Speech Sound Disorders
When a child has a speech sound disorder, they have trouble saying sounds or it’s hard to understand what they say. In the United States, monolingual English-speaking children learn some sounds early—like p, m, or w. Other sounds can take longer to learn—like z, v, or th. Most children can say almost all speech sounds correctly by 4 years old. A speech sound disorder may also be called an “articulation disorder” or “phonological disorder.”
Common Signs
It's normal for young children to make occasional speech mistakes as they’re learning to talk, but it could be a problem if they keep making those mistake as they get older. Children with speech sound disorders might:
- Substitute sounds, like saying "wabbit" for "rabbit."
- Leave sounds out, like saying "nana" for "banana."
- Add extra sounds, like saying "buh-lue" for "blue."
How you say sounds might be influenced by where you live, your community and peers, or the language(s) and dialect(s) you speak. These differences are not considered a speech sound disorder.
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. |
| By 4 years | Says y and v in words. |
Possible Causes
Many children learn to say speech sounds over time, but some do not. There are many reasons a child may have trouble speaking. Some factors that can contribute to speech sound disorders include:
- Apraxia of speech. Some children have speech problems because their brain has trouble sending messages to the speech muscles telling them how and when to move.
- Brain damage from a head injury or cerebral palsy.
- Developmental disorders.
- Dysarthria. Children can have speech problems because weak muscles can’t make speech sounds.
- Genetic syndromes, like Down syndrome.
- Hearing loss from ear infections or other causes.
Seeking Help
If you're concerned about your child's speech development, consult a speech-language pathologist (SLP). An SLP will test your child's speech and communication skills.
- Hearing should be checked to rule out hearing loss, which can affect speech development.
- The SLP listens to how your child says sounds and watches how lips, jaw, and tongue move.
- The SLP may also test language skills, since children with speech sound disorders can also have language delays. For example, they might have trouble following directions or telling stories.
Treatment for Speech Sound Disorders
SLPs provide strategies to help children speak clearly and confidently. Treatment can include helping a child:
- Learn the correct way to make sounds.
- Recognize when sounds are correct or incorrect.
- Practice sounds in different words, sentences, or stories.
- Use sounds in conversations.
Early support can improve a child’s communication skills and boost their confidence. Visit Tips for Your Child’s Speech and Language Development to learn more ways to support your child at home.
To find an SLP near you, visit ProFind.
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Find a Professional
ASHA ProFind is your connection to over 30,000 ASHA-certified audiologists and speech-language pathologists. Find the right professional for your needs.
Search Now