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Childhood Speech and Language Disorders Fact Sheet

Articulation disorders

Patients with an articulation disorder have problems creating sounds when speaking, making it difficult for others to understand them. These problems may include substituting the wrong sound, leaving off sounds, adding sounds or distorting sounds.

Young children often have sound errors in their speech. For example, a child may use a /th/ sound for the /s/ sound, making the word 'thoap' for 'soap.' A child may also leave sounds out of a word, such as 'nana' for 'banana.' If these errors continue past the age expected for development, then the child may have a speech articulation disorder and may benefit from speech therapy.

Phonological disorders

A phonological process disorder means the patient has problems with patterns of speech errors. For example, the child may make errors of cluster reduction, such as omitting a sound from a cluster, making a word such as 'store' into 'tore.' Another pattern children may follow is called fronting, where the sounds in the back of the mouth like /k/ and /g/ become /t/ and /d/. This results in words like 'car' becoming 'tar' and 'goat' produced as 'doat.'

Many young children make these errors in speech patterns and eventually grow out of it. However, if the errors continue, the child may have a phonological disorder.

Childhood apraxia of speech

Childhood apraxia of speech (CAS) is a motor speech disorder in which the child has difficulty producing sounds, syllables or words. The child does not have muscle weakness that affects the speech production; instead, there is a breakdown in the center of the brain that plans the muscle movements needed for speech. The child may know what he or she wants to say, but the brain has trouble directing the muscles to say the sound or word.

CAS presents in various ways in children. A very young child with CAS may show the following symptoms:

  • Lack of cooing or babbling as an infant.
  • Late first words, and those words may be missing sounds.
  • Only uses a few different consonant and vowel sounds.
  • Problems combining sounds or long pauses between sounds.
  • Simplifies words by replacing difficult sounds with easier ones.
  • Problems with eating.

An older child with CAS may show the following symptoms:

  • Inconsistent sound errors that are not the result of immaturity.
  • Understands language much better that he or she can talk.
  • Difficulty imitating speech, but imitated speech is more clear than spontaneous speech.
  • Appears to be groping when attempting to produce sounds.
  • More difficulty saying longer words or phrases clearly than shorter ones.
  • Appears to have more difficulty speaking when he or she is anxious.
  • Speech that is hard to understand, especially for an unfamiliar listener.
  • Choppy or monotonous speech; sometimes stresses the wrong syllable or word.

Language disorders

A child may also present with a language delay or disorder. This may include difficulty expressing him or herself verbally; difficulty understanding auditory language, reading or writing; or a combination of all these areas. A language delay is often not related to another diagnosis. However, delays sometimes exist as a result of a diagnosis of cerebral palsy, autism, head injury, neglect and more.

Evaluation of childhood speech and language disorders

A speech language pathologist (SLP) is a professional who evaluates and treats children with speech and language difficulties. A referral from the child's physician is often required for an initial evaluation by a speech language pathologist. During the evaluation, the speech language pathologist will listen to the child in an informal setting, such as while the child plays. He or she may also complete a formal test to record and quantify errors for comparisons to the child's age groups. An examination of the child's oral structures and hearing may also be included in the evaluation. If the speech language pathologist determines a disorder in the child's speech or language, he or she may recommend speech therapy.


Treatment for a child with a speech or language disorder may target specific sounds, sound patterns or language to improve overall intelligibility. The treatment may include demonstrations of the correct sounds or words, training the child to recognize errors, and practicing correct speech and language. The SLP should work closely with the child's caregivers to assist with generalization of therapy goals outside of the therapy session.

For more information or to schedule an appointment, please contact the UK Speech Therapy Clinic at 859-257-7918.

To find out more

Learn more about childhood apraxia of speech and other speech and language disorders at:

American Speech-Language-Hearing Association website

Page last updated: 10/16/2013 4:40:03 PM