Speech sound disorder

Speech sound disorders are speech disorders in which some speech sounds (called phonemes) in a child's (or, sometimes, an adult's) language are either not produced, not produced correctly, or are not used correctly. The term protracted phonological development is sometimes preferred when describing children's speech to emphasize the continuing development while acknowledging the delay.

Errors produced by children with speech sound disorders are typically classified into four categories:

Sometimes, even for experts, telling exactly which type has been made is not obvious — some distorted forms of /r/ may be mistaken for /w/ by a casual observer, yet may not actually be either sound but somewhere in between. Further, children with severe speech sound disorders may be difficult to understand, making it hard to tell what word was actually intended and thus what is actually wrong with it. Some terms can be used to describe more than one of the above categories, such as lisp, which is often the replacement of /s/ with /th/ (a substitution), but can be a distortion, producing /s/ just behind the teeth resulting in a sound somewhere between /s/ and /th/.

There are three different levels of classification when determining the magnitude and type of an error that is produced:

Note that omissions do not mean the sound cannot be produced, and some sounds may be produced more easily or frequently when appearing with certain other sounds: someone might be able to say "s" and "t" separately, but not "st," or may be able to produce a sound at the beginning of a word but not at the end. The magnitude of the problem will often vary between different sounds from the same speaker.

Speech sound disorders may be subdivided into two primary types, articulation disorders (also called phonetic disorders) and phonemic disorders (also called phonological disorders). However, some may have a mixed disorder in which both articulation and phonological problems exist. Though speech sound disorders are associated with childhood, some residual errors may persist into adulthood.

Articulation disorders (also called phonetic disorders, or simply "artic disorders" for short) are based on difficulty learning to physically produce the intended phonemes. Articulation disorders have to do with the main articulators which are the lips, teeth, alveolar ridge, hard palate, velum, glottis, and the tongue. If the disorder has anything to do with any of these articulators, then it is an articulation disorder. There are usually fewer errors than with a phonemic disorder, and distortions are more likely (though any omissions, additions, and substitutions may also be present). They are often treated by teaching the child how to physically produce the sound and having them practice its production until it (hopefully) becomes natural. Articulation disorders should not be confused with motor speech disorders, such as dysarthria (in which there is actual paralysis of the speech musculature) or developmental verbal dyspraxia (in which motor planning is severely impaired).

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