Phonological Disorder

What is phonological disorder?

Phonological disorder is a communication disorder. Children who have it have problems making the right sounds for letters or words. Children with this disorder make 3 types of mistakes:

• replacing one sound with another (saying "bat" instead of "cat," for example)
• leaving out a sound (such as saying "dess" for "dress")
• adding a sound (like saying "plaper" instead of "paper")

The disorder is usually diagnosed in children from 3 to 8 years old. Between 2% and 3% of children ages 6 and 7 have phonological disorder. It is more common in boys than girls.

What is the cause?

Several kinds of problems may cause this disorder:

• abnormalities with the roof of the mouth of the tongue, such as cleft lip and palate
• nerve problems that cause the muscles of the mouth to have trouble forming sounds
• hearing problems
• environmental factors, such as exposure to chemicals
• differences in parts of the brain

By the age of 8, most children have all the skills needed to produce speech sounds. Producing speech sounds depends on control of the tongue, lips, palate, larynx, jaw, and breathing muscles. It also depends on being able to hear and recognize sounds (vowel and consonant sounds, rhythm, intensity). Problems in any of these areas may lead to phonological disorder.

Parents who have speech problems have a higher risk of having children who develop speech problems.

What are the symptoms?

Symptoms include:

• speech that is less developed than would be expected for the child's age
• replacing one sound with another
• leaving out sounds
• adding sounds
• difficulty with school
• difficulty in social situations

How is it diagnosed?

Parents usually notice this disorder and consult a healthcare provider about it when their child is about 3 years old. The provider will ask about the child's symptoms and family medical and mental health history. Your child will be examined and tested to rule out physical causes, such as hearing problems. A psychologist, speech pathologist, or other professional will test your child's speech skills.

How is it treated?

If your child also has a hearing problem or other medical condition, the medical condition is treated first.

The most common treatment for this disorder combines language and speech therapy. Many public schools have a speech therapist or tutor who works with children diagnosed with this disorder. There may be treatment centers in your community that help children and adults with communication disorders.

Children learn words and the rules for using them by listening to others talk. Therefore, what you say and how you say it is important. Talking is a natural part of many daily routines such as mealtime, bath time, and dressing. Encourage your child to ask for items, make choices, and answer questions. Encourage him to tell stories and share information.

How long do the effects last?

This problem can go away by itself by the time a child is around 8 years old. However, the more time the child spends in speech therapy, the more likely he or she is to overcome the effects of this disorder.

What can I do to help my child?

• Learn as much as you can about communication disorders. Most libraries and bookstores have information on these topics.
• Find out what type of treatment is being offered in the schools and your community.
• Continue to follow the treatment plan.