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Speech Sound Disorder (Phonological Disorder)
Speech is the generation of sound patterns that form words. By listening to the sounds they hear in the languages around them, children learn how to employ speech sounds. Children begin by babbling and subsequently advance to employing sounds in words, phrases, and conversations. The development of children's usage of speech sounds varies with age. Children, who exhibit difficulty in accurately pronouncing speech sounds, may have Speech Sound Disorder.
What is Speech Sound Disorder?
In this disorder, there may be difficulties in the accurate production of speech sounds, in the omission of speech sounds, and in the cognitive and semantic aspects of language processing that are necessary for building vocabulary and linguistic maturation. These aspects of language processing are necessary for building vocabulary and linguistic maturation. When children let too much air pass from the side of their mouth while pronouncing sounds like ‘shh’ or producing sounds like ‘s’ or ‘z’ with their tongue protruding, distortions in the sounds they produce result. This condition was once known as a phonological disorder. Errors in speech sound can also arise in patterns when a child has an irregular airflow rather than a consistent airflow, which prevents their words from being pronounced correctly (for example, bacuum for vacuum).
Speech sound production requires the precise articulation of the phonemes (or individual sounds) that, when put together, become words. It is necessary to have phonological knowledge of speech sounds to produce speech sounds and the capacity to coordinate the movement of the articulators (i.e., the jaw, tongue, and lips) with breathing and vocalizing. Children with trouble producing speech may have varying degrees of difficulty with phonological awareness of speech sounds or the capacity to coordinate movements for speaking. Multiple factors can cause these challenges. Speech sound disorder includes both phonological problems and articulation disorders. It is diagnosed when a child's speech sound production is not what would be expected based on the child's age and developmental stage and when the deficits are not the result of a physical, structural, neurological, or hearing impairment. The disorder causes mistakes in complete words as a consequence of improper pronunciation of consonants, replacement of one sound for another, absence of entire phonemes, and, in certain cases, dysarthria (slurred speech due to incoordination of speech muscles) or dyspraxia (difficulty planning and executing speech). If a person's poor articulation is caused by a medical condition, such as persistent ear infections, a hypotonic or incomplete palate, or neurological difficulties, then it is not appropriate to diagnose the disorder.
Course and Development
By the age of three, a child should have made significant progress in learning the production of speech sounds, which should result in mostly intelligible speech. On the other hand, children with speech sound disorder continue to use immature phonological simplification mechanisms much past the age at which most children can understandably generate words. Children over the age of 5 who struggle with their articulation have a greater chance of having issues with their auditory perception. By the time a child is seven years old, most speech sounds should be produced clearly, and most words should be pronounced appropriately according to age and cultural standards. After the age of 8 years, spontaneous recovery is rare.
Perinatal issues, genetic factors, and difficulties in auditory processing may all contribute to the development of the disorder. A maturational delay in the developmental brain process that underlies speech has been proposed in certain cases, given the high rates of spontaneous remission observed in very young children. The finding that children with speech sound problems are also more likely to display "soft neurological signs," language disorder, and a greater percentage of reading disorder supports the hypothesis that neuronal dysfunction is also a contributing factor. The results of twin studies demonstrate a concordance rate for monozygotic twins that are greater than the chance level providing evidence for a possible contribution of genetic factors.
There may also be a case for the role of environmental factors, but constitutional factors seem to have the most impact.
The most common problems seen in people with speech sound disorders are language disorder, reading disorder, and developmental coordination disorder. Enuresis is another symptom that can accompany this disorder. However, most children with speech sound disorder start speaking at the right age. It has been noted that some children with speech sound delay in attaining speech milestones such as their first word and their first sentence. Children who have issues with speech sounds and language are at an increased risk of having attention difficulties and specific learning disorders.
The majority of children with speech sound disorder respond well to treatment, and speech impairments improve over time.
Two primary techniques have proven to be helpful. Children who have severe patterns of numerous speech sound problems, such as final consonant deletion or consonant cluster reduction, are typically treated with the phonological method. In this method, patients are first given activities in which they are directed to practice individual sounds, such as final consonants; once these sounds have been learned, they are then given exercises in which they practice using these sounds in the context of actual words and sentences.
For a child with only a few issues with sounds with replacement or distortion, the conventional method may be used. In this method, the child repeats making the problematic sound as the clinician gives real-time feedback and suggestions on how to better position the tongue and lips for clearer speech. Most children with speech sound disorder respond well to treatment, and speech impairments improve over time.
Two primary techniques have proven to be helpful. Children with severe patterns of numerous speech sound problems, such as final consonant deletion or consonant cluster reduction, are typically treated with the phonological method. In this method, patients are first given activities in which they are directed to practice individual sounds, such as final consonants; once these sounds have been learned, they are then given exercises in which they practice using these sounds in the context of actual words and sentences.
The conventional method may be used for a child with only a few issues with sounds with replacement or distortion. In this method, the child repeats making the problematic sound as the clinician gives real-time feedback and suggestions on better positioning the tongue and lips for clearer speech.
Speech sound problems refer to a child's difficulty in acquiring, articulating, or utilizing their language's sound patterns. It is diagnosed when a child's speech sound production is inconsistent with what would be expected given the child's age and developmental stage. Possible causes include challenges during fetal development, genetic predisposition, and impaired auditory processing. Most kids with speech sound disorder get better with treatment, and their speech issues reduce with time.
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