Children may say some sounds the wrong way as they learn to talk. They learn some sounds earlier, like p, m, or w. Other sounds take longer to learn, like z, v, or th. Most children can say almost all speech sounds correctly by 4 years old. A child who does not say sounds by the expected ages may have a speech sound disorder. You may hear the terms "articulation disorder" and "phonological disorder" to describe speech sound disorders like this.

Speech Sound Acquisition

Your child may substitute one sound for another, leave sounds out, add sounds, or change a sound. It can be hard for others to understand him.

It is normal for young children to say the wrong sounds sometimes. For example, your child may make a "w" sound for an "r" and say "wabbit" for "rabbit." She may leave sounds out of words, such as "nana" for "banana." This is okay when she is young. It may be a problem if she keeps making these mistakes as she gets older.

Your child may also sound different because you have an accent or dialect. This is not 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.

Iowa-Nebraska Articulation Norms

Many children learn to say speech sounds over time, but some do not. You may not know why your child has problems speaking.

Some children have speech problems because the brain has trouble sending messages to the speech muscles telling them how and when to move. This is called apraxia. Childhood apraxia of speech is not common but will cause speech problems.

Some children have speech problems because the muscles needed to make speech sounds are weak. This is called dysarthria.

Your child may have speech problems if he has

• a developmental disorder, like autism;

• a genetic syndrome, like Down syndrome;

• hearing loss, from ear infections or other causes; or

• brain damage, like cerebral palsy or a head injury.

As a speech-language pathologist, or SLP, I can test your child's speech. During the evaluation, I will listen to your child to hear how he says sounds. I also will look at how your child moves his lips, jaw, and tongue. I will most likely also test your child’s language skills. Many children with speech sound disorders also have language disorders. For example, your child may have trouble following directions or telling stories.

It is important to have your child’s hearing checked to make sure he does not have a hearing loss. A child with a hearing loss may have more trouble learning to talk.

I can also help decide if your child has a speech problem or speaks with an accent. An accent is the unique way that groups of people sound. Accents are NOT a speech or language disorder.

As an SLP, I can help your child say sounds correctly and clearly. Treatment may include the following:

• Learning the correct way to make sounds

• Learning to tell when sounds are right or wrong

• Practicing sounds in different words

• Practicing sounds in longer sentences

by Harriett Hoeprich, Speech/Language Specialist

Be a practice partner.

Ask your child's speech/language therapist to let you know when it would be helpful for you to practice at home. Then practice your child's successful words, using word cards or objects, at home. Use games and other fun activities, and make your sessions short and frequent. (5-15 minutes a day)

Don't directly correct sounds that your child has not worked on yet.

Direct correction has been shown to be largely ineffective and disruptive. This is especially true when the child has not had the opportunity to have the new skill presented in a more isolated way than connected speech. At some point, your therapist will let you know if your child is at the stage where gentle reminders may be effective during connected speech for the targeted sound. This is usually after mastery has been achieved at the single word level, however.

Use revision every day to address the articulation needs as a whole.

Parents don't realize how powerful this can be, particularly if the revision is used consistently and simply. Revision is the technique where you repeat what the child has said, but use the correct pronunciation. You may want to give the sound a little extra emphasis. (Example--Child: Look at bu! Adult: Look at that bug! Go, bug, go!)

Don't directly imitate your child's errors. Model good speech.

Some of the cute things our children say are very precious to us. But don't inadvertently reinforce the incorrect productions by laughing or drawing attention. Certainly don't imitate the incorrect production. Repeat the utterance using the correct pronunciation. And make a tape or video recording to save your memories of some of the adorable things your child says at this age! Model good speech.

Address health issues that may contribute to the problem.

Fight ear infections. Address other physical difficulties that may contribute, such as mouth breathing or voice difficulties.

Read to your child.

It's amazing how much this accomplishes. Use reading as a way to surround your child with the targeted sound. (See "Ideas for Books to Enhance Articulation Skills".)

Play with your child.

Spend time talking with your child in play, while you model the correct productions very simply, using revision.

Talk to your child.

Talk to your child as you go through your daily routine. This is a chance to model many correct productions, use revision, and stimulate language development, too.

Below are some fun ideas of games and activities you can use to practice your child's sounds. Many of these games involve the use of simple picture cards which can be made out of index cards and catalogs.

Use the picture cards to play Concentration (Memory) or Go Fish.

Play a board game like Candyland, but have your child say a word before he takes a turn each time. Don't forget to take a word yourself! Then it's one more model your child gets to hear. When your child is ready for this step, let your child "catch" you making the sound "the old way" and let him show you how it should be said with the "new sound".

If your child isn't quite ready to enjoy traditional board games like Candyland, use something like Hi-Ho Cherrio, which is a simpler type of game. Use the picture cards in the same manner, however.

Play more active types of games, such as Nerf Golf, Bean Bag Toss, Ring Toss, and Bowling by simplifying the game to include less movement. This works really well with the minimal pairs. Put out two bowling pins with a picture card of the pair against each one (pin-bin, for example). Then try several approaches: Have your child tell you which one he knocked over, or which one he will knock over. Then gently tell him: "You said you were going to knock over the picture of 'pin'. You knocked over 'bin'."

Hide the picture cards and let your child "find" them. You can also hide the pictures in other containers, such as plastic eggs.

by Harriett Hoeprich, Speech/Language Specialist 1995

The following are only a brief beginning list of possible books to enhance articulation skills. One reason that reading can be a helpful way of enhancing articulation is by "bombarding" the child with many opportunities to hear the correct pronunciation of the targeted sound. When you know your child has worked on a certain sound in therapy, it can also be another way to practice new skills. When you talk about the book with your child, the sound should come up naturally because of the topic or words in the book. You can use a "closure" technique to elicit certain words, if you feel fairly confident that your child can produce the sound. (For example: "Caps for sale! Fifty cents a ____." letting your child fill in the blank.) Or you could have the child "read" part of the book with you, if it's a story he is very familiar with. Very repetitive stories are also helpful in eliciting phrases--such as "Polar Bear, Polar Bear, what do you hear?"

Remember to use a very natural, low-key approach. Drilling under pressure will probably result in the child disliking the activity and possibly the whole idea of reading and speaking, which is certainly not your goal! Remember that even if your child is "only" listening, she is still gaining the auditory bombardment of the sound and opportunities to hear the correct pronunciation in a controlled setting, not to mention all the other benefits of spending time with you and reading.

K SOUND

THE VERY HUNGRY CATERPILLAR by Eric Carle

CROSS COUNTRY CAT by Mary Calhoun

CAPS FOR SALE by Esphyr Slobodkina

CATS AND CANARY by Michael Foreman

CAN I KEEP HIM by Steven Kellogg

CORDUROY by Don Freeman

MILLIONS OF CATS by Wanda Gag

D SOUND

A DARK, DARK TALE by Ruth Brown

HAVE YOU SEEN MY DUCKLING? by Nancy Tafuri

MAKE WAY FOR DUCKLINGS by Robert McCloskey

P SOUND

EACH PEACH, PEAR, PLUM by Janet and Allen Ahlberg

HAROLD AND THE PURPLE CRAYON by Crockett Johnson

PAT THE BUNNY by Dorothy Kunhardt

THE PIG'S WEDDING by Helen Heine

POPPY THE PANDA by Dick Gackenbach

F SOUND

FAMILY by Helen Oxenbury

FEELINGS by Aliki

FINDERS KEEPERS by Will and Nicholas Mordvinoff

A FARMER'S ALPHABET by Mary Axariun

THE FOOT BOOK by Dr. Seuss

THE FOOLISH FROG by Pete and Charles Seeger

FIVE LITTLE FOXES AND THE SNOW by Tony Johnston

ONE FISH, TWO FISH, RED FISH, BLUE FISH by Dr. Seuss

FIX-IT by David McPhail

GONE FISHING by Earlene Long

THE LITTLE FUR FAMILY by Margaret Wise Brown

M SOUND

MOON MAN by Tomi Ungerer

MAMA DON'T ALLOW by Thatchur Hurd

MADELINE by Ludwig Bemelmans

MARY HAD A LITTLE LAMB by Mary Josepha Hale

MAX'S FIRST WORD by Rosemary Wells

MITCHELL IS MOVING by Marjorie Weinman Sharmat

G SOUND

GOOD MORNING, CHICK by Mirra Ginsburg

GOOD-BYE HOUSE by Frank Asch

GONE FISHING by Earlene Long

GOODNIGHT MOON by Margaret Wise Brown

I GO WITH MY FAMILY TO GRANDMA'S by Riki Levinson

H SOUND

THE VERY HUNGRY CATERPILLAR by Eric Carle

THE THREE LITTLE PIGS by many different authors

HAPPY BIRTHDAY, MOON by Frank Asch

HAROLD AND THE PURPLE CRAYON by Crockett Johnson

HIPPOS GO BERSERK by Sandra Boynton

HOLES AND PEEKS by Ann Jonas

HOW DO I PUT IT ON? by Shrego Watanabe

HUSH LITTLE BABY by Jeanette Winter

B SOUND

I AM A BUNNY by Ole Risom

HUSH LITTLE BABY by Jeanette Winter

PAT THE BUNNY by Dorothy Kunhardt

THE RUNAWAY BUNNY by Margaret Wise Brown

L SOUND

I KNOW AN OLD LADY by Nadine Bernard Wescott

I LOVE MY BABY SISTER by Elaine Edelman

A LION FOR LEWIS by Rosemary Wells

THE LITTLE DUCK by Judy Dunn

THE LITTLE PUPPY, THE LITTLE LAMB, THE LITTLE KITTEN, ETC... by Judy Dunn

THE LADY AND THE SPIDER by Faith McNulty

THE LITTLE FUR FAMILY by Margaret Wise Brown

LYLE, LYLE, CROCODILE by Bernard Waber

SH SOUND

HUSH LITTLE BABY by Jeanette Winter

ONE FISH, TWO FISH, RED FISH, BLUE FISH by Dr. Seuss

SHEEP IN A JEEP by Nancy Shaw

SHEEP IN A SHOP by Nancy Shaw

SHHHH! by Suzy Kline

SHHHHH...BANG by Margaret Wise Brown

SHINE, SUN! by Carol Greene

TH SOUND

THE THANK YOU BOOK, by Francoise Seignobuse

THINGS I HATE by Harriett Wittels

THE LITTLE ENGINE THAT COULD by Wally Piper

AND TO THINK THAT I SAW IT ON MULBERRY STREET by Dr. Seuss

TEETH by Michael Ricketts

THANK YOU by Edith Flack Ackley

THUNDERSTORM by Mary Szilagyi

THUMP AND PLUNK by Janice May Udry

THE THINKING BOOK by Sandol Stoddard

THE THINKING PLACE by Barbara Joosse

THIS AND THAT AND THUS AND SO by Evaline Nuss

THIDWICK, THE BIG-HEARTED MOOSE by Dr. Seuss

THREE BY THE SEA by Edward Marshall

R SOUND

ROSIE'S WALK by Pat Hutchins

ROTTEN RALPH by Jack Gantos

LITTLE RED RIDING HOOD by the Brothers Grimm

S SOUND

SWIMMY by Leo Lionni

BROWN BEAR, BROWN BEAR by Bill Martin

SEE AND SAY by Antonio Frasconi

THE SEAL MOTHER by Mordicai Berestein

SEARCH FOR SAM by Neil Morris

SEEN ANY CATS? by Frank Modell

SEEDS by Terry Jennings

T SOUND

THE TEENY-TINY WOMAN by Paul Galdone

TEN, NINE, EIGHT by Molly Bang

TOUCH! TOUCH! by Riki Levinson

TEENY TINY by Jill Bennett

TASTING by Richard Allington

TAN TAN'S HAT by Kazuo Iwamura

TICKLE TICKLE by Helen Oxenbury

TIGER CAT by Slawomir Wolski

TIC, TAC AND TOE by Bruno Munari

FINAL CONSONANTS

LOUIS THE FISH by Arthur Yorinks

THE LITTLE DUCK by Judy Dunn

MOON MAN by Tomi Ungerer

PERFECT THE PIG by Susan Jeschke

THE CAT IN THE HAT by Dr. Seuss

ONE FISH, TWO FISH, RED FISH, BLUE FISH by Dr. Seuss

CROSS COUNTRY CAT by Mary Calhoun

CAN I KEEP HIM? by Steven Kellogg

A DARK, DARK TALE by Ruth Brown

THE FOOT BOOK by Dr. Seuss

GOODNIGHT MOON by Margaret Wise Brown

HAPPY BIRTHDAY MOON by Frank Asch

OLD MACDONALD HAD A FARM Several versions available

HOP ON POP by Dr. Seuss

TEETH by Michael Ricketts

TIC, TAC, AND TOE by Bruno Munari

You will probably come up with many more of your own favorites!

Harriett Hoeprich, M.S., CCC 1995

Childhood apraxia of speech (CAS) is a motor speech disorder that makes it difficult for children to speak. Children with the diagnosis of apraxia of speech generally have a good understanding of language and know what they want to say. However, they have difficulty learning or carrying out the complex sequenced movements that are necessary for intelligible speech.

Apraxia Kids