Speech and Language Therapy for Speech Sound Disorders

Unclear speech is expected in very young children. Speech and language therapy for unclear speech is only required when children are struggling to make themselves understood by familiar adults, stop making progress with their speech sounds, are very behind their peers or make unusual speech sound errors. Speech refers to the sounds used to make up the words we say, so unclear speech could refer to a child saying “bine the tat” for “find the cat”. This is different from a language difficulty, which refers to vocabulary knowledge and sentence construction and understanding.

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  • There are lots of different types of speech sound difficulties. In children’s speech and language therapy, the umbrella term “speech sound disorder” is used to encompass all the different types. Often children may have more than one type of speech sound difficulty. Children’s speech and language therapy consists of full assessment and then personalised goal setting, followed by regular speech and language therapy sessions, to improve the clarity of the child’s speech so they can get their message across more successfully. This work often requires the expertise of a speech and language therapist to assess if difficulties are likely to need intervention or if they are part of a more typical speech development profile.

  • Speech sound disorders can be related to articulation (physical production of the sound) and/or phonology (organising sounds into patterns). Some difficulties are classed as consistent (the same every time), whereas others are inconsistent. Sometimes children can say the sound on it’s own but have difficulty combining it with other sounds in a word.

  • A Speech and Language Therapist can carry out a structured assessment to find out exactly which sounds or combinations of sounds your child is finding it hard to say. They can then advise if this is likely to resolve with a little support at home or if speech and language therapy sessions are advised. There are lots of different approaches depending on the type of speech sound disorder, and there is lots of evidence to show that speech and language therapy can help.

  • This depends entirely on your child! If your child does not have many words yet, it can be hard to work out if they need help for their speech sounds, so we often recommend working on language skills first with very young children. Children need a certain level of motivation and attention and listening to practice changing their speech sounds and again this is not yet usually present in very young children. Age 3-4 can be a good time to start for lots of children as it is important to resolve as many difficulties with speech sounds as possible before they start to learn to read and write.

  • Repeat back what they have said clearly when they make a mistake, but don’t ask them to copy you e.g. child: “bid tat”, adult: “it’s a big cat!”. You can also play games with speech sounds e.g. “what is the bag?” with items starting with a sound e.g. “s” – you name the items so they hear the sound lots of times. 

  • Children seen recently for speech sound therapy include:

    • An 8 year old who came to therapy to change his s and z sounds so they were produced correctly behind his teeth instead of with his tongue sticking out (interdental lisp) and his ch, j and sh sounds to be produced with central airflow rather than lateral airflow (lateral lisp). These are called articulation difficulties and this child has worked so hard we are about to finish therapy after 4 months.

    • A 3 year old who uses g for lots of her sounds – we are working on swapping g for d and s using an approach called minimal pairs so she can communicate more successfully.

    • A 4 year old who uses d for lots of his sounds – we are using the “multiple oppositions” approach to help him use lots of new sounds instead of d.

  • Childhood Apraxia of Speech (CAS) is a type of speech sound disorder. It used to be called Developmental Verbal Dyspraxia (DVD). Children with childhood apraxia of speech have difficulty learning or carrying out the complex sequences of movements required for intelligible speech. They usually have good understanding of language and know the words that they want to say. Frequent speech and language therapy sessions are often required to support repetitive practice.