As children grow, we expect them to have more and more speech sounds.  By age 6, children should have all their speech sounds. Different approaches are needed for different types of speech sound errors.

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Articulation Disorders

Children with articulation disorders have difficulty with the placement with tongue, lips or teeth to make a sound correctly.  Articulation disorders include lisps where the tongue is between the teeth for /s/ causing it to sound more like TH.  Children often have articulation difficulties with the R sound and say it with the tongue relaxed in the mouth (lax vowel) rather than tight causing it to sound more like the "oo" in book. 

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Phonological Disorders

Children with phonological disorders will often substitute sounds (e.g., say "tat" for 'cat') or drop sounds (e.g., say "nake" for 'snake').  The research indicates that the best treatment for these types of errors involves using minimal pairs, contrastive pairs or multiple oppositions.  Using an articulation approach may lead to overgeneralization (e.g., now using K for T sounds).  These students often can make the sounds in isolation but not in words due to rule based errors.  Many times these children also have weaknesses in phonological awareness skills which can impact reading abilities. 

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Childhood Apraxia of Speech (CAS)

CAS is a motor planning difficulty. The brain has difficulty planning and making speech movement involving the tongue, lips and/or jaw. It is a difficulty transitioning between sounds. The child may know how to make all the speech sounds but has difficulty putting sounds together. As a result, the child may have inconsistent errors for sounds depending on what other sounds are in the word. The number of sounds put together (length) and the word shape (complexity) will affect the child’s ability to say speech sounds. 

• Children with CAS can also have articulation/phonological speech errors 

• Often the ability to understand language is intact but their difficulty putting sounds together affects their verbal output 

• They tend to say a word differently each time they say it 

• These children have difficulty with prosody and may lack intonation when they talk 

• They are at risk for reading challenges 

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I have training in the Dynamic Tactile and Temporal Cueing approach to treat Apraxia