Speech Conditions and Diagnoses

Articulation (Speech) Disorder

Related Services

A child with an articulation (speech sound) disorder has difficulty producing individual speech sounds or producing sounds correctly in words. There may be incorrect placement of the lips, teeth, tongue, or even soft palate during speech. This often affects the clarity of speech.

Speech sounds develop gradually over time, but most sounds should be correctly produced by the age of 3, and all sounds should be correctly produced by the age 6. Below are common symptoms of an articulation disorder.

Cause

In many cases, there is not a clearly identifiable cause of the articulation disorder. However, many children with articulation disorders have evidence or oral-motor dysfunction due to minor brain damage or neurological dysfunction. Speech may be affected by weakness or lack of coordination of the movements of the mouth. Other causes include a history of cleft palate or hearing loss.

Symptoms

Early feeding problems
Lack of cooing with vowels at 2 to 3 months of age
Lack of babbling using consonant sounds (particularly /b/, /m/, /d/, /n/) by 6 to 7 months
Use of mostly vowel sounds and gestures for communication after the age of 18 months
Unclear speech at the age of 3
Omission of consonants in words at the age of 3
Still unable to produce certain sounds at the age of 6
Speech errors that increase when sentences are longer or more complex
The child is embarrassed or disturbed by his or her speech at any age

The following speech sound (articulation) errors can occur:

Sounds in words and sentences are completely omitted: "I go o coo o the bu" for "I go to school on the bus."
An incorrect (usually easier) sound is substituted for the correct one: "I saw a wittle wamb" instead of "I saw a little lamb."
Sounds are distorted: a slushy sound occurs on /s/ sounds.
Extra sounds or syllables are added to a word: "animamal" for "animal."
There is slow, slurred speech.

Treatment

When a speech problem is suspected, a speech evaluation should be performed by a speech-language pathologist. In the evaluation, speech and language skills are evaluated using parent reports, standardized tests, and clinical observation of play and communication activities. Social interactions, play skills, and behavior are also evaluated. A hearing screening or audiology evaluation is recommended prior to a speech evaluation to rule out hearing loss.

During speech therapy, treatment focuses on correcting, through a variety of strategies, the production of defective speech sounds. Once the child is able to produce the sound or family of sounds correctly, then work is done to incorporate that production in syllables, words, phrases, and sentences.

When to Call the Doctor

Review the symptoms above. If you have concerns, talk to your pediatrician about a referral to Speech Pathology at Cincinnati Children's Hospital Medical Center, 513-636-4341.

Special Instructions

If it hasn't been done in the past, a hearing screening or audiology evaluation is recommended prior to a speech evaluation to rule out hearing loss.

Why Cincinnati Children's?

As a national leader in pediatric speech pathology, Cincinnati Children's has a program for the treatment of articulation disorders. This program is staffed by speech-language pathologists who have undergone specific specialty training. We welcome referrals from primary care providers and specialty physicians.