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Developmental Articulation
(ICD 315.39)

Article by:
Sarah Morales, BS
Children's Speech Care Center

A developmental articulation disorder involves the mispronunciation of speech sounds. Examples include lisping, for example, on the “s” sound, substituting “w” for “r”, etc. These are common childhood speaking errors, but by the age of 5 or 6, nearly all speech sounds have been learned by typically developing children. Some children do not learn sounds as quickly, and intervention by a speech-language pathologist becomes necessary.

Children may produce speech sounds incorrectly for a variety of reasons. I recall vividly the fun my grandfather used to have asking us to say “three thirsty thistles” with our front teeth missing. The normal processes of development of the mouth and teeth, however, are usually not enough to induce a developmental articulation disorder. There are two main types of developmental articulation disorders, those that occur due to a physical disability and those that occur in absence of a physical disability (called organic and functional articulation disorders, respectively). Functional articulation disorders are most common. In such cases, a child frequently does not hear (or process) speech sounds correctly, or he/she may not hear his/her own mispronunciations.

Organic articulation disorders occur due to some detectable abnormality. Examples include hearing loss and cleft palate. Children with congenital (meaning present at birth) hearing loss will have difficulty learning to speak; their speech is imprecise, unusual in pitch, and nasal sounding. Children with frequent middle ear infections (otitis media) may have similar difficulties (secondary to transient hearing loss—hearing loss that is not permanent; see section on otitis media). Children with a cleft palate (a hole in the roof of the mouth) sound nasal because they have no tissue at the top of their mouths to block the nasal cavities as normal speakers do. Transient hearing loss is also common in these children due to middle ear infections. Children with functional developmental articulation disorders, in contrast, do not have any detectable physical abnormalities. They have difficulty hearing sounds properly and/or producing sounds to match adult speech. Children who hear sounds incorrectly or are unable to imitate accurately tend to progress less quickly than those who can produce sounds correctly with an adult’s example.

Below is a chart of the typical order of speech sound mastery in children. Keep in mind, however, that children’s performances are very diverse, and each child is unique in his/her sound learning. However, if his/her peers are more accurate in their speech, or worse yet, if your child is being teased over his speech, trust your instincts and seek an evaluation with a speech-language pathologist.

p, m, h, n, w, b, k, g, d, t, ng
f, y
r, l, s
ch, sh, z, j, v, th

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