Why Can’t I Understand My Child?: Articulation Disorders vs. Phonological Processing Disorders
Hearing your child find their voice with cooing, babbling, and giggling, say their first true meaningful word, ask for something they need or want, and start to use language functionally more and more each day, is such an incredible series of milestones in their early months/years. However, what happens when you can’t understand what they’re saying to you?
First, it’s important to note that “speech” and “language” are different areas of development, and therefore, have their own respective set of milestones. “Language” refers to the words we use to communicate, specific grammar rules, and the meaning behind what we say. First words are expected to emerge around your child’s first birthday (12 months). “Speech” refers to the specific sounds that make up those words (for the remainder of this post, we will be referring to “speech” milestones only).
Back to the original question: what happens when you can’t understand what your child is saying?
From the perspective of a Speech-Language Pathologist, a few things could be happening.
Articulation Disorders:
○ Distortions of sounds (e.g., lisp due to incorrect placement of the tongue, difficulty producing “r”, etc.)
○ Substitutions of sounds (e.g., replacing “r” with “w” in the word “rabbit”)
○ Omissions of sounds (e.g., leaving out sounds altogether like “how” for “house” or “pider” for “spider”)
○ Addition of sounds (e.g., inserting new sounds into words like “puh”-”lay” for “play”
Typical speech sound milestones by age:
| Age | Speech Sounds |
|---|---|
| 2 Years | /b/, /n/, /m/, /p/, /h/, /w/, /d/ |
| 3 Years | /g/, /k/, /f/, /t/, “ng” (like sing), “y” |
| 4 Years | /v/, /s/, /l/, /z/, “CH”, “SH”, “J” (like in jump) |
| 5 Years | “R”, “TH” (voiced – like that), “ZH” (like in vision) |
| 6 Years | “TH” (voiceless – like three) |
● 2 years old: /b, n, m, p, h, w, d/
● 3 years old: /g, k, f, t/, “ng” (like “ing”), and “y”
● 4 years old: /v, s, l, z/, “CH”, “SH”, and “J” (like in “jump”)
● 5 years old: “R”, “TH” (specifically “voiced” like in “that” or “the”), and “ZH” (like in “vision”)
● 6 years old: “TH” (specifically “voiceless” like in “three”)
Phonological Processing Disorders:
○ Patterns of errors across different words (e.g., all “l” sounds are “w”, all final or “end” sounds are left off of words, all “k” sounds are “t”, etc.)
○ Errors are happening in order to make speaking easier for the child
○ Various ages of elimination based on the process - if patterns of errors are observed beyond the developmental age of elimination, speech therapy is appropriate
Difficulty being understood can cause significant frustration with communication and can lead to behaviors or refraining from making attempts at getting your wants and needs met. If you are struggling to understand what your child is saying or if you have concerns with where your child’s sound inventory falls in regards to the milestones above, reach out to us at Pioneer Therapy. We are here to help you understand the “why” behind low intelligibility (or your ability to understand your child’s speech), and will help you know if speech therapy can benefit your child. We have fantastic, talented Speech-Language Pathologists on our team who are here for you!
Written by:
Kenna Marquardt, MHS, CCC-SLP
Pronouns: she/her
Pediatric Speech-Language Pathologist
Pioneer Therapy
2232 N Clybourn Ave, 3rd Level,
Chicago, IL 60614
Resources:
American Speech-Language-Hearing Association (ASHA)
McLeod et al. (2018 and 2020)