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SPEECH SOUND DISORDERS:
ARTICULATION & PHONOLOGICAL PROCESSES

Definition

 

 

Speech sound disorders is an umbrella term referring to any difficulty or combination of difficulties with perception, motor production, or phonological representation of speech sounds and speech segments—including phonotactic rules governing permissible speech sound sequences in a language.

 

Speech sound disorders can be organic or functional in nature.

Organic speech sound disorders result from an underlying motor/neurological, structural, or sensory/perceptual cause.

Organic speech sound disorders include those resulting from motor/neurological disorders(e.g., childhood apraxia of speech and dysarthria), structural abnormalities (e.g., cleft lip/palate and other structural deficits or abnormalities), and sensory/perceptual disorders (e.g., hearing impairment).


 

Functional speech sound disorders are idiopathic—they have no known cause.

Functional speech sound disorders include those related to the motor production of speech sounds and those related to the linguistic aspects of speech production. Historically, these disorders are referred to as articulation disorders and phonological disorders, respectively.

Articulation disorders focus on errors (e.g., distortions and substitutions) in production of individual speech sounds.

Phonological disorders focus on predictable, rule-based errors (e.g., fronting, stopping, and final consonant deletion) that affect more than one sound.

It is often difficult to cleanly differentiate between articulation and phonological disorders; therefore, many researchers and clinicians prefer to use the broader term, "speech sound disorder," when referring to speech errors of unknown cause

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How to Detect

Signs and symptoms of functional speech sound disorders include the following:

  • omissions/deletions—certain sounds are omitted or deleted (e.g., "cu" for "cup" and "poon" for "spoon")

  • substitutions—one or more sounds are substituted, which may result in loss of phonemic contrast (e.g., "thing" for "sing" and "wabbit" for "rabbit")

  • additions—one or more extra sounds are added or inserted into a word (e.g., "buhlack" for "black")

  • distortions—sounds are altered or changed (e.g., a lateral "s")

  • syllable-level errors—weak syllables are deleted (e.g., "tephone" for "telephone")

Instructional Strategies

Teachers can look for different errors in these areas to determine if a student MAY have a speech sound disorder:

Articulation

Grammar/ Sentence Structure

Vocabulary/ Word Meanings

Social Communication

Following Directions/ Processing Information

Expansion of Limited Expressive Language Skills

Stuttering

Basic Concept Understanding

Vocal Quality

Speech-language pathologists (SLPs) play a central role in the screening, assessment, diagnosis, and treatment of persons with speech sound disorders. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment); prevention and advocacy; and education, administration, and research.

Practice and maintain easy and effective communication skills by modeling good listening skills and by facilitating participation of all students in classroom discussions and activities.

Individual instruction may be necessary to remediate these deficits, but should be provided discreetly to avoid embarrassment and possible resistance

 

Teachers should constantly model the correct production of sound. Maintain eye contact with the student, then tell her to watch the movements of your mouth when providing direct instruction. Ask her to copy these movements when she produces the sounds.

Teaching Approaches

  • Having a student sit near you to easily meet her learning needs.

  • Discussing possible areas of difficulty and working with the student to implement accommodations.

  • Always asking before providing assistance, and using positive reinforcement when the student completes an activity independently.

  • Using peer assistance when appropriate.

  • Modifying activities or exercises so assignments can be completed by the student, but providing the same or similar academic objectives.

  • Creating tests that are appropriate for the student with speech impairment (for example, written instead of oral or vice versa.)

  • Providing scribes for test taking if a student needs assistance.

    • Allowing more time for a student to complete activities, assignments and tests.

  • Making sure the student understands test instructions completely and providing additional assistance if needed

 

Other Approaches:

Articulation approaches target each sound deviation and are often selected by the clinician when the child's errors are assumed to be motor based; the aim is correct production of the target sound(s).

Phonological/language-based approaches target a group of sounds with similar error patterns, although the actual treatment of exemplars of the error pattern may target individual sounds. Phonological approaches are often selected in an effort to help the child internalize phonological rules and generalize these rules to other sounds within the pattern (e.g., final consonant deletion, cluster reduction).

Articulation and phonological/language-based approaches might both be used in therapy with the same individual at different times or for different reasons.

Both approaches for the treatment of speech sound disorders typically involve the following sequence of steps:

  • Establishment—eliciting target sounds and stabilizing production on a voluntary level.

  • Generalization—facilitating carry-over of sound productions at increasingly challenging levels (e.g., syllables, words, phrases/sentences, conversational speaking).

  • Maintenance—stabilizing target sound production and making it more automatic; encouraging self-monitoring of speech and self-correction of errors.

  • Transition Planning—the development of a formal transition plan in middle or high school that includes discussion of the need for continued therapy, if appropriate, and supports that might be needed in postsecondary educational and/or vocational settings (IDEA, 2004).

Disability Support Services—individualized support for postsecondary students that may include extended time for tests,  accommodations for oral speaking assignments, the use of assistive technology (e.g., to help with reading and writing tasks), and the use of methods and devices to augment oral communication, if necessary.

Teacher and Student
Preschool Teacher and Students
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Useful Websites
Research
  • Catts, H. W., McIlraith, A., Bridges, M. S., & Nielsen, D. C. (2017). Viewing a phonological deficit within a multifactorial model of dyslexia. Reading and Writing, 30, 613–629.       

Participants were administered multiple measures of phonological awareness, oral language, and rapid automatized naming at the beginning of kindergarten and multiple measures of word reading at the end of second grade. A structural equation model was fit to the data and latent scores were used to identify children with a deficit in phonological awareness alone or in combination with other kindergarten deficits​

  • Flipsen, P. (2015). Emergence and prevalence of persistent and residual speech errors. Seminars in Speech Language, 36, 217–223.

​This report reviews the existing literature on the emergence and prevalence of speech sound errors in older children and adults. Findings from several different sources suggest that 1 to 2% of the young adult population overall may present with these errors. Up to 75% of these errors may resolve on their own between the end of the developmental period (i.e., age 9 years) and the end of high school, though speech therapy services may still be justified to reduce any negative social consequences of these errors.

  • Peña-Brooks, A., & Hegde, M. N. (2015). Assessment and treatment of articulation and phonological disorders in children. Austin, TX: Pro-Ed.

This book gives assessments for students to understand the differences in articulation and phonological disorders and how to use them in the classroom.​

  • Storkel, H. L. (2018). The complexity approach to phonological treatment: How to select treatment targets. Language, Speech, and Hearing Sciences in Schools, 49, 463–481.

​ Although there are a variety of speech sound disorders, this article will focus on children with functional phonological disorders. Children with functional phonological disorders exhibit delays in sound production in the absence of any obvious motoric, structural, sensory, cognitive, or neurologic cause.

  • Wren, Y., Miller, L. L., Peters, T. J., Emond, A., & Roulstone, S. (2016). Prevalence and predictors of persistent speech sound disorder at eight years old: Findings from a population cohort study. Journal of Speech, Language, and Hearing Research, 59, 647–673.

​The purpose of this study was to determine prevalence and predictors of persistent speech sound disorder (SSD) in children aged 8 years after disregarding children presenting solely with common clinical distortions (i.e., residual errors).

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