Phonological Disorder

What is phonological disorder?

Phonological disorder is a type of speech sound disorder. Children with this condition have trouble organizing the sounds that create speech. Examples include replacing certain sounds with other ones or dropping the first or last sound of a word.

Phonological disorders are a bit different from articulation disorders. Kids with articulation disorders have difficulty forming the sounds to create speech. Kids with phonological disorders have trouble organizing them.

All children make speech errors as they learn their native language. But kids with phonological disorders continue to make incorrect speech patterns after the expected age (usually around age 3 or 4).

Phonological disorders can occur on their own or alongside learning disorders like dyslexia. (In fact, they’re a main cause.) But not all children with phonological disorders develop dyslexia, and vice versa.

Working with a speech-language pathologist can successfully treat severe phonological disorders. Mild cases may go away on their own with time — usually by age 6.

Other names for phonological disorders include “phonological processing disorders” and “phonological speech disorders.”

Types of phonological disorders

There are two types of phonological disorders:

• Consistent: Your child makes the same predictable speech error across multiple words. For instance, maybe they always swap the “g” sound for a “d” sound. Or they might drop the first consonant of a word, like saying “at” when they mean “cat” or “ag” when they mean “tag.”
• Inconsistent: Your child mispronounces the same word differently each time. For instance, when trying to say “dog,” they might say “pog,” “nog” and “cog.”

How common are phonological disorders?

About 8% to 9% of young children living in the United States have some type of speech sound disorder. This includes articulation disorder and phonological disorder.

What are the symptoms of phonological disorder?

Symptoms vary for each person. Children with phonological disorder have speech patterns specific to them.

General examples include:

• Changing certain consonant sounds.
• Difficulty using multisyllabic words.
• Dropping a consonant sound.
• Saying only one syllable in a two-syllable word (like “kee” instead of “kitty”).
• Repeating the same syllable to simplify a word (like “baba” instead of “baby”).

What causes phonological disorder?

Healthcare providers don’t know why some children have phonological disorders and others don’t. There isn’t always a clear cause. They believe it could be a combination of genetic and environmental factors.

Risk factors

Even though the causes aren’t clear, there are risk factors that increase your child’s chances of developing phonological disorder. These include:

• A family history of speech sound disorders.
• Developmental delays.
• Gene variations that affect speech and language.
• Hearing loss.
• Neurological disorders.

What are the complications of phonological disorder?

Left untreated, phonological disorder can result in complications like:

• Academic challenges.
• Decreased comprehension.
• Delayed language development.
• Difficulty communicating with others.
• Poor reading skills.
• Trouble forming sentences.

How is phonological disorder diagnosed?

Your child will have an evaluation with a speech-language pathologist. During this visit, they may ask your child to:

• Speak certain words.
• Read aloud.
• Repeat phrases.

A speech evaluation can help your healthcare provider rule out other conditions like hearing loss, neurological conditions or intellectual disability.

How is phonological disorder treated?

Healthcare providers use speech therapy to treat phonological disorders. A speech-language pathologist will design a personalized treatment plan for your child based on their specific needs.

The goal of phonological disorder treatment is to unlearn sound errors that your child learned during language development. To do this, a speech-language pathologist will use activities that involve listening and speaking like:

• Arts and crafts.
• Board games.
• Flashcards.
• Hide-and-seek.
• Hopscotch.

Can phonological disorder be prevented?

You may be able to prevent phonological disorder in some instances. Here are some tips:

• Make sure your child gets routine screenings for hearing loss.
• Play games with your child that require listening and speaking.
• Read to your child every day.

Remember, speech disorders often occur for unknown reasons. If your child has phonological disorder, it doesn’t mean you’ve done something wrong. Sometimes, it just happens.

What’s the outlook for phonological disorder?

It’s possible to cure phonological disorder, especially for children who begin speech therapy at a young age. But outcomes can vary depending on the severity and when you seek treatment.

When should I see my healthcare provider?

Tell your pediatrician if you’re worried about your child’s speech and language development. If your child is 2 years old, you should understand about 50% of their speech. If your child is 4 years old, you should understand most of their speech.

Specifically, call your healthcare provider if your child:

• Can’t make certain speech sounds by age 6.
• Is embarrassed because of their speech challenges.
• Leaves out or substitutes certain speech sounds by age 7.

What questions should I ask my doctor?

It’s normal to feel concerned if your child receives a phonological disorder diagnosis. Here are some questions you might want to ask your healthcare provider:

• How severe is my child’s speech disorder?
• What are my child’s treatment options?
• How long will my child need speech therapy?
• What signs should I watch for at home?
• What are some things I can do with my child to help them?