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Articulation Impairment (Delay) and Phonological Disorders

Articulation impairment refers to pronunciation of sounds. When a disorder is present, the person is motorically unable to produce the target sound. Articulation impairments are commonly seen with /r/ and /s/, though it can occur with any sound.


A phonological disorder refers to errors in how sounds are combined to make words. These errors are called phonological processes. While there are many phonological processes, only the most common are detailed below:

Substitutions – replacing one sound with another sound, in this case, the child is capable of producing the sound but does not use the sound in the correct place within a word (ex. “tea” for “key”).

Stopping- occurs when a sound that should have continued air flow (/s/, /f/ etc) is ‘stopped’ and produced as a short sound (ex. “to” for “shoe” or “mitt” for “miss”).

Syllable Reduction- occurs when a child drops a syllable from a multiple syllable word (ex. “nana” for “banana”).

Consonant Cluster Reduction- a sound is eliminated from a consonant cluster (ex. “top” for “stop” or “side” for “slide”).

Language Impairment (Delay)(Language Learning Disability)

• Receptive language – what the child understands when spoken to (ex. Follows directions, understands vocabulary, etc.)
• Expressive language- what the child says (ex. Age appropriate vocabulary, irregular forms of words (eat vs. ate), all grammar, etc)

The term “Language Impairment” covers a wide range of errors, which occur when a child is learning language.
• Receptive disorders impact a child’s ability to follow directions, understand vocabulary, and further understand and process what is said to them.
• Expressive disorders are characterized by a limited vocabulary, grammatical errors (word order, past tense, plural ‘s’, etc.), sentence length, etc.


Dysphagia is a term to describe impaired swallowing functions. A disordered swallow can lead to coughing, choking and aspiration. A Modified Barium Swallow Study (MBSS) should be performed by a Radiologist to identify the severity and type of swallowing disorder. During treatment, strategies to improve swallowing function, safety and diet will be addressed.


Stuttering is a disorder in the fluency of speech. It can occur as repetitions (m-m-m-m-my), blocks (long pauses), and prolongations (mmmmmommy). It is common for children of the preschool age to have some dysfluent speech. A parent should contact a speech therapist for an evaluation if their child is past the preschool age, has longer periods of dysfluent speech than fluent speech, has blocking in their speech (long periods of silence when it appears they are trying to make a sound), is showing frustration with not being able to say words, or has secondary behaviors such as stomping their foot or nodding their head in attempt to make the words come out.

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