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 

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 (SLP), I can assess 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 also assess your child’s language skills. Many children with speech sound disorders also have language disorders. For example, your child may have trouble understanding concepts (in, on, next to) 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 delay 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 move the articulators to produce sounds correctly

• 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.

Here’s a list of book ideas organized by speech sounds to help enhance articulation skills during therapy or at home. These books incorporate repetitive sound patterns or themes featuring target sounds, making them ideal for articulation practice.

B Sounds

• Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr.

• Baby Beluga by Raffi

• Biscuit series by Alyssa Satin Capucilli

P Sounds

• Panda Bear, Panda Bear, What Do You See? by Bill Martin Jr.

• If You Give a Pig a Pancake by Laura Numeroff

• Llama Llama Red Pajama by Anna Dewdney

M Sounds

• Goodnight Moon by Margaret Wise Brown

• If You Give a Moose a Muffin by Laura Numeroff

• Moo, Baa, La La La! by Sandra Boynton

T Sounds

• The Very Hungry Caterpillar by Eric Carle

• Ten Little Ladybugs by Melanie Gerth

• The Tale of Peter Rabbit by Beatrix Potter

D Sounds

• Are You My Mother? by P.D. Eastman

• Dear Zoo by Rod Campbell

• Duck on a Bike by David Shannon

K/G Sounds

• Good Night, Gorilla by Peggy Rathmann

• Click, Clack, Moo: Cows That Type by Doreen Cronin

• Go, Dog, Go! by P.D. Eastman

F Sounds

• Five Little Monkeys Jumping on the Bed by Eileen Christelow

• Fly Guy series by Tedd Arnold

• Frog and Toad Are Friends by Arnold Lobel

S Sounds

• The Snowy Day by Ezra Jack Keats

• Silly Sally by Audrey Wood

• The Very Busy Spider by Eric Carle

SH Sounds

• Sheep in a Jeep by Nancy Shaw

• Shark in the Park by Nick Sharratt

• A Big Mooncake for Little Star by Grace Lin

CH Sounds

• Chicka Chicka Boom Boom by Bill Martin Jr.

• Charlie and the Chocolate Factory by Roald Dahl (for older readers)

• Chicken Little by Rebecca Emberley

R Sounds

• Runaway Bunny by Margaret Wise Brown

• Rainbow Fish by Marcus Pfister

• Room on the Broom by Julia Donaldson

L Sounds

• Llama Llama Mad at Mama by Anna Dewdney

• The Little Engine That Could by Watty Piper

• Leo the Late Bloomer by Robert Kraus

TH Sounds

• The Cat in the Hat by Dr. Seuss

• Thank You, Omu! by Oge Mora

• There's a Wocket in My Pocket! by Dr. Seuss

Z Sounds

• Put Me in the Zoo by Robert Lopshire

• Zoom! by Robert Munsch

• Zach's Alligator by Shirley Mozelle

V Sounds

• Olivia by Ian Falconer

• Victor Vito and Freddie Vasco by Laurie Berkner

• Vera Viper’s Valentine by Maxwell Higgins

These books not only engage children with their stories and illustrations but also provide natural opportunities to practice articulation in a fun and interactive way.

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