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Phonological Speech Sound Difficulties- When to go to Speech and Language Therapy

 

 

You may have noticed that your child has difficulty pronouncing some sounds and may do things such as substitute one sound for another, leave sounds out, add on sounds, or change a sound. This can make it difficult for people to understand your child and can impact on your child’s confidence, socialisation with other children, and motivation to communicate.

It is normal for young children to say sounds incorrectly, and it is an indication that their speech sound systems are developing and maturing. There are some typical ‘processes’ that children will do, referred to as ‘natural phonological processes’. These processes have age norms which indicate the age at which a ‘typically developing’ child will stop doing them by. They include the following:

 

Natural Phonological Process	Age of Elimination
Reduplication When a syllable is repeated e.g. ‘bottle’ à ‘baba’	2;0
Pre-vocalic voicing When a voiceless consonant at the start of a word like /p/ or /t/ is substituted with a voiced consonant like /b/ or /d/ e.g. ‘pink’ à ‘bink’, ‘tummy’ à ‘dummy’	3;0
Word-final devoicing When a voiced consonant at the end of a word like /b/ or /d/ is substituted with a voiceless consonant like /p/ or /t/ e.g. ‘bib’ à ‘bip’, ‘mad’ à ‘mat’	3;0
Final consonant deletion When the consonant at the end of the word is left off e.g. ‘sun’ à ‘su’	3;3
Velar fronting When back sounds such as /k/ and /g/ are replaced with front sounds such as /t/ and /d/ e.g. ‘kat’ à ‘tat’, ‘go’ à ‘do’, ‘back’ à ‘bat’ ‘bag’ à ‘bad’	3;6
Palatal fronting When sounds made by the tongue touching the roof of the mouth such as /sh/ are replaced with front sounds such as /s/ e.g/ ‘shoe’ à ‘su’, ‘fish’ à ‘fis’	3;9
Stopping /f,s/ When /f/ and /s/ is replaced with /p/ or /t/ e.g. ‘fan’ à ‘pan’, ‘sat’ à ‘tat’, ‘pass’ à ‘pat’	3;0
Stopping /v,z/ When /v/ and /z/ is replaced with /b/ or /d/ e.g. ‘van’ à ‘ban’ ‘zip’ à ‘dip’	3;6
Stopping /sh, ch/ j When /sh/ /ch/ and j sounds are replaced with sounds such as /t/ /b/ /d/ and /p/ e.g. ‘shop’ à ‘top’ ‘chip’ à ‘bip’ ‘jam’ à ‘dam’	4;6
Weak syllable deletion When the unstressed, or ‘weak’ syllable is deleted from the word e.g. ‘banana’ à ‘nana’	4;0
Cluster reduction When two consonants together, referred to as a cluster, are reduced to one consonant by itself, referred to as a singleton. e.g. ‘crash’ à ‘cash’, ‘smile’ à ‘mile’	4;0
Consonant harmony When there are 2 consonants in separate places in a word, and one consonant changes to be the same as the other e.g. ‘coat’ à ‘koak’, ‘top’ à ‘pop’	4;0
Stopping /th/ When /th/ sounds are replaced with /t/ or /d/ e.g. ‘think’ à ‘tink’ ‘that’ à ‘dat’	5;0
Gliding When /r/ becomes a /w/ and /l/ becomes a /w/ or y sound e.g. ‘rabbit’ à ‘wabit’ ‘lick’ à ‘yick’	5;0-6;0

Bowen, C. (2011)

If your child is still doing some of these processes a significant time after the appropriate age of elimination, it is likely that your child has a ‘phonological (speech sound) delay’.

 

In addition to these processes there are some atypical processes which children may present with and are not seen in typically developing children. If your child presents with some of the following patterns it is likely they have a ‘phonological disorder’ (i.e. ‘speech sound disorder’).

 

Atypical Pattern	Example
Alveolar backing When front stop sounds such as /t/ and /d/ are replaced with back sounds such as /k/ and /g/	‘tea’ à ‘kee’ ‘bat’ à ‘bak’ ‘mad’ à ‘mag’ ‘dog’ à ‘gog’
Spirantisation When stop sounds such as /p/ /t/ /d/ /b/ are replaced with fricative sound such as /s/ /f/ /v/ /z/	‘pan’ à ‘fan’ ‘tap’ à ‘taf’ ‘doll’ à ‘soll’
Gliding of fricatives When fricative sounds such as /f/ /s/ /v/ /z/ are replaced with glide sounds such as /r/ /w/ /l/ and y sound	‘fall’ à’yall’ ‘sun’ à ‘wun’
Systematic sound preference When a child substitutes multiple sounds for one specific sound	‘give it to me’ à ‘di di do de’
Initial consonant deletion When the consonant at the start of the word is deleted	‘ball’ à ‘all’
Consonant insertion When a consonant is put in before or after a vowel	‘eye’ à ‘jeye’
Sequencing errors When a child has difficulty sequencing and co-ordinating words with more than one syllable	‘elephant’ à ‘efelint’ ‘umbrella’ à ‘bumrela’

Dodd 2013

It is important that if you think your child may be presenting with a phonological delay or disorder you attend Speech and Language Therapy for intervention. Approximately 2 children in every class of 30 will have speech difficulties (Norbury 2016), and the impact of speech sound difficulties can be long lasting, with evidence suggesting that children need to be intelligible by 5 or they will have difficulty with literacy and subsequent academic achievement (Hodson 2015).

 

Direct Speech and Language Therapy for the treatment of speech sound difficulties is appropriate for children aged 3+. Intervention before this age has shown to not be valid nor reliable, and prior to this age children’s speech inventory is constantly developing and changing. Your Speech and Language Therapist will formally or informally assess your child’s speech production and for an intervention plan which is individualistic to your child’s needs and incorporates personal goals into therapy.

 

In addition to this, you can facilitate your child at home in their speech development in the following ways:

• Listening carefully to your child and waiting for them to tell you something, whatever way they can. This can include gestures, such as pointing, to help get their message across.
• Modelling clear speech e.g. child: “look at the tat” parent: “yes, there’s a cat”
• Repeat what the child has said so they can listen to the correct production e.g. child: “that’s my tup” parent: “yes, that is your c It’s a red cup. You drink from a cup”.
• Not asking them to repeat words or sentences after you. They may not be ready to attempt to use the sound and this may affect their confidence.
• Playing games involving sounds and rhymes e.g. I spy, Simon Says.

 

Most importantly:

If you don’t understand – don’t pretend to!

Reassure the child and acknowledge that talking can be difficult e.g. “I think you are trying to say something hard and I am not sure what it is. Maybe we can find out later”. Remember it takes time to develop a new speech sound and use it in conversation.  Be patient and practise regularly!

 

Written By

 

Sarah Gorman, Senior Speech & Language Therapist at Sensational Kids, Kildare

 

Copyright Sensational Kids CLG 2018