Speech Sound Disorders
On this page:
- About Speech Sound Disorders
- Signs and Symptoms of Speech Sound Disorders
- Causes of Speech Sound Disorders
- Seeing a Professional
- Other Resources
About Speech Sound Disorders
Children learn some sounds early—like p, m, or w. Other sounds take longer to learn—like z, v, or th. Most children can say almost all speech sounds correctly by 4 years old. A child who has frequent trouble saying sounds or who is hard to understand may have a speech sound disorder. You may hear the terms “articulation disorder” and “phonological disorder” to describe speech sound disorders like this.
To learn more about what you should expect your child to be able to say, see these two resources:
- ASHA's Communication and Feeding Milestones: Birth to 5 Years
- Your Child's Communication Development: Kindergarten Through Fifth Grade
Adults can also have speech sound disorders. Some adults have problems that started when they were children. Some adults may have speech problems after a stroke or traumatic brain injury. To learn more about adult speech disorders, see apraxia of speech in adults, dysarthria, laryngeal cancer, and oral cancer.
Signs and Symptoms of Speech Sound Disorders
Your child might substitute one sound for another, leave sounds out, add sounds, or change a sound. It can be hard for others to understand them.
It is normal for young children to say the wrong sounds sometimes. For example, your child might say “wabbit” for “rabbit.” They might leave sounds out of words, like “nana” for “banana.” This is okay when they are young. It may be a problem if they keep saying words that way as they get older.
How you say sounds is also based on your culture and background, the languages or dialects you speak, accents, and your community. Saying sounds in a different manner because of these influences is not a speech sound disorder. If you have concerns, contact a speech-language pathologist.
The chart below shows the ages when most English-speaking children develop sounds. Children learning more than one language may develop some sounds earlier or later.
| By 3 months | Makes cooing sounds |
| By 5 months | Laughs and makes playful sounds |
| By 6 months | Makes speech-like babbling sounds like puh, ba, mi, da |
| By 1 year | Babbles longer strings of sounds like mimi, upup, bababa |
| By 3 years |
Says m, n, h, w, p, b, t, d, k, g, and f in words Familiar people understand the child's speech |
| By 4 years |
Says y and v in words May still make mistakes on the s, sh, ch, j, ng, th, z, l, and r sounds Most people understand the child’s speech |
Causes of Speech Sound Disorders
Many children learn to say speech sounds over time, but some do not. You may not know why your child has problems speaking.
Some children have speech problems because the brain has trouble sending messages to the speech muscles telling them how and when to move. This is called apraxia. Childhood apraxia of speech is not common but will cause speech problems.
Some children have speech problems because the muscles needed to make speech sounds are weak. This is called dysarthria.
Your child may have speech problems if he has
- a developmental disorder, like autism;
- a genetic syndrome, like Down syndrome;
- hearing loss, from ear infections or other causes; or
- brain damage, like cerebral palsy or a head injury.
Seeing a Professional
Testing for Speech Sound Disorders
A speech-language pathologist, or SLP, can test your child’s speech. The SLP will listen to your child to hear how they say sounds. The SLP also will look at how your child moves their lips, jaw, and tongue. The SLP may also test your child’s language skills. Children with speech sound disorders may also have language disorders. For example, your child may have trouble following directions or telling stories.
It is important to have your child’s hearing checked to make sure they do not have a hearing loss. A child with a hearing loss may have more trouble learning to talk.
An accent is the unique way that groups of people sound. An accent is NOT a speech or language disorder. If you have concerns, contact a speech-language pathologist.
Treatment for Speech Sound Disorders
SLPs can help you or your child say sounds correctly and clearly. Treatment may include the following:
- learning the correct way to make sounds
- learning to tell when sounds are right or wrong
- practicing sounds in different words
- practicing sounds in longer sentences
- practing sounds in telling stories or conversation
