DIFFERENTIAL DIAGNOSIS

Why is it important for my child's progress?

Differential diagnosis of speech sound disorders drives treatment. Progress in speech therapy is dependent upon the careful selection of treatment approach(es) chosen specifically to fit your child's unique needs based on their speech sound disorder. Kelly specializes in the differential diagnosis of the four different kinds of speech sound disorders.

Childhood Apraxia of Speech

"Childhood Apraxia of Speech (CAS) is a speech label in which the planning and/or programming of the movements to produce speech is inefficient. This means that although a child with CAS may know what they want to say, their mouth may not move the way it needs to in order to say words clearly." - Dr. Edythe Strand

 

 The most qualified professional to diagnose CAS is a speech-language pathologist with post graduate training and understanding of differential diagnosis of speech sound disorders. CAS can range from mild to severe.

Visit childapraxiatreatment.org for more information.

Phonological Disorder

Phonological disorders occur when a child has difficulty understanding the sound system and speech rules of our language. Errors in a child with phonological disorder's speech typically follow consistent patterns. For example, they may leave off ending sounds (ex. bow/boat), reduce syllables (ex. e-phant/elephant), or even substitute a specific sound for an entire class of sounds (ex. using the /t/ and /d/ sounds for all /k/ and /g/ sounds (ex. tea/key, do/go). Children who have phonological disorders need special approaches for learning to produce these sounds correctly. Phonological disorders can range from mild (1-2 processes active in speech) to severe (>4-5 processes active in speech).

Articulation Disorder

Articulation disorders are typically considered more mild types of speech sound disorders as they typically manifest in errors on only a few sounds which only slightly impact intelligibility. Children with articulation disorders may present with the following:

-Frontal lisp or lateral lisp on /s, z, sh, ch, zh, j/ 

-Difficulty producing the R sound resulting in distortions (ex. caw/car, guwl/girl, weally/really)

-Difficulty producing the /th/  sound (ex. tooth, those)

Dysarthria

Dysarthria is a speech sound disorder caused by muscle weakness due to brain damage which can range from mild to severe. Children with dysarthria may produce speech too slowly or too fast, too quietly, they may produce slurred speech, have difficulty moving their articulators well, and may have co-occurring voice difficulties such as a hoarse/breathy quality.

See ASHA.org for more information on pediatric dysarthria.

Can my child have more than one speech sound disorder?

YES! Some children who are highly unintelligible may present with more than one speech sound disorder impacting their speech development. Typically, treatment focuses on selecting the best approach for which diagnosis is impacting overall intelligibility most. As the child's speech improves, the treatment approach may be modified or changed entirely. Speech sound disorder treatment is dynamic.