When children begin attending speech therapy for unintelligible speech or speech sound errors, the first thing their therapist will do is work to determine more information about the errors and the possible reason or cause for the errors, so that the treatment plan can be the most effective.
While speech sound errors can be the result of structural differences, such as cleft lip or palate, hearing loss, or additional differences, most frequently speech sound impairments are due to articulation impairments, phonological impairments, or childhood apraxia of speech. Each of these types of speech sound disorders changes the pattern of errors.
Articulation refers to the errors in producing individual speech sounds. For example, if a client is producing distortions of /r/ instead of a clear, crisp /r/, or if they are producing /s/ with an interdental or lateralized lisp, these would be targeted through an articulation approach. This approach includes teaching placement of the articulators, voicing, and how to produce each sound.
Phonology refers to errors that are predictable and impact groups of sounds rather than each individual sound. For example, when a child produces s-blend errors such as “no” for “snow” and “pot” for “spot,” they are demonstrating a pattern of errors where they are consistently deleting the /s/ out of each cluster. Another example of phonological errors include fronting, which is producing back sounds such as /k/ or /g/ in the front of the mouth, resulting in producing them as /t/ and /d/. Treatment for phonological impairments may also teach about articulators and how to produce each sound, but it will likely include teaching the difference between the sound that is being produced and the sound they intend to produce. This approach also emphasizes that changing the sounds can change the meaning of the word (ex. “Key” and “tea” are different words and mean different things).
Childhood apraxia of speech refers to a speech disorder that is caused by motor planning difficulties, which make it difficult to sequence sounds to create words. Children who present with childhood apraxia of speech (CAS) often have inconsistent errors in their speech due to the brain not correctly planning how to move the articulators to accurately produce sounds. Treatment for CAS often includes specific cues to help move from one sound to the next to create the motor plan for functional words.
Works Cited:
American Speech-Language-Hearing Association. (n.d.). Speech sound disorders: Articulation and phonology. American Speech-Language-Hearing Association. https://www.asha.org/practice-portal/clinical-topics/articulation-and-phonology/