Speech delay & speech disorders: How to help my child

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Many parents are concerned about their child’s speech clarity and are worried about speech delay. Often, mums or dads ask how they can teach or fix their child’s speech delay. So before I go into that, I will explain some background information about speech sound delay & difficulties.

My child has unclear speech…you’re not alone!

Speech clarity or unclear speech is a very common concern amongst parents of toddlers and preschoolers. In fact, between 2.30% to 24.60% of school age children in Australia and the United States are estimated to have a speech sound delay or disorder.

The classifications of a speech sound delays:

Speech pathologists classify speech difficulties based on where the breakdown of the difficulty originates from. Classification is complex and requires a certified speech pathologist to do so. Here are the general classifications that will hopefully help parents understand why speech sound difficulties are difficult to diagnose and treat:

Speech sound difficulties are first classified into either articulation or phonological category.

Articulation refers to ability to use the articulators (tongue and lips) to produce a sound. It refers purely to the physical aspect of producing a sound.

Phonological refers to how the brain organises the speech patterns of our language in order to have correct speech output. It refers to the cognitive level of speech sounds.

Therefore, a child’s speech difficulty will be classified as either an articulation disorder, phonological delay or a phonological disorder.

Articulation disorder:

This simply refers to difficulty at the ‘articulator’ level (articulators are the lips, tongue). A child cannot use the articulators to produce a sound. This means, a child cannot make the sound (non-stimulable for the sound) and will need explicit teaching to know where to place their tongue, lips and in some case, air-flow to make the sound. Some examples are below:

  • Lisp – unable to produce the /s/ sound
  • Unable to produce a /th/ sound and saying /f/ instead
  • Unable to say the vowel in “cow” and says “coo” instead.

Phonological disorder or delay:

Speech sounds develop over time, and while your child learns to talk and use speech sounds, they will naturally make predictable speech sound errors, as part of “typical development”. These speech errors are referred to as ‘phonological processes’ or ‘phonological patterns’.

Based on decades of numerous research studies, children make speech errors (phonological processes) while they are learning to talk. At a certain age, these phonological processes will resolve. Typically, a child presenting with a phonological difficulty can say the sounds in isolation (i.e., stimulable). Although, still continues to substitute, omit or distort the sounds. This makes their speech very difficult to understand.

Phonological delay/speech delay:

Children with phonological processes that surpass the “cut-off” age, are classed with having a phonological delay. Essentially, a child’s speech sound acquisition is phonologically delayed. Thee child has not resolved those phonological processes at the expected age.

Phonological disorder/speech disorder:

In contrast, children with phonological processes NOT within typical development (deemed atypical) are classed with having a phonological disorder. The child has atypical phonological processes, so they have a disordered speech sound system at the cognitive level.

Below is a summary of typical, atypical (unexpected) speech sound errors and the general acquisition of speech sounds.

Figure 1. Speech sound development – Typical & atypical speech errors

How do I help my child say a speech sound?

Speech sound difficulties are complex, especially ones that are phonological (cognitive level) in nature. For parents, I will provide some basic information on how to help a child with mild articulation difficulty only. I will present one simple method that speech pathologists use.

General advice for improving speech sounds:

Firstly, make sure you’re only targeting speech sounds that are obtainable for their age. So don’t work on speech sounds that are not expected a child’s age. (e.g. working on /j/ sound for a 3 year old would not be appropriate). Refer to Figure 1.

Bear in mind that is a very simple approach and not necessarily the order in which I or other speech pathologist would follow. However, it is a very good place to start when you are a parent and don’t have the knowledge & skills a speech pathologist has.

  • Choose the speech sound that is having the most impact on their speech clarity.
  • Choose a sound that they are stimulable for. This means a sound that your child can already say on it’s own when they copy you. This will make it easier for both you and your child. Speech pathologists (SP) will work on non-stimulable sounds in therapy, but this needs to be guided by an SP in person.
  • Work on one sound at a time, again, to make it easier for you and your child. A speech pathologist will have more knowledge and skill to guide you into targeting multiple speech sounds.

How should I teach or correct speech sounds?

For children with mild articulation difficulties, I would like to share the most simple approach to speech sound teaching. It is called “traditional articulation therapy” for teaching sounds. A summary of the steps involved in traditional articulation therapy is below:

Step 1

Discriminate the target sound from the error sound. This means the child needs to hear the difference between the target sound, and the sound they’re substituting it with. E.g. A child says ‘bun’ instead of ‘fun’, so they must first discriminate between the f and b sound.
For example, you may present two pictures ask your child to point to the picture you say (e.g. phone>bone, Fee>bee, fight>bight).

Step 2

Say the sound in isolation. If your child is 2 years or older, you can give this step a go. However, if your child really cannot say the sound, and they are getting frustrated at you making them try, then discontinue.

Step 3

Say the sound in initial position, within 1-syllable words (E.g. Phone), at work level only.
This is a great place to start, if you know your child can say the sound (as in step 2), and is able to imitate you upon request.

Step 4

Say the sound in initial position, within 1-syllable words, at short phrase level (e.g. red phone)

Step 5

Say the sound in initial position, within 1-syllable words, at sentence level (e.g. It’s a red phone / put the phone in the box)

Step 6

Generalise the target words in conversation, introduce longer syllable words.

Speech sound difficulties are rather complex and have a very high theoretical and tactile component to remediation/therapy. Therefore, I would only recommend parents work on simple therapy techniques, and to always seek support from a therapist when the difficulty is moderate to severe.

Watch out for more information on speech sounds over on Instagram

Is your child’s hearing affecting their speech sound development? See article on hearing here

References

  • Grunwell, P. (1997). Natural phonology. In M. Ball & R. Kent (Eds.), The new phonologies: Developments in clinical linguistics. San Diego, CA: Singular Publishing Group, Inc.
  • Bowen, C. (2011). Table 2: Phonological Processes. Retrieved from http://www.speech-language-therapy.com/ on 22/06/2021/
  • Black, L. I., Vahratian, A., & Hoffman, H. J. (2015). Communication disorders and use of intervention services among children aged 3–17 years; United States, 2012 (NHS Data Brief No. 205). Hyattsville, MD: National Center for Health Statistics.
  • Law, J., Boyle, J., Harris, F., Harkness, A., & Nye, C. (2000). Prevalence and natural history of primary speech and language delay: Findings from a systematic review of the literature. International Journal of Language and Communication Disorders, 35, 165–188.
  • Shriberg, L. D., Tomblin, J. B., & McSweeny, J. L. (1999). Prevalence of speech delay in 6-year-old children and comorbidity with language impairment. Journal of Speech, Language, and Hearing Research, 42, 1461–1481.
  • Wren, Y., Miller, L. L., Peters, T. J., Emond, A., & Roulstone, S. (2016). Prevalence and predictors of persistent speech sound disorder at eight years old: Findings from a population cohort study. Journal of Speech, Language, and Hearing Research, 59, 647–673.
  • American Speech-Language-Hearing Association (n.d.) Speech Sound Disorders: Articulation and Phonology. (Practice Portal). Retrieved month, day, year, from www.asha.org/Practice-Portal/Clinical-Topics/Articulation-and-Phonology/.

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