Thursday, May 4, 2017

Therapy Tip: Help! My Child Pronounces Speech Sounds Wrong!

Welcome to Therapy Thursday! This is the day that I give a tip based upon my experience as a pediatric speech-language pathologist and a mother of a child with special needs. Today's tip is:

I'm Worried About My Child's Pronunciation of Speech Sounds! What do I do?

Photo By Chaojoker - Own work, CC BY-SA 3.0,

I have been working in the field of pediatric speech-language pathology since 2004. A big part of the job is evaluating and treating articulation disorders. This is a fun part of the job for me because children can pronounce words and sounds all sorts of ways. Treating these errors and hearing improvements is exciting and rewarding!

Articulation is the fancy speech therapy word for how a child produces speech sounds. Sometimes, a child makes one or two specific sounds incorrectly such as wabbit for rabbit. Other children are very difficult to understand because they make errors on multiple speech sounds.

Parents often hear many of these errors in young children. But, they don't often know if the errors are age appropriate or warrant speech therapy. If your child is making errors, there are many things that a speech-language pathologist will consider when screening your child or evaluating them.

First, the child's age is important.
Research has been completed that shows when certain sounds should be developed. Click here to visit a developmental norms chart. From this, you can see that /p, b, m, w, h/ are the first sounds to be fully developed in a toddler. You can also see that /s, z, r/ takes a long time for many children to develop. We wouldn't expect a 3 year old to say the /r/ sound correctly, but we would definitely expect a 4 year old to have the /h/ sound developed. This chart of developmental norms is the best resource parents can use to check to see if their child should be expected to make a certain sound correctly.

The American-Speech Language Hearing Association (ASHA) also provides good information on this subject.  ASHA reports that almost all children make some sort of speech sound errors while they are developing their speech. But, they report that all sounds should be developed by age 8.

Developmental norms for sounds are important, but the child's health history is equally important.
If a child has a history of ear infections or multiple sets of ear tubes, then we can understand why a child may make some speech articulation errors. If ear infections are an on-going problem, then this should be a factor that the speech-language pathologist considers. If a child has a diagnosis such as Down syndrome, then we know that the oral features may contribute to certain speech sound errors. Children with autism or intellectual disabilities may make errors in speech too, but they may not be able to complete formal testing at a young age due to their cognitive abilities. Speech-language pathologists can screen or evaluate children that fall into this category and decide if and when articulation therapy may be warranted or successful.

The type of errors the child makes is important.
A speech language pathologist listens to articulation errors and decides what kind of errors the child is making. These errors may be:
-distortions (i.e. a child makes an /s/ sound with his tongue protruding forward making it sound "off")
-substitutions (using a sound in place of another such as /w/ for /r/ or /t/ for /d/)
-omissions (leaving a sound off completely as in tu- for tub)
-additions (adding another sound in where it's not needed)

Some errors are considered typical errors such as making a /t/ for a /k/. Other errors are atypical such as /h/ for /f/. Atypical errors make a child more difficult to understand because it's something that a listener wouldn't expect. Many atypical errors or too many of the typically occurring errors may make a child eligible for speech therapy.

The Bottom Line:
If you have concerns, consult with a licensed or certified speech-language pathologist (SLP). This consultation may lead to a screening or a full evaluation. Sometimes, your young child may not qualify for services but the SLP may suggest a follow up evaluation in a certain amount of time if progress hasn't been made. Other times, the SLP may agree that speech therapy may be needed to correct the errors the child is making. This can often be a long process depending on the child's age and number or errors.

SLPs are trained in this area, so don't be afraid to call one and ask questions if something in your child's speech is making you worry.

Therapy Thursday is for educational purposes only and not intended as therapeutic advice.

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