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What is a Phonological Disorder and How Can Speech-Language Therapy Help?

Updated: Feb 19, 2021

We are all familiar with the often adorable ‘toddler talk.’ When we hear a two-year-old child say ‘wawa’ for water, ‘baba’ for bottle, and ‘do’ for go, we know that this is just a part of child development. But how do we know when these speech errors are indicative of a speech delay or disorder? Our SLPs are here to help!

Phonological patterns are patterns of sound errors that children use to simplify speech as they are learning to talk. Phonological patterns are a part of typical development, and different sound errors are appropriate at different ages. For example, if we hear a three-year-old say ‘wed’ for ‘red,’ this is perfectly appropriate. If that same child is still saying ‘wed’ for ‘red’ at the age of 10, that is no longer typical. We call this a phonological delay, meaning the child is demonstrating a developmentally appropriate phonological pattern past the typical developmental time frame.

When a child is demonstrating sound errors that are atypical, we call this a phonological disorder. These sound errors are not a part of the natural learning process for speech and therefore require skilled intervention to remediate. The following are examples of atypical phonological patterns:

  • Backing: The child replaces the sounds ‘t’ and ‘d’ with ‘g’ and ‘k.’ For example, they may produce ‘ko’ for ‘toe’ or ‘gog’ for ‘dog.’

  • Initial Consonant Deletion: The child does not produce initial consonants. For example, they may produce ‘ottle’ for ‘bottle’ or ‘ig’ for ‘big.’

  • Glottal Replacement: The child replaces middle sounds in word with ‘uh.’ For example, they may produce “puh - ee” for ‘puppy.’

  • Affrication: The child replaces a sound like ‘t’ or ‘p’ (known as plosives) with a sound like ‘ch’ or ‘j’ (known as affricates). For example, they may produce ‘choy’ for ‘toy.’

  • Metathesis: The child consistently switches the order of sounds in a word. For example, they may produce ‘efulant’ for ‘elephant.’

SLPs work with children with phonological delays and disorders to establish a more developmentally appropriate sound pattern. To take the example of a child that produces ‘wed’ for ‘red’ at the age of 10, the SLP will first ensure that the child can hear the difference between sounds. This is called auditory discrimination. Then, the therapist will work with the child to achieve proper placement of the articulators - that is, the tongue, teeth, lips, palate, and jaw - to make the ‘r’ sound. They will then practice this sound at increasing levels of complexity, moving from syllables to words, phrases, sentences, and conversation.

If a child can already produce the correct sound but continues to present with speech sound errors, there are many established and evidence-based treatment methodologies that SLPs can implement. One example of this is contrast therapy. If a child consistently replaces the sound ‘t’ with ‘k’, the therapist may use a contrast therapy strategy known as minimal pairs. This therapy approach consists of selecting words that sound the same except for the target sound: tar/car, ate/ache, T/key, oat/oak. In this therapy approach, the child becomes the ‘teacher’, asking the SLP to point to words or pictures of words that the child says. If the child says ‘T’ when they really meant ‘key’, they will see that the SLP misunderstood their intended message. This helps to build awareness of how the sound error impacts how the child is understood.

Targeting phonological delays and disorders takes a lot of practice, but our therapists have plenty of experience in putting the ‘fun’ in functional therapy! If you have questions regarding your child’s speech development that are not answered in the speech section of our website contact us HERE and our SLPs would be happy to help!

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