What is a speech sound disorder?
A speech sound disorder is an umbrella term that encompasses any disorder related to the production or perception of speech sounds (i.e. articulation disorder, phonological disorder, dysarthria, apraxia, etc.) These disorders can be caused by a neurological/motor condition, or the speech sound disorder may have no known cause at all. Two categories are typically considered when diagnosing and treating a speech sound disorder. These categories include:
Functional Speech Sound Disorder
A functional speech sound disorder has no known cause. Therefore, it is not considered secondary to another condition. Functional speech sound disorders typically include articulation disorders and phonological disorders.
Organic Speech Sound Disorder
An organic speech sound disorder, unlike a functional speech sound disorder, has a known cause. An organic speech sound disorder is usually secondary to another diagnosis, whether it be motor or neurological. For example, dysarthria may be diagnosed secondary to a cerebrovascular accident (stroke). The same can be said for dysarthria or apraxia secondary to a traumatic brain injury.
What are the signs and symptoms of a speech sound disorder?
Children with speech sound disorders may also exhibit delayed language development, reduced vocabulary, and difficulty with grammar and syntax.
In adults, the signs and symptoms of a speech sound disorder may be more subtle and may include difficulty with word retrieval, reduced speaking rate, monotone voice, or difficulty with intonation and stress patterns. Adults with speech sound disorders may also experience difficulty with social interactions and may avoid situations that require speaking.
If a speech sound disorder is suspected, it is important to seek a comprehensive evaluation from a speech-language pathologist. Early intervention and treatment can help improve speech and language skills and promote optimal communication outcomes.
The signs and symptoms of a speech sound disorder may vary depending on the type and severity of the disorder. Some common signs of a speech sound disorder in children include:
Difficulty producing speech sounds
Inconsistent or incorrect pronunciation of words
Difficulty being understood by others
Frustration or reluctance to speak
What causes a speech sound disorder?
Often, a speech sound disorder has no known cause, but some speech sound errors may be caused by such risk factors:
It is important to note that not all children with these risk factors will develop a speech sound disorder, and some children without any known risk factors may still develop the disorder.
Family history
children with a family history of speech sound disorders are more likely to develop the disorder themselves. Hearing loss, particularly if the hearing loss was present before or during the primary speech development period in early childhood.
Developmental disabilities
children with developmental disabilities, such as autism spectrum disorder or Down syndrome, are more likely to experience speech sound disorders.
Events such as strokes
Events like strokes, traumatic brain injuries (TBIs), or other illnesses that affect the brain can often lead to speech and language difficulties. After such incidents, speech-language pathologists commonly observe conditions like dysarthria (difficulty speaking due to muscle weakness) or apraxia (difficulty coordinating the movements needed for speech).
Structural Differences
uch as a cleft lip or cleft palate, can lead to challenges in producing clear speech sounds, often resulting in a speech sound disorder. These physical variations affect how sounds are formed, making it more difficult for individuals to articulate words clearly.
How are speech sound disorders diagnosed?
Speech sound disorders are typically diagnosed through a comprehensive evaluation by a speech-language pathologist. Typically, a patient/client will be referred to a speech-language pathologist by either a medical professional, an educator, or even a parent/guardian when the issues with the speech sounds appear or persist. Following this referral, the speech-language pathologist will gather background information on the individual, whether this be a developmental history for a child or medical history for an adult who may have suffered some sort of traumatic event like a stroke or TBI. The speech-language pathologist might initially utilize a screener in order to get an idea of what speech sounds are missing/distorted, and if said screener is failed by the individual, then the speech-language pathologist might follow up with a more in-depth and normative-based assessment. If this assessment is also failed by the individual, then they will be considered for treatment and diagnosed with a speech sound disorder (either secondary to another diagnosis or it may be considered functional without an initial diagnosis).
Articulation therapy
This approach focuses on teaching the individual to produce speech sounds correctly through targeted practice and feedback.
Phonological therapy
This approach addresses underlying patterns of errors in speech sound production and aims to improve the individual's ability to use and understand language.
Oral-motor therapy
This approach focuses on improving the strength and coordination of the muscles used for speech production, including the lips, tongue, and jaw.
Augmentative and alternative communication (AAC)
For individuals who are unable to produce speech sounds or who have severe speech sound disorders, AAC devices or strategies may be used to facilitate communication.
Parent or caregiver involvement
In many cases, parents or caregivers may be trained to support and reinforce speech and language skills at home.
How are speech sound disorders treated?
Speech sound disorders can be treated through a variety of approaches, depending on the specific type and severity of the disorder. Some common treatment methods for speech sound disorders include: