Speech Sound Disorders in Children

Are you worried your child might have a speech sound disorder? Here’s what you need to know to help you recognise any potential problems.




There are different types of speech sound disorders including articulation disorder, phonological disorder, and childhood apraxia of speech.

Articulation disorder involves difficulties in making certain speech sounds. “For example, a child may say the ‘s’ sound by placing the tongue in between the teeth instead of behind the teeth, causing the ‘s’ to sound like a ‘th’ sound (e.g. saying ‘thun’ instead of ‘sun’),” explains speech therapist at Singapore General Hospital, Lim Hui Zhen.

Phonological disorder refers to patterns of sound errors. “For example, substituting sounds produced at the back of the mouth (‘k’ and ‘g’) with sounds produced at the front of the mouth (‘t’ and ‘d’), such as saying ‘teep’ for ‘keep’ and ‘dough’ for ‘go’,” says Lim.

Lastly, childhood apraxia of speech (CAS) is a motor speech disorder. A child with CAS finds it difficult to say sounds, syllables and words – not because of muscle weakness – but because the brain has trouble with the planning of moving the muscle movements required for speech.



Here are some symptoms to look out for that may indicate your child has a speech sound disorder, according to Lim:

  • Unclear speech (‘Generally, you should understand 50 per cent of your child’s speech at two years old, 70 to 80 per cent at three years old, and 100 per cent by four years old,” says Lim)
  • Child is often asked to repeat himself, and/or
  • Has difficulties copying the adult’s pronunciation, and/or
  • Produces less variety of sounds than expected for his/her age
  • Child or family members experience frustration during communication



Children with speech sound disorders usually undergo speech therapy as treatment. “During speech therapy, children may learn about the function of sounds, that changing a sound can change the meaning of a word (e.g. saying ‘tick’ for ‘kick’) and that can change the message communicated. They may also learn to use the correct placement of their articulators (e.g. teeth, tongue and lips) to produce speech sounds accurately in words, phrases and sentences,” says Lim.



There are also cases whereby a child’s speech sound disorder may be caused

by an underlying medical issue.



According to Lim, in these situations, the doctor “may recommend fixing the underlying issue where applicable, for example, hearing aids or cochlear implants for the child with hearing impairment, or surgery for the child with a cleft palate”. The treatment of the medical condition can also work alongside speech therapy.

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