Speech Impediment Types

If your child is hard to understand when they talk, it could be due to a speech impediment (often called a “speech impairment”). Depending on the particular difficulties, the impairment might fall under one of these categories:

Articulation Disorder

As children’s speech develops, it’s normal for them to have difficulty with certain sounds because some sounds (such as “r” or “th”) are harder to learn and take more time to master. By around age 5, it’s expected that children will be able to say nearly all the speech sounds. If your child has had trouble with a particular sound or sounds for awhile and their speech is difficult to understand (studies show that children should be nearly fully intelligible to unfamiliar listeners by age 4), it might be time to consult a speech-language pathologist.

Phonological Disorder

Another term you might have heard is a phonological disorder. Compared to an articulation disorder, where a child might have difficulty with some individual sounds, a phonological disorder occurs when a child uses processes to simplify the production of categories of sounds. One example of this is called “fronting,” where a child substitutes sounds that are made at the front of the mouth (like “t” and “d”) for sounds that occur at the back of the mouth (like “k” and “g”). If a child uses only one of these processes, it may not be reason for concern. However, if they use more than one and their speech is very hard to understand, you might want to speak with a speech-language pathologist.

Apraxia of Speech

A third, less common category of speech impairment is called “childhood apraxia of speech” (CAS). Children with CAS know what they want to say but have difficulty getting the message from their brain to the muscles of the mouth. The issue here is not due to any muscle weakness but to difficulty with the motor plan needed to produce speech smoothly. Some signs of CAS include: distortions of vowels, groping movements of the mouth as they try to produce sounds, saying the same word in different ways, using incorrect stress with words, and difficulty imitating simple words. If you notice any of these characteristics in your child’s speech, a speech-language pathologist can conduct an evaluation to help determine what the issue might be and if speech therapy can help.

Stuttering

Most children experience some dislfuencies/irregularities in their speech as they are learning to talk. For the vast majority of these children, the problem will not continue past childhood. For others, however (approximately 1%), these patterns will persist. Examples of irregular disfluencies include the prolongation of sounds, repetition of sounds, or short periods of silence while the child is trying to produce a word. The exact cause of stuttering is still unknown. However, a number of factors have been determined to contribute to its development, specifically genetics, the presence of other speech or language disorders, home environment/family interactions, and structural differences in the brain. Stuttering is also far more likely to affect males than females (4:1). As children get older and become more aware of their stuttering, other physical characteristics may begin to develop, such as facial tension or hand movements. If you notice irregularities in your child’s speech like those listed above that have lasted at least six months, it may be time to seek an assessment by a speech-language pathologist.

What Does Online Speech Therapy for a Speech Impediment Look Like?

Speech therapy for articulation and phonological disorders will work to help your child produce all his sounds as clearly as possible. At the beginning, this will involve teaching the child auditory discrimination, to ensure that they can hear the differences between the sounds they’re producing and the target sounds. The speech therapist (also known as a speech-language pathologist) will then use a number of different methods to elicit the correct sound including visual cues, modeling, and using other sounds your child already has to help shape the erroneous one. After your child is successful producing the sound by itself, they will move on to producing the sound in words, phrases, sentences, and conversational speech.

For stuttering, the focus of speech therapy will differ greatly depending on your child’s age. For preschool-aged children, therapy focuses significantly on parent education, especially what kind of environmental changes can be made at home to best support the child’s speech (slowing down the pace, decreasing verbal demands, turn-taking, reducing sequential question-asking, etc). As the child becomes aware of their stutter, therapy will focus more on identification of stuttered speech and strategies that can be used to enhance fluency. As children get older, therapy expands to address emotional attitudes towards speaking and methods to reduce avoidance behaviors.

Online speech therapy has been shown to be as effective as in-person therapy. Although speech therapy does require lots of repetition (practice makes perfect!), your child’s speech therapist will use games and other engaging activities to make it as fun and effective as possible. They will also provide worksheets and practice activities for you to work on between your online sessions.