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Speech Difficulties & Disorders

As children are learning to talk, they will inevitably have difficulty articulating some sounds as their speech develops. Generally, they will learn to some say sounds earlier than others e.g. sounds like b, m, or w, are often some the first sounds they will produce when they start to babble. Other sounds, such as s, r, th etc. will take longer and develop as they grow. By the age of 4 years old children should be able to make most sounds (although there is a bit of variability between children) and be understandable most of the time. However, if a child does not say certain sounds by the expected ages, and these difficulties persist, they may have a speech sound disorder. Speech sound disorders can occur for different reasons.

Speech Sound Disorders

  • Functional Speech Disorder (often called an Articulation Disorder) – this is a difficulty learning to make specific sounds. Common sounds that children have difficulty with are /th/, /r/, /l/, /sh/ etc.
  • Phonological Disorders which follow an error pattern e.g. a certain group of sounds is nearly always produced in a certain way because the child may have poor awareness of their speech production, or have a particular difficulty with analysing the different speech sounds when they hear them. An example of an error pattern is when a child consistently uses one sound instead of another e.g. they always use a /t/ sound instead of a /k/ sound so they will say “tar” and “tat” instead of “car” and “cat“. The may have these pattern for several sounds, or they may use one sound for several e.g. they may “dat” for “cat“, “sat“, “chat” “fat” etc.It is difficult to differentiate between articulation and phonological disorders and clinicians often use the term “speech sound disorder” to cover these speech errors when the exact cause is unknown.

    Organic Speech Sound Disorders

      • Motor/neurological disorders – these disorders happen when signals from the brain to the speech muscles are not clear, or the speech muscles are weak e.g. childhood apraxia of speech and dysarthria. These types of speech disorders are quite rare.
      • Structural abnormalities – speech is unclear because the parts of the body that make speech (lips, tongue, larynx, facial muscles etc.) are not working well, or are not formed properly e. g. cleft lip/palate, dental problems, physical injury etc.
    • Sensory/perceptual disorders e.g. hearing impairment


    Why do children have speech problems?

Often there is no known reason why children have speech delays or disorders. Sometimes there is a family history of speech difficulties which may indicate there is a genetic element to some speech problems. Some children have temporary recurring hearing difficulties in early childhood that affects speech development. Speech difficulties may also be caused by a condition or genetic syndrome e.g. Autism, Down Syndrome, or from a traumatic brain injury, cerebral palsy, stroke etc. Whatever the reason, in most cases speech skills can be improved with the right help from a speech pathologist/therapist and lots of practice.

Seeing a Professional

If you have concerns about your child’s speech development, it is best to seek professional help sooner rather than later. Early problems with speech can sometimes indicate underlying disorders of language and later with literacy learning. If you suspect speech difficulties, always get your child’s hearing checked (even if you do not think there is a problem). Many children get Glue-Ear (otitis media) which can significantly affect their speech development.

A qualified Speech Pathologist / Speech Therapist (different titles in different countries) will have a degree in the subject of communication difficulties and will have a broad knowledge of speech disorders, language difficulties, literacy problems autism, hearing impairment and many other areas around communication difficulties. They will be able to carry out tests to identify the reason’s for your child’s difficulties and provide the appropriate advice and treatment.

For the milestones of development for speech see below or go to the Speech and Language Milestones section.

You can read more about specific speech difficulties by clicking on the links below:


The top tips to improve your child’s speech development:

  • Get their hearing checked if their speech is delayed or you have any concerns
  • Be a good model – speak clearly and slowly and face your child when speaking.
  • If your child says a word or sentence incorrectly, rather than correct them or ask them to repeat it, just say the word / sentence back to them correctly to show you have understood. This way your child always hears the correct version.
  • In a busy household make sure they have plenty of time to get their message across
  • Take the dummy / pacifier out of your child’s mouth – let them speak!
  • Play with your child every day
  • Make time to sit down with your child and have a conversation – even if it is just for a few minutes a day (although the more one-to-one time the better), spend some quiet time with your child, away from distractions. Look at a book together and talk about the pictures.
  • Sing songs and nursery rhymes – songs and rhymes contain rhythm and rhyme, skills that help with speech and literacy development.
  • When playing with your child, let them take the lead – let them lead the play, let them be the boss of play. This can build self-confidence and does not put pressure on them to talk and respond to the adult all the time.
  • Feed language in, don’t force it out – comment and expand on your child’s words and sentences, rather than asking them to repeat words. If your child says “car”, respond with “big car” or “yellow car” or “fast car”. This is how children learn words, by hearing new vocabulary and linking it to the items or events they are focussing on.
  • Books, books, books – books can be used in many ways to develop language and early literacy skills. Evidence shows that children that have more exposure to books prior to schooling often find it develop early literacy skills earlier.
  • Observe and comment – when you are playing with your child, take a step back, do not feel that you have to fill the silences, just comment on the things your child is doing so they can here (and learn) the new vocabulary.


Below is a milestones guide for normal speech development. For a more comprehensive overview of child development and other milestones Click Here.


Milestones for speech

The rate of children’s speech and language development can vary, depending on the child. Some children will develop certain skills quicker than others, and some children will be slow to develop certain skills compared to their peers, even if there are no related problems. This information below is just a general guideline, and many experts vary considerably on what they believe to be the normal stages of development. There may also be some difference between boys and girls and when they develop certain skills.

If you feel your child’s speech is delayed please contact your local speech and language pathologist/therapist. Also, look at the resources on this website to facilitate your child’s speech production.

The information below is about a fictitious boy called Bill and describes how his speech develops over time.


Milestones 0 – 12 months

Birth – 6 months – The first communication. In the early months Bill has no recognisable speech but he is communicating. In the first 2 months after birth he will be making reflexive crying sounds when hungry or uncomfortable. By two months he will be starting coo in response to his mothers voice. By six months, Bill will start to make some sounds, will laugh and squeal, but will still cry loudly when hungry, uncomfortable or annoyed.
6 – 8 months – Babbling. Bill starts to babble. Babbling is not only maturational but is also linguistic and relies on both visual and auditory input as the baby is learning. This is highlighted by blind children who use less labial sounds (sounds made with their lips) and deaf children who use more labial sounds (as these are can be seen more easily).
8 – 10 months – Babbling becomes more complex. Bill is starting to combine consonants and vowels in babbling, e.g. “baba”, and attempts to imitate other speech sounds. Some babies may even use a kind of singing voice when babbling.
10 – 12 months – Jargon. Bill now starts to use long chains of babbled sounds, which include different intonation. He may talk to toys and attempt to sing along to music, and his vocalisations vary in intensity and volume. Bill may now be using sounds p, b, m, and d in his vocalisations.
12 months – The first recognisable words. Bill’s parents are overjoyed when he starts uttering his first simple recognisable words e.g. “mama” “bye bye”


Milestones 12 – 18 months

Bill’s speech and listening are now becoming more integrated as he is listening to others, learning new sounds and words and learning the meaning of non-speech sounds. During this period he is developing more speech sounds and although some children may develop them a little later, many babies are attempting – m n p b d w h. At 12 months Bill may be verbalising 1 or 2 meaningful words (e.g. “mama / dada”) and may babble while looking at a book. He will attempt to imitate and practice new sounds, vowels and words. By 18 months he may be using up to 10 to 20 meaningful words mixed with jargon (although many babies may not be using recognisable words yet) and may use them to request when pointing to an object. Auditory memory is also developing and Bill is able to remember one item if he hears the word at the end of a sentence.


Milestones 18 – 24 months

Bill’s sound inventory is beginning to increase ( m n p b t d w h ) and he is using most vowel and diphthong sounds accurately. Other sounds that may be emerging are k g t ng, but many children will not have developed these yet. Bill is may now be getting towards using between 10-20 words during this period. As well as real words, he still uses jargon and may often chatter away in jargon when looking at a book. Many babies like to sing in jargon and their vocalisations will increase as their activity level increases. Babies will often try to imitate words others are saying. Bill is beginning to put 2 syllables together, but it will generally be the same syllable duplicated e.g. “nana” for banana, “wawa” for water. Many words will be approximated and sounds that have not developed will be substituted. Final and medial sounds will also often be omitted. Bill now has an auditory memory that can store 2 items.


Milestones 24 – 30 months

Bill is really starting to talk more freely now and by 30 months has an expressive vocabulary of 200 words. Many sounds have to develop but he has m n p b t d h w in his inventory and ng k g are now being used more freely. More consonants appear in word final positions (m,b,p), although he still over pronounces some words, produces the same words differently, shortens words, and misses out medial sounds. Although Bill’s speech contains omissions and approximations, his speech is still 75% understandable to friends and family. His use of jargon is disappearing and he is able to whisper.


Milestones 30 – 36 months

Bill’s speech continues to develop and he now has m n p b t d w ng k g h y in his sound inventory and is starting to use f and s, although these sounds may still be stopped (replaced with a plosive sound e.g. “sun” becomes “tun”). Other common substitutions will be to replace th with f and r with w. Some sound combinations are still difficult for him including clusters (st pl tr etc) and he will often just reduce these to 1 sound, and medial sounds may still occasionally be omitted . His speech is now so clear that strangers understand him 75% of the time. He is also using more stress and intonation correctly in his words, although he may still omit some parts of less stressed speech. Bill will now listen more from a distance and his auditory memory can hold 2-3 items in different linguistic contexts.


Milestones 36 – 48 months

Over this period Bill’s sound inventory really starts to be completed and he produces most consonant sounds correctly. He is now able to use words with many different sounds – m n p b t d w ng k g h f s y with most other sounds and clusters developing over this year – j l r sh ch z v sp st sk sl sm sn sw tr gr br pr cr fl bl pl gl. He is now using around 1000 words and his speech is 90% understandable. His speech now includes words with final consonants (e.g., hat, duck), but he may still occasionally delete weak syllables, e.g., “efant” for elephant. There will be occasional repeats or hesitations as in “ma-ma-ma-mom” and this is common amongst many children. Bill’s parents initially worry he may be acquiring a stammer, but many children experience a period of dysfluency and this sometimes happens because the demands to use language are greater than the capabilities to produce it. Most children overcome a dysfluent period and it is best to just keep an eye on the problem and not make an issue of it, but remembering to always give your child plenty of time to speak. Bill’s listening skills are also improving and he should be able to listen and attend to a story for 15 minutes. His auditory memory also increases and he can store up to 4 items by 48 months.


Milestones 48 – 60 months

Bill is totally intelligible to everyone now he has most sounds and clusters perfected – m n p b t d w ng k g h f s y v z l r sh ch j th sp st sk sl sm sn sw tr gr br pr cr fl bl pl gl. Some of Bill’s friends are still having difficulty with r and l, but many children of this age take a little longer to acquire these sounds. Bill only gets tripped up on longer clusters – spr str scr spl, and some clusters in the middle and end of words are still being reduced occasionally. Bill is using 1500 plus words now and his rate, rhythm, intonation and volume are all normal. Bill’s auditory memory can now hold and repeat back 3 – 4 digits.


Milestones 60 – 72 months

Bill now has no difficulties producing any sounds – m n p b t d w ng k g h f s y l r v z sh ch th sp st sk sl sm sn sw tr gr br pr cr fl bl pl gl spr str scr spl. He is using around 2000 words and his auditory memory allows him to store and repeat back 4 -5 digits.


Milestones 72 months +

Speech is error-free and adult-like.


For a more comprehensive overview of child development and other milestones Click Here.


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