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Articulation disorder

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ASHA speech sound disorders articulation disorder signs assessment treatment

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https://www.asha.org/practice-portal/clinical-topics/articul…

Articulation disorder is a type of speech sound disorder in which a person has persistent difficulty producing particular speech sounds correctly. It may involve:
  • Substitution: “wabbit” for “rabbit”
  • Omission: “ca” for “car”
  • Distortion: an imprecise /s/ sound, such as a lisp
  • Less commonly, adding an extra sound
The problem is judged relative to the person’s age, language or dialect, and developmental level. Sounds such as /r/, /l/, /s/, /z/, /sh/, /ch/, and /th/ are often mastered later and may be the ones affected. Kaplan and Sadock's Synopsis of Psychiatry, p. 375.

Causes and important exclusions

A developmental articulation disorder is not explained by a structural, hearing, or neurologic cause. Assessment should rule out hearing loss, cleft palate or other oral structural differences, and motor-speech disorders such as dysarthria or childhood apraxia of speech. A speech-language pathologist typically assesses speech patterns, intelligibility, oral structures and movements, language, and hearing status. The ASHA assessment guidance includes an oral-mechanism examination and hearing screening.

Management

The main treatment is speech-language therapy, individualized to the error pattern. Therapy commonly progresses from learning correct sound placement and production to practicing syllables, words, sentences, conversation, and use in daily life. Family practice activities may support therapy.

Seek assessment promptly if

  • Speech is difficult for family or teachers to understand
  • The child becomes frustrated, avoids speaking, or is teased
  • Speech errors persist beyond the expected age range
  • There are concerns about hearing, language development, feeding, oral structure, weakness, regression, or loss of previously acquired speech skills
A pediatrician, ENT clinician, audiologist, or speech-language pathologist can help identify the cause and arrange care. Speech sound disorders can coexist with language and later literacy difficulties, so timely assessment is useful. A 2026 systematic review on long-term outcomes is indexed in PubMed as PMID 41937368.
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