Articulation disorders


Speech sound disorders include problems with:

  • Articulation
  • Phonological processes

Articulation means how a child pronounces words. Articulation disorders - when a child has trouble pronouncing certain words - make it difficult to be understood.

Phonologic process means patterns of sounds made when your child pronounces certain consonants or vowels.

The 3 categories of articulation disorders include:

  1. A speech sound disorder when mistakes continue past a certain age. Children typically acquire speech sounds in a developmental sequence. Some speech sounds such as r, l, and s are harder to say than others such as p, b, and m.
  2. A phonological process disorder: When there are patterns of not saying words correctly.
  3. A motor speech disorder: When the child has trouble moving muscles required to talk. There are two types of motor speech disorders: dysarthria and apraxia.
  • Dysarthria: the muscles of the mouth, face, and respiratory system become weak, move slowly, or do not move at all.
  • Apraxia: When a child has trouble saying what he or she wants to say correctly and consistently. The problem is with speech coordination, not weakness of the muscles of the face, tongue and lips.

Patients can be seen by Texas Children's experts in Ear Nose and Throat (Otolaryngology) and Speech, Language and Learning.

Causes & Risk Factors

Speech sound errors are quite common in young children who are learning to talk. By the age of 8, children should be able to produce all sounds in English correctly.

Causes of some speech sound errors include:

  • Genetic syndromes
  • Hearing loss
  • Neurological disorders (stroke, brain injury, tumors, and cerebral palsy)

Causes of dysarthria and apraxia include:

  • Conditions that involve the nervous system, such as stroke, brain injury, tumors and cerebral palsy

The causes of many speech sound disorders are not known.

Symptoms & Types

Symptoms include:

  • Failing to correctly pronounce letters and words at the expected age
  • Trouble using the muscles necessary to talk so that it is hard for others to understand what is said
  • Having trouble saying words

Diagnosis & Tests

The speech-language pathologist will test your child's ability to pronounce letters and words and examine whether the muscles of the mouth work correctly.

This includes:

  • Recording sound errors while  listening to your child say words, phrases, and sentences
  • Deciding if the speech ability is at an appropriate stage for your child's age.  

Based on the examination, the speech-language pathologist decides how easily your child can be understood.

The speech-language pathologist then decides whether treatment is needed and what kind of treatment to recommend.

Treatment & Care

Treatment  for articulation includes:

  • Showing how to make sounds correctly
  • Helping your child recognize which sounds are correct and incorrect
  • Having your child practice sounds in different words

Treatment for dysarthria includes:

  • Slowing the rate of speech
  • Improving breath support
  • Strengthening muscles
  • Improving articulation (making sounds)

Treatment for apraxia includes:

  •   Improving the planning, order, and coordination of muscle movements for speech

Living & Managing

Treatment is very effective for correctly learning to make individual sounds (articulation) and sound patterns (phonological process).   

Treatment for apraxia is likely to be more intense and longer in duration. With appropriate treatment, however, significant progress can be made.

Progress for the child who has dysarthria depends upon the degree of neurological involvement.