Articulation Disorders
Articulation/Phonological Disorders:
Problems involving the appropriate production and use of speech sounds are referred to as articulation or phonological problems. Generally, articulation refers to the ability to produce individual speech sounds and phonology refers to the rules used by speakers to put the sounds together to make words. Typically articulation/phonology problems are encountered in children, however some adults experience problems in production of certain sounds particularly s, w and r. Children master the various sounds at different ages. Some sounds such as p,m, and w are typically learned early and others such as l, r and y (as in you) tend to be developed latter.
As a rule, most children should be able to produce most of the sounds correctly in at least some words by about age four. This does not mean that they can use every sound correctly in all words or all situations. It is also quite common for young children to simplify the adult form of words by doing such things as deleting the final consonants, omitting an unstressed syllable or substituting an early developing sound for a latter developing sound (eg. pronouncing "sun" as "tun"). Most of these simplification patterns should also be suppressed by around age four. Children who are four years old or older and still exhibit many speech sound errors or are hard to understand in connected speech likely need an articulation/phonological assessment. Children who are older than six or seven and adults who have consistent difficulty with any sound may also be in need of such an assessment. Some people may have a structural or neurological cause for their problems with speech sounds (eg. cleft palate or cerebral palsy). However, in most cases the cause of an articulation/phonological problem is not immediately apparent.
Assessment of Articulation/Phonological Disorders.
The length of time required to assess an articulation/phonological disorder varies with the severity. An older child with a single sound error may be assessed completely in a half-hour, while a younger child with many errors may require two hours. The first step in an articulation/phonological assessment is to gather medical, developmental and educational history as well as a description of the problem. This information is typically gathered by asking the parent (or patient in the case of an adult) to complete a case history form. The case history is reviewed and follow-up questions are asked during an intake interview.
Once this background information is gathered the clinician will attempt to sample the subject’s speech in a variety of utterances and situations. These frequently include naming items or pictures, telling stories, and spontaneous connected speech such as a conversation.
In many cases, children with moderate or severe phonological problems also have language problems. In many cases a standardized language test might be administered. Hearing can also contribute to articulation problems and a hearing screening is a part of every assessment. Finally, the oral structures such as lips, teeth, soft and hard palate are examined.
Following the assessment, a graduate student clinician and a faculty member will discuss the results with the parents or other family members. Recommendations will be made. In many cases additional analysis will have to be made from tape recorded samples of the speech produced during the assessment. This is often time-consuming and the results of this analysis will be shared with the parents or other family members at a later date.