Phonological disorders involve error patterns related to the speech sound systems of languages, understanding and using meaningful contrasts, and organizing speech sounds to form words based on the rules of the language being spoken (i.e., difficulty sorting out which sounds in the language make a difference in meaning). These patterns are called phonological processes. While use of a phonological process is common for developing children, it should not persist as they get older.

Children with phonological disorders may be hard to understand. Typically, imitation of most age appropriate speech sounds can be correctly produced. Children may correctly produce a sound or sounds in certain positions of words while they may regularly struggle to produce that same sound(s) in other positions of words.

Consistently replacing sounds like /k/ that should be produced at the back of the mouth with a sound like /t/ that is made at the front of the mouth - a pattern known as fronting (e.g., "tat" for "cat").

Gierut, J. A. (1998). Treatment efficacy. Journal of Speech, Language, and Hearing Research, 41(1). https://doi.org/10.1044/jslhr.4101.s85
Dodd, B., Reilly, S., Ttofari Eecen, K., & Morgan, A. T. (2018). Articulation or phonology? Evidence from longitudinal error data. Clinical Linguistics & Phonetics, 32(11), 1027-1041. https://doi.org/10.1080/02699206.2018.1488994
Furlong, L. M., Morris, M. E., Serry, T. A., & Erickson, S. (2021). Treating childhood speech sound disorders: Current approaches to management by Australian speech-language pathologists. Language, Speech, and Hearing Services in Schools, 52(2), 581-596. https://doi.org/10.1044/2020_lshss-20-00092

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PRESENTATION:

EXAMPLE:

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Causes

Causes for phonological disorders are mostly unknown. A family history of speech and language disorders, hearing loss, developmental delays, genetic diseases, and neurological disorders appear to be risk factors for the disorder.

Interventions

Successful treatment for phonological disorders focuses heavily on increasing a child’s awareness to the speech errors. Treatment approaches are individualized for the child based on their needs and the clinical opinion of the SLP. Common approaches are listed below:

Cycles Approach
Core Word Approach
Distinctive Feature Therapy
Minimal Oppositions Contrast Therapy
Maximal Oppositions Contrast Therapy
Multiple Oppositions Contrast Therapy
Metaphon Therapy

Assessments

A simple speech evaluation involving a number of tests can determine the type and severity of a phonological disorder, if one is present. Common assessment tasks are outlined below:

Conduct a hearing screening to rule out hearing impairment as a cause for the speech sound errors.
Collect a sample of the child's speech through conversation or story telling.
Listen to how the child produces each sound in different word positions to note if the sound is produced in some contexts but not others.
Differentiate between words or sounds spoken in isolation and those said in a sentence.
Determine the child's ability to produce sounds based on instruction or modelling .

Speech Sounds Disorders