Speech Sound Disorders

It is common for children to make errors in how they say words.  Many times, these errors are normal.  For instance, if a 4-year-old says “wight” instead of “light,” this is no cause for concern.  When these speech errors persist beyond the age at which the sounds are usually mastered, or when the errors make it very difficulty to understand what the child is saying, speech therapy may be needed to correct the child’s pronunciation of the sounds they are having trouble with.

There are many reasons why an individual might have difficulty producing certain speech sounds.  Sometimes the problem may be caused by difficulty controlling the muscles of the mouth.  For other children, speech errors may be related to how they perceive speech sounds and represent them in the brain.  A problem with the structure speech mechanism, such a cleft palate, can also interfere with a person’s ability to correctly produce speech sounds.  Children with a hearing loss often require speech therapy to correct speech errors.  Finally, syndromes like Down Syndrome or Fragile X syndrome are often accompanied with speech difficulties.

Adults may also exhibit errors in their speech that started when they were children and were never corrected.  These are sometimes referred to as “residual speech errors,” and they can often be improved or completely corrected with speech therapy.

How speech therapy helps:

Speech therapy for an individual with a speech sound disorder begins with a thorough evaluation to identify the cause of the speech problem.  After identifying which speech sounds are in error and in what contexts, a speech therapist can develop the right treatment plan for the individual’s unique communication needs.  Depending on the type of speech sound disorder, a treatment plan may begin with helping the individual learn to produce a difficult sound by itself (rather than in the context of a word or sentence).  Once this has been mastered, the sound can be practiced in simple syllables.  Next words are targeted, then short phrases, sentences, and finally whole conversations.  The final hurdle is for the individual to learn to use the correct form of the sound automatically in all conversations throughout their week.  The rate of progress for people receiving speech therapy for a speech sound disorder varies based on the underlying cause.  For example, a child receiving treatment for a mild-moderate phonological disorder (problems with perceiving and representing speech sounds in the brain) would most likely progress much faster than another child who is receiving treatment for moderate-severe childhood apraxia of speech (problems with controlling the muscles of the mouth).  Regardless of the cause, it is usually possible for individuals to achieve significant improvements in their production of speech sounds and in their overall communication abilities.

Measurable success:

One of my most memorable clients was a 9-year-old boy who struggled to produce /r/ correctly.  To make his speech problem more complicated, his father was British and spoke with an accent (although his mother did not).  It was not always easy to tell when he could not pronounce a word correctly and when he was simply producing a word the way his father did.  Accented speech is not considered to be a disorder and is not addressed in speech therapy unless the individual is specifically looking for accent reduction services.  This child’s unique situation presented an interesting challenge.  He was very motivated, however, and quite enthusiastic about speech therapy.  As a result, he made extremely rapid progress, and we were both sad when the time came much quicker than we anticipated for him to “graduate” from speech therapy.

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