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Understanding Speech Sound Disorders

Speech sound disorders affect up to 15% of pre-school children and 6% of children in primary school. They are heterogeneous and include articulation disorders, delayed phonological acquisition, consistent speech disorders, and inconsistent speech disorders. Interventions should target the specific subtype and can be effective with low intensity (6 hours over 6 months). Speech sound disorders are associated with literacy difficulties for 30-77% of children, especially those with atypical error patterns or vowel errors. Factors like receptive language, IQ, phonological awareness, and family history also influence outcomes.

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Rafael Alves
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64 views2 pages

Understanding Speech Sound Disorders

Speech sound disorders affect up to 15% of pre-school children and 6% of children in primary school. They are heterogeneous and include articulation disorders, delayed phonological acquisition, consistent speech disorders, and inconsistent speech disorders. Interventions should target the specific subtype and can be effective with low intensity (6 hours over 6 months). Speech sound disorders are associated with literacy difficulties for 30-77% of children, especially those with atypical error patterns or vowel errors. Factors like receptive language, IQ, phonological awareness, and family history also influence outcomes.

Uploaded by

Rafael Alves
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© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

What we know about: Speech sound

disorders and treatment


Prevalence:
 Speech sound production difficulties affect up to:
o 10-15% of children in pre-school
o 6% of children in lower primary school
 Speech or speech and language difficulties in children constitute 70% of referrals to speech pathology
services
 Very heterogeneous group

Dodd’s subtypes of speech sound disorders:

Subtype Prevalence Description

Articulation 10% Diagnostic categories include dysarthria, structural anomaly,


Disorder mislearned motor patter (eg lisp). Treatment after 6yo is quicker and
(0.6% pop)
yields better results. Indicated Intervention: Speech sound in isolation
(articulation therapy)

Delayed 60% All sounds errors typical of a child of a younger chronological age.
Phonological Comorbid articulation disorder, language and global delays are not
(3.6% pop)
Acquisition uncommon. Indicated Intervention: Whole language or error pattern.

Consistent 20% At least one error pattern is atypical of expected phonological


Speech acquisition (backing, ICD). Delayed phonological patterns generally co-
(1.2% pop)
Disorder occur. Indicated Intervention: Error pattern (Minimal or maximal pairs)

Inconsistent 10% Inconsistent production of >40% based on three elicitations of the same
Speech lexical items in the same phonetic context. Indicated Intervention:
(0.6% pop)
Disorder Whole word (core vocabulary)

Childhood Rare Lifelong disorder. Consonants and vowels equally effected.


Apraxia of Characterised by disturbance of rate, prosody, oro-motor skills,
(up to 1 in
Speech consistency and errors in imitation rather than spontaneous production.
1000)
Indicated Intervention: limited evidence regarding treatment efficacy

Intensity and duration of intervention:


Law, Garrett and Nye’s (2010) systematic review of the literature indicated that there was some support for
the effectiveness of interventions focusing on speech sounds.

Page 1 of 2
What we know about speech sound disorders and treatment

Differential diagnosis is crucial as each subtype of speech sound disorder requires a different approach to
intervention and different intensity of service provision for long term impact.
Short-term gains in speech intelligibility have been demonstrated in response to low intensity, time limited
interventions ie. 6hrs of intervention over 6mths.
Association with literacy difficulties:
There is widespread agreement that there is an association between speech disorders and either literacy
skills attainment difficulties and/or poorer educational outcomes. It is important to note that many children
with speech disorders learn to read and spell without difficulty. Association does not imply causality.
Estimates of the extent of this association varies, with identified rates of co-morbid speech sound disorders
and literacy difficulties of between 30% and 77%.
Success with learning and literacy development is attributed to a range of factors including the type and
severity of the speech sound disorder, and the presence of developmental and psychosocial comorbidities.
Some studies indicate that the significance of a history of developmental speech sound delays on literacy
and learning lessens as children progress through primary school.
Inconsistent Speech Disorder and Consistent Speech Disorders (ie. disorders with atypical sound errors) are
increasingly associated with persistent literacy acquisition difficulties in both reading and spelling domains.
Factors that significantly increase the likelihood that a child with speech errors will also have difficulties with
literacy and learning include:
 Errors in vowel production
 Poor receptive language skills
 Low non-verbal IQ
 Poor phonological awareness
 Family history of learning difficulties
 Persistent speech difficulties (into primary school)

References:
Broomfield, J. & Dodd, B. (2011) Is speech and language therapy effective for children with primary speech and
language impairment? Report of a randomised control trial. International Journal of Language and Communication
Disorders.46-6, 628-640
Dodd, B. (2007) Intervention for Differentially Diagnosed Subtypes of Speech Disorder. American Speech-Language-
Hearing Association Convention. Seminar 1206
Holm, A., Farrier, F., & Dodd, B. (2008) Phonological awareness, reading accuracy and spelling ability of children with
inconsistent phonological disorder. International Journal of Language and Communication Disorders. 43-3, 300-322
Law, J., Garrett, Z., & Nye, C. (2010) Speech and language therapy interventions for children with primary speech and
language delay or disorder. Cocharane of systematic Reviews
Leitao, S. & Fletcher, J. (2004) Literacy outcomes for students with speech impairment: long-term follow-up.
International Journal of Language and Communication Disorders. 39-2. 245-256
McCabe, P., Ballard, K., Morgan, A., Murray, E., Purcell, A., Thomas, D., McKechnie, J., & Lim, J. (2014) Childhood
Apraxia of Speech: Prevalence, prognosis and services. Submission to the Australian Government Senate Inquiry
Regarding Prevalence of Different Types of Speech, Language and Communication Disorders and Speech Pathology
Services in Australia
McLeod, S., McCormack, J., & Daniel, G. (2014) Evidence of the social cost of failing to treat communication disorder.
Submission to the Australian Government Senate Inquiry Regarding Prevalence of Different Types of Speech,
Language and Communication Disorders and Speech Pathology Services in Australia.

Page 2 of 2 Children’s Health Queensland Hospital and Health Service

Common questions

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There is an association between speech disorders and literacy difficulties, with identified comorbidity rates between 30% and 77%. Factors increasing the likelihood of literacy issues include errors in vowel production, poor receptive language skills, low non-verbal IQ, poor phonological awareness, family history of learning difficulties, and persistent speech difficulties into primary school .

Speech sound disorders are linked with poorer educational outcomes, but these implications may lessen as children progress through primary school. Consistent and Inconsistent Speech Disorders are particularly associated with persistent literacy acquisition difficulties in both reading and spelling domains .

Differential diagnosis is essential because each subtype of speech sound disorder requires a distinct approach to intervention and different intensity of service provision, which impacts long-term outcomes. Identifying the specific subtype guides the choice of therapeutic methods for effective treatment .

Family history of learning difficulties is one of the key factors that increase the risk of both speech sound disorders and associated literacy challenges. It suggests a genetic or environmental component that influences the prevalence and severity of these disorders .

Poor phonological awareness is a significant factor that increases the likelihood of co-occurring literacy difficulties in children with speech sound disorders. It impacts the development of reading and spelling skills and highlights the need for targeted interventions in these areas .

Low-intensity, time-limited interventions, like 6 hours over 6 months, can lead to short-term gains in speech intelligibility. However, their long-term effectiveness is less clear, and such interventions may be insufficient for managing persistent or complex cases .

Dodd classifies speech sound disorders into five main subtypes: Articulation Disorder (10% prevalence), Delayed Phonological Acquisition (60%), Consistent Speech Disorder (20%), Inconsistent Speech Disorder (10%), and Childhood Apraxia of Speech (rare, up to 1 in 1000).

Failing to treat communication disorders can lead to significant social costs, including educational challenges, limited career opportunities, and broader social and economic implications due to reduced communication skills. Effective early diagnosis and intervention are crucial to mitigate these long-term impacts .

Different subtypes require distinct approaches. Articulation Disorder treatment involves speech sound in isolation, Delayed Phonological Acquisition uses whole language or error patterns, Consistent Speech Disorder uses error patterns (minimal or maximal pairs), Inconsistent Speech Disorder uses whole word or core vocabulary approaches, and Childhood Apraxia of Speech has limited evidence of treatment efficacy .

Early intervention is crucial because it can lead to quicker and more effective treatment outcomes, particularly for disorders like Articulation Disorder, where treatment success is higher after the age of six. Early intervention can prevent the development of associated literacy and learning difficulties .

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