WHAT SPEECH SOUND DISORDER DOES MY CHILD HAVE?

by Lauren Schrotenboer, MA, CCC-SLP

Is it Apraxia, articulation or phonological?

You know that your child is difficult for you and/or others to understand, but you’re still not quite sure what the problem is. Perhaps your speech-language pathologist (SLP) gave your child a diagnosis and you’ve done your follow-up research; however, you continue to have questions and are unsure what the treatment process looks like. Let’s dig into each speech sound disorder to improve your understanding of childhood apraxia of speech, articulation disorders, and phonological disorders.

Childhood Apraxia of Speech (CAS)

CAS is considered a motor programming or sequencing disorder. A child with CAS has difficulty with the consistency and precision of movements underlying speech without a neuromuscular deficit such as having abnormal facial tone or reflexes. Because they have difficulty with planning and programming movements needed for speech, they often exhibit inconsistent speech sound errors and irregular prosody.

The following are common characteristics of CAS:

• Inconsistent errors when producing consonants and vowels
• Lengthened transitions between sounds and syllables
• Irregular prosody, or rhythm of speech (rate, pitch, loudness)
• Vowel distortions
• Addition of “uh” in the middle and at the end of words
• Easier to produce automatic phrases (ie. “I love you.” “My name is _____.”)
• Voicing errors
• Omitting consonants at the beginning of words

Articulation Disorder

An articulation disorder or delay is typically associated with structural and motor-based difficulties. For example, children with cleft palate or craniofacial anomalies may have difficulty producing certain sounds due to structural deficits. The sound errors are not necessarily patterned in nature, but result from difficulty and/or inability to sequence/produce certain consonants and vowels. An articulation disorder affects speech at a phonetic level.

The following are common characteristics of an articulation disorder:

• Difficulty producing /r/ or /l/ in words (ie. saying “wabbit” for “rabbit”)
• Distortion of /s/, also known as a lisp
• Producing non-nasal sounds through the nose

Phonological Disorder

A phonological disorder results from an impaired phonological representation of speech sounds in the brain. Children with phonological disorders typically display patterned errors when speaking that simplify adult speech. They may have difficulty understanding and perceiving the difference between speech sounds. Therapy targets building their awareness of phonemic rules through discriminating between different speech sounds and their placement in words. Treatment also focuses on breaking their mislearned patterns of spoken language by learning correct sound productions.

The following are common characteristics of an articulation disorder:

• Consistently omitting or deleting sounds at the beginning or end of words (ie. “nail” for “snail,” “ha” for “hat”)
• Patterned Substitutions (ie. “dat,” for “that,” “dod” for “dog”)
• Whole-word/syllable errors. A syllable is repeated or deleted (ie. “tephone” for “telephone,” “wawa” for “water”)
• Voicing unvoiced sounds (ie. “bat” for “pat,” “gat” for “cat”)

Never hesitate to ask your speech-language pathologist for more information about these speech sound disorders. Asking questions will build your understanding and help your child succeed!