Phonological disorder is a type of speech disorder known as an articulation disorder.
Children with phonological disorder do not use some or all of the speech sounds expected for their age group.
Articulation disorder; Developmental articulation disorder; Speech distortion; Sound distortion
This disorder is more common in boys. About 3% of preschool children and 2% of children ages 6 - 7 have the disorder.
The cause of phonological disorder in children is often unknown. Close relatives may have had speech and language problems. Other risk factors may include poverty and coming from a large family.
Phonologic disorders may also be caused by:
Most children have problems pronouncing words early on while their speech is developing.
However, by age 3, at least half of what a child says should be understood (intelligible) by a stranger.
By age 5, a child's speech should be mostly intelligible.
Children with phonological disorder will substitute, leave off, or change sounds. These errors may make it hard for other people to understand the child. Only family members may be able to understand a child who has a more severe phonological speech disorder.
Commonly, children with this disorder have:
Children should be examined for disorders such as:
The health care provider should ask about issues, such as whether more than one language or a certain dialect is spoken at home.
Milder forms of this disorder may disappear on their own by around age 6.
Speech therapy may be helpful for more severe symptoms or speech problems that do not get better. Therapy may help the child create the sound, for example by showing where to place the tongue or how to form the lips when making a sound.
The outcome depends on the age at which the disorder started, and how severe it is. Many children eventually develop almost normal speech.
In severe cases, the child may have problems being understood even by family members. In milder forms, the child may have difficulty being understood by people outside the immediate family. Problems with social interaction and academic performance may occur as a result.
Call your health care provider if your child is:
Friedman O, Wang TD, Milczuk. Cleft lip and palate. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Saunders Elsevier;2010: chap 186.
Sharp HM, Hillenbrand K. Speech and language development and disorders in children. Pediatr Clin North Am. 2008;55:1159-1173.
Simms MD. Language disorders in children: classification and clinical syndromes. Pediatr Clin North Am. 2007;54:437-467.
Lyon GR, Shaywitz SE, Shaywitz BA. Specific language and learning disabilities. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 32.