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Help! No one can understand what my child says!

Child smiling in speech therapy

First things first, speech therapy can help your child become more confident in their speaking abilities and help reduce those dreaded communication breakdowns with others. Successful speech therapy starts with being able to diagnose your child's specific type of speech sound disorder.

There are four main types of speech sound disorders: articulation, phonological, dysarthria, and apraxia.

Articulation disorders involve minor errors on specific sounds, such as difficulty producing "r," "th," or having a "lisp" when producing /s/ sounds incorrectly.

Phonological disorders occur when children struggle to grasp the "rules" of our speech sound system, often co-occurring with difficulties in reading and spelling due to challenges in understanding sound group differences. Children with phonological disorders may consistently replace one sound with another, like saying "t" for "k" (e.g., "tea" for "key" or "bite" for "bike"). The severity of phonological disorders can range from mild, with one or two patterns, to severe, involving multiple sound substitution consistencies. Severe cases can make children very difficult to understand.

Dysarthria arises from an overall weakness in the muscles used for speech production, often resulting from a known cause such as cerebral palsy or stroke.

Lastly, apraxia of speech is a disorder where children struggle with planning and programming the complex movements required for clear speech production. Despite knowing what they want to say, children with apraxia experience incorrect movements of the mouth, tongue, lips, etc., leading to errors in their speech production. Treatment for apraxia focuses on a motor-based approach, helping children move between sounds and syllables correctly. Unfortunately, many graduate programs do not provide sufficient detail or depth on treating apraxia, so parents with concerns should seek a speech therapist with additional postgraduate training.

If you're in Virginia Beach, Kelly Kirby at Resolute Therapy Collaborative specializes in apraxia of speech. If you've stumbled upon this page but are not local, check the vetted Apraxia Kids registry to find an apraxia provider near you!

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