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Understanding Articulation Disorder in Children: Causes, Symptoms, and Treatment Options

If your child has difficulties articulating certain sounds in words, especially if they are school-aged, you may wonder if your child has an articulation disorder.

Perhaps, even a pediatrician or teacher has suggested you seek additional evaluation. As a parent, it can be scary to face the prospect of a speech sound disorder diagnosis. Yet, there are many resources available to support and treat children who have difficulty producing sounds.

Articulation disorder is one of many speech sound disorders diagnosed in children.

We will dive into a thorough explanation of the definition, causes, symptoms, diagnosis, and treatment options for children with articulation disorder.

What is Articulation Disorder in Children?

Articulation disorder is part of a family of disorders labeled as Speech Sound Disorders. These include a wide variety of difficulties people may have in producing sounds common in speech. According to American Speech-Language-Hearing Association (ASHA), “articulation disorders focus on errors (e.g., distortions and substitutions) in the production of individual speech sounds.”

Also known as functional speech disorder and articulation delay, articulation disorder, more specifically, is when a child has difficulty with sound production. They may also produce certain sounds incorrectly. For example, he or she may use the “f” sound instead of the “th” sound.

Children with this disorder struggle to get their lips, tongue, teeth, lungs, and palate to coordinate to produce the needed sounds. The National Institute on Deafness and Other Communication Disorders explains that the difficulty in motor control is because of the “imprecise placement, timing, pressure, speed, or flow of movement” of these body parts.

This leads to the child swapping out sounds for ones they can produce. It can also cause them to have distorted speech.

This disorder is often confused with phonological disorder. These two disorders are difficult to distinguish many times and children can have both simultaneously.

Children with an articulation disorder are unable to produce the sound in isolation or as part of a word. Articulation disorders are about the motor functions associated with producing sounds.

In contrast, with a phonological disorder, children can produce the sounds, they just have difficulties putting them together correctly.

Articulation disorder can affect a child’s self-esteem. Sometimes other children may make fun of a child who has difficulties making sounds correctly. It can also be associated with learning difficulties, troubles in reading, writing, and listening, and can be paired with other language and speech disorders.

What are The Causes of Articulation Disorders in Children?

Articulation disorders in children usually have no known cause. However, certain factors can make a child more at risk of developing an articulation disorder. Alternately, adults who develop speech sound disorders usually do so after traumatic brain injury.

Males have a higher incidence of speech sound disorders than females. It is unknown why this is the case.

Children with a family history of speech sound disorders are also more likely to have difficulties with speech themselves.

Pregnancy complications, pre-term deliveries, and low birth weight are also associated with speech sound disorders.

Stanford Medicine also lists some of the following as possible risks:

  • Hearing loss

  • Genetic disorders like Down Syndrome

  • Developmental disorders, such as autism

  • Nervous system disorders like cerebral palsy

  • Frequent ear infections

  • Cleft lip or palate

  • Too much thumb-sucking or pacifier use

  • Parents with low education levels

  • Lack of learning support at home

These are simply risks of articulation disorders, not the actual causes. The true cause is unknown in articulation disorders.

Symptoms of Articulation Disorder in Children

To determine for certain that your child has an articulation disorder, it is important to get your child evaluated by a speech-language pathologist (SLP). Children can be screened for this disorder and many other language, speech, and learning disorders with a speech-language assessment.

Yet, common symptoms of articulation disorder involve specific speech sound errors. If you are hearing these articulation errors consistently and your child is 4 or older, you may want to get him or her evaluated:

  • Distortions: A child uses different sounds or changes a typical sound in words. A lisp is an example of a distortion

  • Substitutions: A child replaces particular sounds for one the child can produce more easily. Consonant sounds can be especially difficult. For example, he or she may use the “th” sound for “s.” Another example is using “wabbit” instead of “rabbit.”

  • Omissions: This is when a child leaves out a sound in a word. This could be at the beginning, middle, or end of a word. (e.g. “ca” instead of “cat”).

  • Syllable-level errors: The weaker syllables in words are deleted. (e.g. “elphant” instead of “elephant”

  • Additions: Extra sounds are added to words (e.g. “buhbaby” instead of “baby”)

It is important to note that not all substitutions and omissions are speech errors. Some may be a part of a speaker’s dialect. A dialect is a regional way of using language. They can vary greatly across any given language. They have different patterns and compositions.

This is another reason it is important to have a speech-language pathologist evaluate any child suspected to have a speech sound disorder to help distinguish between regional differences and actual difficulties with speech.

Also, some sound errors are common as a child is developing speech. Children can produce different letter sounds at different ages. Typically, by 6 years old, most children without speech issues can say almost all of the speech sounds. The following is a list of sounds children are typically able to produce by age:

  • 2-3 years old: P, B, D, M, N, H, W; a child is about 15% intelligible at age 3.

  • 3-4 years old: T, K, G, NG, F, Y; a child is about 50% intelligible at age 4.

  • 4-5 years old: V, S, Z, SH, CH, J, L; a child is about 75% intelligible at age 5.

  • 5-6 years old: voiced TH, ZH, R; a child is about 80% intelligible by age 6.

  • 6-7 years old: voiceless TH; a child is about 90% intelligible at age 7.

Remember that different children develop differently. This is merely a guide and not necessarily any hard and fast rule. If you think your child isn’t developing speech at the correct rate, it is important to get your child evaluated.

What is Involved in Screening for Articulation Disorder in Children?

If you suspect your child has a speech sound disorder, you can begin by taking your child to a pediatric healthcare provider. This professional will informally evaluate a child for errors in speech and physical barriers. If the professional believes your child may need a more comprehensive assessment, they will refer you to a speech-language pathologist.

A speech-language pathologist will perform a more comprehensive assessment to decide whether your child has a delay in speech development. Some errors may be due to typical developmentally appropriate patterns in young children or the result of regional dialects or accents. This more comprehensive assessment will use formal and informal assessment tools to evaluate any body structure impairments, deficits, conditions, limitations, social, and/or environmental factors that may play into the child’s speech issues.

The assessment will include an oral examination to check the structures in the mouth for any obstructions, such as cleft palate, that may be causing a physical barrier to speech. A hearing test will also be performed to check for any auditory conditions. A speech-sound assessment will be used to determine the severity of the child’s articulation disorder. And a phonological processing assessment will be given to assess how the child processes spoken language.

They will also be tested on their spoken and written language skills since children with speech sound disorders often develop difficulties with language development. It is completely normal to see children with speech problems also diagnosed with language disorders.

Then, a diagnosis and a recommendation for treatment will be given to the child’s caregiver.

Often this diagnosis also comes with a severity rating. Severity is judged by the SLP based on the impact the disorder has on the child’s ability to communicate. The scale for severity is usually given using a number rating. More severe cases will have extensive omissions and many substitutions, whereas milder cases will only have a few of these.

The severity determines the length and approach of the treatment plan.

Treatment Options for Articulation Disorder in Children

Once a diagnosis has been made, a treatment plan can be put into action. If physical barriers are preventing your child from creating the appropriate sounds, they will be referred to a medical professional who can suggest treatment for their physical condition.

However, the most common treatment option is speech therapy. A speech therapist can provide your child with articulation therapy based on the child’s individual needs.

In a speech therapy session, your child will learn to notice their sound errors and correct the sounds. They will practice the sounds they have difficulty with and learn how to correctly produce those sounds. They will learn how to move their muscles, lips, and tongues to produce the needed sounds.

Practice does make perfect, so the SLP will also spend time having the child practice words and sounds over and over until he or she gets them right. They will also provide the caregiver with strategies and activities you can try to work on the sounds at home.

Speech therapy can go a long way in building your child’s confidence back, as they become more successful in producing sounds that were once difficult for them.

If other developmental delays or disorders are diagnosed along with the articulation disorder, there may be other strategies and treatments suggested alongside speech therapy. These could include interventions at school.

Ways to Support Your Child At Home

One of the best ways to support a child with an articulation disorder is to make sure he or she makes it to all their appointments, including health and speech therapy appointments. It is important to keep an open line of communication between yourself and your child’s healthcare providers to let them know any concerns you may have.

If your child is in school, make sure to let the school know. Advocate for additional support for your child at the school level. According to the severity of the case, your child may need special services or interventions to help

Practice the strategies your child is learning with the SLP at home to continually reinforce that development. The more your child practices, the better he or she will become.

Your child may need more reassurance during this time, too. They will be having to do a lot of new and different things that may be scary and/or frustrating.

If you think any of the symptoms become more severe, make sure you contact your child’s healthcare provider as soon as possible.

Finding a Speech-Language Pathologist

Seeking out a professional in speech-language pathology doesn’t have to be difficult, The California Scottish Rite Foundation can help connect you with a skilled SLP. We are partnered with many practitioners throughout California. Our SLPs can provide your child with the speech, learning, and language help that he or she needs to be more confident in social situations and more successful in academics.

We not only provide services at locations across California, but we also partner with universities and private practices to offer a greater breadth of services to children.

And, the best part is that these services are offered free of charge, making it easier for you to get your child the services he or she needs.


An articulation disorder doesn’t have to be scary. Knowing what it is, the symptoms to look out for, the risks of developing it, and the treatment options can give you peace of mind.

You can take this knowledge to help you find a treatment plan that is best for your child. This will give your child the tools to be successful and confident. The earlier a speech disorder is treated, the better.

So, if you are still worried your child may have an articulation disorder, make sure to get him or her evaluated by a Speech-Language Pathologist sooner rather than later.


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