Speech Sound Disorders in Children

Submitted by jortiz5 on Tue, 07/24/2018 - 13:00

 

You may have noticed that young children often misproduce certain sounds. Many children produce some sounds differently than what we may expect. It is very common for young kids to swap out one sound for another, or to have a little difficulty getting one sound just right. This is a normal developmental process for children; as they are expanding the range of sounds that they can say, some sounds will come earlier than others. For some children, though, the process of speech sound development may not follow a typical trajectory, because of a speech sound disorder.

A speech sound disorder is a broad category of that includes several types of communication disorders which affect the perception or production of sounds. Difficulty in speech production often results in impaired intelligibility, or how well someone can be understood. Intelligibility is often rated as a percentage. For example, a parent may say that they can understand about half of what their child says. We would say that this child is about 50% intelligible to a familiar listener.

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Types of Speech Sound Disorders

There are several distinct types of speech sound disorders, including phonological disorders, articulation disorders, and motor speech disorders. Each of these types of disorders has a different etiology, and treatment approach. Phonological and articulation disorders are two of the most frequently occurring types of speech sound disorders in children. When a child has a phonological disorder, this means that they are having difficulty producing specific sounds, and substitute certain sounds for others. For example, many young children may produce the sound “d” in place of “g”, resulting in a word like “dog” being produced as “dod”. These types of substitutions are consistent, and make up what we refer to as phonological processes.

Articulation disorders are similar to phonological disorders, in that certain sounds are produced incorrectly. The main difference, though, is that articulation disorders do not involve sound substitutions, but rather sound misarticulations or distortions. In other words, certain sounds are produced slightly off-target, but they are not being substituted by other sounds. For example, a child who has difficulty producing clear “s” sounds would likely be identified as having an articulation disorder.

Motor speech disorders are a type of speech sound disorder that result from difficulty coordinating the motor movements associated with the articulators. Childhood apraxia of speech (CAS) is a common type of pediatric motor speech disorder. Children diagnosed with CAS often have difficulty consistently producing speech sounds, resulting in reduced intelligibility. For more information about CAS, please visit the American Speech-Language Hearing Association website.

 

Speech Sound Development

As children are learning the sounds of their language, they will often have limited intelligibility simply because they have not yet acquired all of the sounds they need to be fully understood. For every language in the world, there is typical trajectory of development. In other words, sounds are acquired in the same order, and within the same range of time for all children learning that language. For English, the following chart shows at what ages specific sounds are acquired.

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The causes of speech sound disorders are often related to other underlying conditions, but it is possible that there may be no clear reason for the disorder. Some conditions that may result in a speech sound disorder include the follow:

  • Developmental disorders, such as autism or developmental delay
  • Brain damage or trauma, like cerebral palsy
  • A genetic syndrome, like Down syndrome
  • Hearing loss
  • A history of ear infections

 

Treatment

Treatment for speech sound disorders should always include a licensed speech-language pathologist. There are a variety of different approaches and treatment techniques. Each treatment plan is highly individualized, and your child’s speech pathologist will determine the most appropriate approach. It is important to note that speech sound disorders have little to do with muscle strength. Doing mouth or tongue exercises to increase strength will do nothing to support the development of improved intelligibility.

If you are concerned about your child’s intelligibility, you should consult with a speech-language pathologist. They will conduct an evaluation to determine the degree to which a speech sound disorder may be causing difficulty with speech production. Although you may be tempted to wait it out, it is best to consult with someone who is knowledgeable about pediatric speech sound development. A speech-language pathologist can offer guidance about the best course of action if treatment is recommended.

 

José A. Ortiz, M.A., CCC-SLP

The Importance of Phonological Awareness

Submitted by jortiz5 on Mon, 07/16/2018 - 16:12

 

Have you ever wondered why children learning to read will start by sounding out letters? Or, have you wondered why clapping syllables is a helpful strategy for kids learning to count syllables in words? Perhaps you have though about how even young children are able to rhyme words without much direct instruction. These are all examples of tasks that are related to phonological awareness. Phonological awareness, simply put, is our ability to identify and manipulate sounds and syllables in words and sentences.

Phonological awareness is a critical skill in early literacy development. Literacy acquisition is fundamentally dependent on phonological awareness. As emerging readers, we rely on our ability to identify the constituent sounds that makes up words in order to learn what each word “sounds like”. For typically developing children, phonological awareness does not have to be explicitly taught; children acquire this skills as they are learning their language. When a child has strong phonological awareness skills, they are well-positioned to develop strong literacy skills in the future. Those children who have difficulty with phonological awareness may require additional support.

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Elements of Phonological Awareness

So what is phonological awareness exactly? Several related elements make up the set of skills that we refer to as phonological awareness. These skills include:

  • Segmenting allows us to identify individual sounds within words. When a child is able to identify that the first sound in the word “bus” is a “b”, they are exhibiting their ability to segment. We can also segment syllables (e.g. “What is the first syllable in the word ‘folder’?”)
  • Blending is the ability to combine individual sounds or syllables, in order to form a word. What word that is made up of the sounds “c”, “a”, and “t”? If you are able to recognize this as the word “cat”, then you demonstrated that you are able to blend sounds together to form a word.
  • Adding, deleting is the ability to create a new word when a new sound is added to the word. For example, if we add the “b” to the word “all”, we have a new word: “ball”. Deleting is just the opposite: “ball” becomes “all” when we take away the “b” sound.
  • Substituting allows us to replace certain sounds with other sounds in words. Imagine that you are asked what word we get when we replace the “r” in the “read” to and “l”. The new word, “lead” has all of the same sounds as the original, with the exception that the “r” has been substituted.
  • Rhyming allows us identify words that share a common final syllable. For example, we know that “cat” and “bat” rhyme, because they end with exactly the same syllable, and only differ in the initial sound.

 

It is important to underscore the point that phonological awareness itself is not the same thing as literacy, but it is a prerequisite skill. Literacy is our ability to decode and comprehend written text, but phonological awareness underlies our ability to become literate. Let’s look at an example like the word “dog”. When we look at this word we need to be able to first identify that there are three individual letters, each with a corresponding sound. By taking each of these three sounds, and blending them together, we are essentially sounding the word out in our head. This process is commonly referred to as decoding. After putting these sounds together into a word, we can then search for this word in our mental dictionary to find the appropriate meaning. Although we may think of reading as a visual activity, one’s ability to recognize and parse out the individual sounds in written text is fundamental to reading.

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Supporting Phonological Awareness at Home

Early literacy development depends on a number of factors. One of the best things that parents can do is to provide early and frequent exposure to printed materials. Children who demonstrate a greater level of interest in printed materials will demonstrate a greater level of success with literacy acquisition. Similarly, parents’ attitudes toward reading is a key factor in determining how engaged children are with literacy activities. Your children should have ample opportunities to manipulate books by the time they are beginning to read. Although young children may not know how to manipulate printed materials, simply giving them the opportunity to open books, turn pages, and move their finger from left to right on the page is incredibly beneficial. The more opportunities that young children have to work with printed material, the greater the potential for successful outcomes.

There are many ways to help children with their phonological awareness development. Below are a few examples of things that parents can do to support phonological awareness skills at home:

  • Play rhyming games with your children. See if your children can produce some rhymes for one and two syllable words.
  • Have your children count the number of syllables in words. You can use clapping as a way of modeling how to count syllables.
  • See if you children can identify new words that are formed if you take away, or add a syllable. For example, adding “shoe” to the word “lace” makes “shoelace”. Similarly, taking away “air” from the word “airplane” makes the word “plane”.
  • Provide a few sounds to your children and ask them what word is formed when you put the sound togher. For example, say the individual sounds “b”, “i”, and “g” (pausing between each sound) and see if they can blend the sounds together.
  • For older preschool-age children who can read a few words, present different words and ask them how the word would change if you added, subtracted, and changed one of the letters.

 

Seeking Help

Although phonological awareness does not need to be explicitly taught for many children, there are instances in which additional support is needed. Importantly, children with diagnosed speech sound delays/disorders are at a greater risk of having delays in phonological awareness development. If you are concerned about your child’s phonological awareness development, seek out the guidance of licensed speech-language pathologist who can conduct the appropriate type of assessment. Support for phonological awareness skill development can be addressed through speech therapy, and with additional instruction in the classroom.

 

José A. Ortiz, M.A, CCC-SLP