If you’ve ever been to see a Speech Therapist or hung around a Speech Therapist, you may have heard the following terms when they refer to Speech Delays/Disorders: Articulation Disorder/Delay, Phonological Processing Disorder, Childhood Apraxia of Speech. These three terms fall under the category of speech delay/disorder but when it comes to treatment planning these three could not be more different. Each disorder has it’s own characteristics with marked differences that require different treatment approaches. As a parent, knowing and understanding these differences is important to identifying if your little one requires speech therapy or helping your child progress through therapy.
Here are the signs and symptoms of each type of Speech Delay/Disorder:
Characterized by substitutions- replacing one sound for another. For example, the word “bath” becomes “baf” substituting the /f/ for a /th/ sound, or the word ‘red” becomes “wed” substituting the /w/ for a /r/.
Most children will have substitutions at some point in their development but as they mature in age these substitutions fade to a more adult like production.
By the age of 7-8 all substitutions should have faded and speech production should sound like an adult.
Most often this type of disorder/delay requires the least amount of therapy time of the three types of disorder/delays with consistent parental support and practice
Phonological Processing Disorder:
Characterized by groups of errors- omitting or consistently producing errors on the same kind of sounds. For example, omitting the endings of words- final consonant deletion- the word “top” become “ta”, “book” becomes “booh”, or “bed” becomes “beh”.
Interestingly, children with this type of speech disorder may mispronounce a sound in certain words, yet pronounce it clearly in others. For example, the s in “sock” may be pronounced clearly, but the s in ‘bus” may be dropped or pronounced bush.
Words with two or more syllables may be pronounced with fewer syllables – elephant may be pronounced ephant.
At other times, whole groups of sounds may be mispronounced the same way. For example, the child may pronounce s, f, sh, and ch sounds as a t: fire becomes tire, shoe becomes too, sun becomes tun, and chin becomes tin. Children mispronouncing entire groups of sounds need special approaches for learning to produce these sounds correctly.
If the SLP diagnoses your child with a phonological problem, be prepared for the possibility of a long-term commitment to speech therapy. Considerable time may be spent on activities other than just trying to pronounce words correctly – which can be frustrating and confusing for parents.
Childhood Apraxia of Speech:
Children with this diagnosis have difficulty planning and consistently producing sequences of speech movements using their tongue, lips, jaw, and palate. This is a very specific motor planning issue. The connections from the brain to the speech articulators is impaired.
When a child receives a diagnosis of CAS, he/she needs to begin speech therapy immediately. Therapy will vary with each child according to the severity of the diagnosis.
Experienced SLPs use many different therapy methods since there is not a “one-size-fits-all” program for apraxia. Children with apraxia need frequent one-on-one therapy and lots of repetitive practice with sounds, sequences, and movement patterns in order to incorporate them into their speech and make them automatic. Practicing at home is important vital to the success of the treatment plan.
Many therapists recommend the use of sign language, picture communication systems, and other augmentative or alternative communications. This combination of therapies (sign and vocal word attempt) enhances the chance that the listener will be able to understand the speaker. Visual supports such as pictures of the mouth producing each sound can support the learning of speech sounds.
Hopefully, you now have more of an understanding between these three disorders and what makes them different from each other. Most importantly if you feel your child is demonstrating any of the speech disorders described seek professional intervention. Speech Disorders/Delays when caught early can most often minimally impact your child’s development and social relationships.
References: Super Duper Publications, ASHA