their brain, mouth or hearing. A speech-language pathologist can diagnose the condition and help your child communicate clearly using speech therapy.


What is articulation disorder?

Most children learn to make all speech sounds by age 4 or 5. Children who have trouble speaking clearly after that age may have a speech sound disorder. One type of speech sound disorder is articulation disorder, which involves problems producing specific speech sounds.

Articulation is the process humans go through to produce sounds, syllables and words. A child with articulation disorder may be unable to produce certain sounds or form particular sounds incorrectly. It can make the child’s speech hard to understand and affect socialization and learning.

The condition is sometimes called functional speech disorder or articulation delay.

What is the difference between articulation vs. phonological disorder?

Articulation disorder and phonological disorder are similar and often confused. But it’s important to differentiate between the two because treatments vary.

Children with articulation disorder have trouble with the motor functions required to make certain speech sounds. They can’t coordinate their lips, tongue, teeth, palate (roof of their mouth) and lungs to produce certain sounds. They may form distorted speech sounds or swap out sounds they can’t make. Articulation disorder examples include not forming the sound “th” and always using “f” instead.

With phonological disorder, children can produce sounds correctly but have trouble putting sounds together correctly. For example, your child may be able to make the sound “d” on its own. But when your child tries to say a word that starts with “d,” they swap it out with a “g.”

Your child can have both types of disorders at the same time.

Who might get articulation disorder?

Articulation disorder occurs in children. If it’s not treated, the disorder may last into adulthood. If an adult develops a speech sound disorder, it’s due to another reason (traumatic brain injury or stroke).

Articulation disorders are more common in boys than girls for unknown reasons. A child is more likely to have a speech sound disorder if the mother had complications during pregnancy or delivery. A speech sound disorder is also more likely in a child whose family has a history of the condition.

How common are speech sound disorders?

Speech sound disorders are common, affecting 8% to 9% of children.


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Symptoms and Causes

What causes articulation disorder?

Articulation disorder has no known cause. It doesn’t mean something is wrong with your child’s brain, nerves, lips, tongue, teeth, jaw, lungs or hearing.

There are other types of speech disorders, including organic, developmental or acquired. These are due to other conditions, such as structural abnormalities or hearing impairment.

What are some signs and symptoms of articulation disorder?

A child with articulation disorder may be difficult to understand. They exhibit one or more of four types of articulation errors:

  • Addition: Adding sounds or syllables to words that don’t belong there (for example, “puh-lay” instead of “play”).
  • Distortion: Changing a sound, which might seem like a lisp (when “s” sounds like “th”).
  • Omission: Leaving certain sounds out of their speech altogether (for example, never using “sc” in “school or “scratch”).
  • Substitution: Always substituting one sound for another (for example, using “s” instead of “th” or “w” in place of “r”).

If your child becomes self-conscious of articulation disorder, they may display certain behaviors:

  • Avoid reading aloud or speaking to other people.
  • Become quiet or seem excessively shy.
  • Get frustrated when speaking.
  • Stop saying certain words altogether.
  • Struggle with confidence and self-esteem.


Diagnosis and Tests

How is articulation disorder diagnosed?

If your child has a speech disorder, your healthcare provider will conduct a physical exam and hearing test. These steps help rule out other conditions.

If a medical issue isn’t causing the speech disorder, your healthcare provider will refer you to a speech-language pathologist (SLP). An SLP is an expert in speech, language and communication problems.

An SLP will evaluate your child in several ways:

  • Ask your child to make certain sounds and form specific words.
  • Chat with your child to assess connected speech during conversation.
  • Perform standardized diagnostic testing.
  • Consider your child’s medical history, such as premature birth, previous ear infections and more.
  • Discuss any family history of speech disorders.
  • Look at the mouth’s structure for any issues that may be contributing (for example, with their teeth and palate).
  • Take your child’s accent and dialect into consideration.
  • Watch the movement of your child’s mouth during speech.

Their SLP will use the observations and diagnostic testing to diagnose articulation disorder or another type of speech disorder.

They also may rate the severity of the articulation disorder from mild to severe. There are several ways to rate severity:

  • How much of your child’s speech the SLP can understand.
  • Numbered scale, such as 1 to 10.
  • Percentage of consonants correct.

Management and Treatment

How do you fix articulation disorder?

To treat articulation disorder, your child’s SLP will recommend speech therapy. Your child will work on speech during regular appointments and have assigned exercises and activities to do at home.

During speech therapy, your child’s SLP uses a variety of activities and exercises to help them:

  • Identify the sounds they can’t make.
  • Correct the way they create sounds.
  • Re-learn ways to control the motor parts of speech (for example, moving their tongue, shaping their lips).
  • Strengthen the muscles involved in speech.
  • Practice sound formation at home.



How can I prevent articulation disorder?

There aren’t any strategies to prevent articulation disorders. But you can prevent a speech disorder from becoming worse by seeking early treatment.

Outlook / Prognosis

What’s the outlook for a child with articulation disorder?

Early diagnosis and therapy can help prevent speech problems from worsening or affecting learning and socialization.

A child with articulation disorder can learn to communicate clearly. More severe cases often require longer courses of speech therapy.

Living With

When should I talk to my pediatrician about speech disorders?

If you have any concerns about your child’s speech or ability to communicate, talk to your pediatrician. This is particularly important if your child:

  • Has any behavioral issues related to talking.
  • Isn’t forming certain sounds correctly by age 4 or 5.
  • Stops making particular sounds or words.

A note from Cleveland Clinic

A child with articulation disorder has trouble producing certain sounds involved in speech. If your child reaches age 4 or 5 and still can’t form certain sounds, talk to your pediatrician. They’ll determine whether there are any medical issues involved or recommend speech therapy.

Medically Reviewed

Last reviewed on 07/08/2022.

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