Articulation Disorder

Articulation is the production of speech sounds. An articulation disorder occurs when a child does not make speech sounds correctly due to incorrect placement or movement of the lips, tongue, jaw, velum, and/or pharynx. It is important to note that there is a wide range of “typical” speech sound development and that all children develop at different rates within that range. Mastering specific speech sounds may take place over the course of several years. An articulation disorder is the mispronunciation of speech sounds, after the critical age for development of that sound has passed and may include sound omissions, substitutions, distortions and additions. Children should be able to produce all speech sounds correctly by age 8. However, if an articulation disorder is present and not addressed, it may persist into adulthood.

Phonological Processes Disorder

Phonology refers to the speech sound system of language. A phonological disorder occurs when a child is not using speech-sound patterns appropriately. A child who is unintelligible, whose overall speech varies from the speech typical for their stage of development, or who produces unusual speech patterns using simplifications, omissions and substitutions of sound combinations, may be demonstrating a phonological disorder.


Motor Speech Disorders

Motor speech disorders are characterized by the is the inability to use articulators such as the lips, tongue, jaw and cheeks for functional speech or feeding. Difficulties with chewing, sucking, blowing or formulating speech sounds may occur. Motor speech disorders can be acquired (secondary to stroke and other neurological conditions) or due to unknown origin.

Signs and symptoms of a motor speech disorder May Include:

  • Low muscle tone in the face

  • Open mouth posture

  • Drooling

  • Oral hyper- or hypo- sensitivity

  • Unclear speech sounds

  • Feeding difficulties

Early intervention and intensive therapy can make a significant difference for both speech and feeding issues. PROMPT Therapy and Sara Rosenfeld Johnson’s Talk Tools OPT are two effective programs used at Speak-2-Me for treatment of Motor Speech disorders.


Childhood Apraxia of Speech

Childhood Apraxia of Speech (CAS) is a common type of motor speech disorder. CAS is characterized by an impaired ability to plan and sequence the motor movements necessary to produce speech in the absence of any muscular problem. Children with CAS may present with feeding problems, expressive language delays, difficulty with coordination of fine motor skills, oral hypo- and hyper-sensitivity and potentially later problems learning to read, spell and write. Signs and symptoms of CAS Include:

  • Late and/or minimal babbling during infancy

  • Problems imitating speech

  • Groping or struggling when attempting to say sounds or words

  • Difficulty saying longer words

  • Inconsistent errors

  • Omitting consonants at the beginning and end of words

  • Vowel distortions

  • Slow rate of speech

  • Errors in word stress, intonation and speech rhythm

Intensive, frequent speech therapy sessions with the inclusion of PROMPT technique, and kaufman program is highly effective in treatment of children with CAS.


Language Delay

A receptive and/ or Expressive language delay is when the patterns of language development are slow, but typical. With early identification and treatment these children typically catch up with same aged peers and no longer require services down the road.


Receptive Language Disorder

Receptive language refers to the skills involved in understanding language. Children with receptive language disorders present with difficulties processing, comprehending, and/or retaining spoken language. It may be either developmental or acquired.  Receptive language disorders usually begin before age four, and often co-exist with expressive language disorders (mixed receptive-expressive).


A few signs and symptoms of Receptive Language Disorder May Include:

  • Difficulty following directions

  • Decreased comprehension of “yes/no” and “wh” questions

  • Limited vocabulary, both content and functional words

  • Poor understanding of grammatical markers and syntax

  • Difficulty attending to spoken language


Expressive Language Disorder

Expressive language refers to the verbal skills required to communicate one's thoughts and feelings to others. Children with an expressive language disorder present with difficulty formulating and expressing their thoughts and ideas in a logical, detailed and sequential manner. Unlike expressive language delay, in which pattern of development is slow but normal, an expressive language disorder occurs when language is slow to develop and sequence of development, patterns or errors is atypical.


A few signs and symptoms of expressive language disorder may include:

  • Difficulty formulating sentences in a logical, sequential manner

  • Smaller vocabulary than same-age peers

  • Use of vague, non-descriptive language

  • Difficulty with verb tense and pronouns

  • Trouble asking questions

  • Decreased verbal organization

  • Difficulty retelling stories

  • Difficulty initiating and maintaining a conversation

Auditory Processing Disorder

Auditory Processing Disorder results from deficits in information processing of auditory signals. The deficits are not due to damages of the physical structures or function of the hearing mechanism, but arise from dysfunction of the central nervous system to interpret auditory signals. Children with APD typically have normal hearing, but often do not recognize subtle differences between sounds in connected speech, making it difficult to process verbal information and filter out background noise.  


Signs and symptoms of an Auditory Processing Disorder:

  • Poor listening skills

  • Problems discriminating similar-sounding speech sounds

  • Difficulty paying attention to and remembering information

  • Problems following multi-step directions

  • More time needed to process information

  • Difficulty listening in noise

  • Poor organization of verbal material

  • Difficulty with reading, comprehension, spelling and vocabulary

  • Low academic performance

  • Behavior problems

It is important to note, in order to fully assess and understand problems exhibited by children with APD, diagnosis of APD requires a multidisciplinary team approach, including teachers (to analyze academic performance), a psychologist (to evaluate cognitive functioning), speech-language pathologist (to evaluate oral/written language and speech) and audiologist. Because APD is deemed an auditory disorder, a definitive diagnosis may only be made by an audiologist.



Stuttering is a communication disorder that negatively Impacts the fluency of an individual's speech. It typically begins in childhood and can persist throughout life.  Stuttering often includes repetitions of words or parts of words, as well as prolongations of speech sounds. For more severe cases, speech may become completely stopped or blocked. Blocking is when the mouth is positioned to say a sound, sometimes for several seconds, with little or no sound production. A treatment program for stuttering focuses on techniques that will help the child speak more fluently and effectively, focus on counseling and confidence, and participate in role playing activites to get optimal practice of strategies acquired in sessions.

Social Pragmatic Disorder

Children with social pragmatic difficulties demonstrate deficits in social and/or cognitive functioning. These children have difficulties making eye contact, turn taking, initiating and maintaining a conversation, maintaining appropriate proximity to speaking partner, interpreting verbal and non-verbal signals, and revising language when misunderstood. Pragmatic disorders often coexist with other language disorders.

Feeding and Swallowing Disorders (Dysphagia)

Feeding and swallowing disorders come in all shapes and sizes and can effect children of all ages. It results in the inability of foods and/or liquids to pass easily from the mouth to the stomach. Many pediatric feeding issues arise from negative feeding experiences in early infancy. The most crucial component to improving feeding skills is to establish trust, build confidence, and allow the child to receive a pleasurable interaction with food. Family participation is crucial to the success of the feeding program. 


Commonly seen in chidden with feeding and swallowing difficulties:

  • Food aversion - intolerance to touch, taste, texture, smell of food

  • Failure to thrive - inability to gain/maintain weight

  • Oral Motor weakness - difficulty chewing, managing food in the mouth and triggering swallow

  • Sensory aversion - Intolerance to touch in or around the mouth; gagging