Kids Health Info

Speech problems – articulation and phonological disorders

  • Articulation and phonology (fon-ol-oji) refer to the way sound is produced. A child with an articulation disorder has problems forming speech sounds properly. A child with a phonological disorder can produce the sounds correctly, but may use them in the wrong place.

    When young children are growing, they develop speech sounds in a predictable order. It is normal for young children to make speech errors as their language develops; however, children with an articulation or phonological disorder will be difficult to understand when other children their age are already speaking clearly.

    A qualified speech pathologist should assess your child if there are any concerns about the quality of the sounds they make, the way they talk, or their ability to be understood.

    Signs and symptoms of articulation and phonological disorders 

    Articulation disorders

    Articulation refers to making sounds. The production of sounds involves the coordinated movements of the lips, tongue, teeth, palate (top of the mouth) and respiratory system (lungs). There are also many different nerves and muscles used for speech.

    If your child has an articulation disorder, they:

    • have problems making sounds and forming particular speech sounds properly (e.g. they may lisp, so that s sounds like th)
    • may not be able to produce a particular sound (e.g. they can't make the r sound, and say 'wabbit' instead of 'rabbit'). 

    Phonological disorders

    Phonology refers to the pattern in which sounds are put together to make words.

    If your child has a phonological disorder, they:

    • are able to make the sounds correctly, but they may use it in the wrong position in a word, or in the wrong word, e.g. a child may use the d sound instead of the g sound, and so they say 'doe' instead of 'go'
    • make mistakes with the particular sounds in words, e.g. they can say k in 'kite' but with certain words, will leave it out e.g. 'lie' instead of 'like'. 

    Phonological disorders and phonemic awareness disorders (the understanding of sounds and sound rules in words) have been linked to ongoing problems with language and literacy. It is therefore important to make sure that your child gets the most appropriate treatment.

    It can be much more difficult to understand children with phonological disorders compared to children with pure articulation disorders. Children with phonological disorders often have problems with many different sounds, not just one.

    When to see a doctor

    If you (or anyone else in regular contact with your child, such as their teacher) have any concerns about your child's speech, ask your GP or paediatrician to arrange an assessment with a speech pathologist. You can also arrange to see a speech pathologist directly; however, the fees may be higher.

    Treatment

    A qualified speech pathologist should assess your child if there are any concerns about their speech. A speech pathologist can identify the cause, and plan treatment with your child and family. Treatment may include regular appointments and exercises for you to do with your child at home.

    With appropriate speech therapy, many children with articulation or phonological disorders will have significant improvement in their speech.

    Brain injuries

    Articulation or phonological difficulties are generally not a direct result of brain injury. Children with an acquired brain injury may have different difficulties with their speech patterns. These are generally caused by  dyspraxia or dysarthria. Some children with acquired brain injuries may also have difficulties with literacy and language. See our fact sheets Dysarthria and Dyspraxia.

    Key points to remember

    • Articulation and phonology refer to the making of speech sounds.
    • Children with phonological disorders or phonemic awareness disorders may have ongoing problems with language and literacy. 
    • If there are any concerns about your child's speech, ask your GP to arrange an assessment with a qualified speech pathologist.
    • With appropriate speech therapy, many children with articulation or phonological disorders will have a big improvement in their speech.

    For more information

    Common questions our doctors are asked

    Could my child just catch up eventually and grow out of an articulation/phonological disorder?

    Some speech disorders can persist well into teenage and adult life. When a person is older, it is much more difficult to correct these problems. Most children with a diagnosed articulation/phonological disorder will need speech therapy.

    What causes articulation and phonological disorders?

    In most children, there is no known cause for articulation and phonological disorders. In some, the disorder may be due to a structural problem or from imitating behaviours and the creation of bad habits. Regardless of the cause, your child's speech therapist will be able to assist with the recommended treatment.


    Developed by The Royal Children's Hospital Paediatric Rehabilitation Service and Speech Pathology department. Adapted with permission from a fact sheet from the Brain Injury Service at Westmead Children's Hospital. We acknowledge the input of RCH consumers and carers. 

    Reviewed July 2018. 

    Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au


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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.