Articulation Disorder : Types, Symptoms, Causes, Treatment, Diagnosis

In phonetics and phonology, articulation means the movement of the tongue, lips, jaw and other speech organs, or the articulators, in ways that make speech sounds. Sound is produced simply by expelling air from the lungs.

Errors in speech sounds by mispronouncing, substituting or leaving out the sound, is known as Articulation disorder. It is age-appropriate for children at certain ages, to be producing some kind of errors with particular sounds. However, articulation disorders may impact a child’s speech intelligibility while communicating with others.

Articulation disorders are related to an individual’s ability to say particular sounds and/or string particular sounds together. At the most basic level, articulation disorders are the result of a person being physiologically unable to produce particular sounds, through the use of their lips, teeth, tongue, palate and even respiratory system, facial nerves and muscles.

Articulation disorders, in children with no associated condition, may be treatable with speech therapy. In persons who have trouble articulating because of another condition, the prognosis of that condition will likely affect their progress in correcting their articulation disorder.

This type of articulation disorder is where the individual routinely pronounces an extra sound or syllable. Just for an example, saying “Assemembly” instead of “Assembly”

Here an individual substitutes one sound for another. For example, pronouncing “W”, instead of an “R”

Distortions are the types of articulation disorder where, the affected person tries hard to pronounce a sound correctly and ends up actually distorting the sound, such as by working very hard to produce a “W” and actually producing a whistling sound instead.

Some signs of articulation disorder can be easily identified by the general untrained listeners, such as the common frontal lisp that results from sticking the tongue between the front teeth, while producing the “S” sound in English. For example, Pronouncing “Thun” for “Sun”, it is a substitution. Below are some other signs and symptoms you need to know if a child or a person is suffering from an articulation disorder.

In such case, the child with articulation disorder may substitute one sound for another.

Here, an extra sound(s) to a word is added, just like, for Black, the child may say Belack.

One more sign or symptom of an articulation disorder is that, there is a sound deletion of the word. For example, for the word”hop”, the child may say, “op”

Here the child makes an incorrect sound that may not sound like any other sound in that language.

In general, children’s speech should be intelligible, or understood, most of the time by both, the familiar as well as unfamiliar listeners, after the age of 3 years. In case the grandparents of your child, or the preschool teacher, have a difficult time understanding the speech of your child, it is highly recommended that you consult with an SLP or Speech Language Pathology and begin the therapy sooner, so as to get the speech of your child on the right track.

In children, there may be lots of causes of an articulation disorder, such as weak muscles, little control over the tongue or the respiratory system, or any other cause. Below are some of them mentioned:

One of the causes of articulation disorder could be permanent or occasional hearing loss. It is highly essential for children to hear clearly, during their critical learning ages of birth to 3 years of their age. A child with even a slight hearing loss, like an inability to hear high-pitched sounds, might not hear some aspects of the native language.

Just imagine, hearing a conversation without hearing all of the sounds that are spoken at the beginning, middle or end of the words; here the speech signal would not be able to provide a complete sample of normal speech. A slight loss of hearing could deprive the child of the opportunity to hear how to produce and master the sounds correctly.

There are numerous types and severities of hearing loss. Some children are born with profound hearing loss, while, others develop a hearing loss after repeated ear infections. It is essential to rule out any medical conditions prior to diagnosing and treating speech and language disorders.

Speech articulation is likely to be affected by disorders that affect the muscular system, like in case of Cerebral palsy and Muscular dystrophies. Some muscular disorders affect the areas of speech production of the brain, specifically, and this results in a motor speech disorder, known as dysarthria. An individual with dysarthria, produces speech that may be slurred, too rapid or too slow, abnormal in pitch and rhythm and is usually difficult to understand.

Articulation disorder can also be caused by a number of developmental disorders, including those that start before birth and also those that are acquired after birth, because of injury or infection. Some developmental disabilities result from maternal infections, during pregnanc y, prenatal exposure to toxins, gene disorders and premature birth.

Some developmental disorders like autism spectrum disorder, has no cause, which affects many areas of the child’s development, including the speech. General developmental delays, that includes intellectual disabilities or learning disabilities, may also cause poor speech skills.

While evaluating the articulation of a child, an SLP may identify symptoms of a developmental disorder, known as Aspraxia of speech or CAS or Childhood Apraxia of Speech. This is a motor speech disorder that results from poor motor planning from the brain to the articulators or the lips and the tongue. This has significant effects on the child’s ability to produce even simple sounds and simple words.

Articulation disorders can also be caused from virtually any change to the normal anatomy of the oral cavity, i.e. mouth, jaw and the throat. Many children are born with or acquire physical malformations, including the cleft lip or palate, where the bone or tissue of the upper portion of the mouth does not form correctly. Similarly in case of ankyloglossia, the tongue is tied to the bottom of the mouth by a short string, known as the frenulum, and in case of dental malocclusions, the teeth are not aligned properly. The child’s speech is likely to be affected, when an articulator is altered by a malformation.

There are also some unknown causes of some cases of articulation disorders. It is important for parents to realize that some children are not as skilled in coordinating speech movements, though they may excel in many other areas.

If you take your child for a speech evaluation, the SLP or Speech language Pathologist, will first want to know if there is a cause for the child’s articulation disorder. In such instance, you will have to provide any significant medical history to the SLP, such as infections, injuries, or diagnoses that your child has received. The SLP will complete an oral peripheral or oral mechanism examination for evaluating the appearance, function and mobility of the articulators, i.e. the lips, teeth, tongue, jaw and the velum.

Then after, the SLP will administer a formal articulation assessment for determining, which sounds are wrongly spoken. Your child will be asked to produce speech sounds in isolation (er), words (mermaid), syllables (mer), phrases (the mermaid), sentences (I see the mermaid), and connected speech in conversation, for determining the level of speech sound errors.

The SLP will also determine if or if not the child is stimulable for the sound(s) spoken in error; i.e., the SLP will ask the child to produce the sound (s) correctly so as to see how easy or how difficult it is for the child to learn the sound(s). This Stimulating testing helps in determining the effectiveness of the therapy for specific sounds.

Finally, the child’s general intelligibility will be rated on a scale, from mild to moderate to sever to profound.

An audiological evaluation is recommended for any child has a speech or language delay.

Those with noticeable and consistent articulation disorders, must be assessed by a speech pathologist. These SLPs are trained in distinguishing speech impairments and will be able to devise a proper treatment plan suitable for each unique individual case. Consistent speech therapy sessions, with extra “home work” and practice activities are to be carried out at home for treating articulation disorders.

The SLP will likely be able to give you some indication of how much progress can be expected in each specific case. Speech pathologists can often be accessed privately or through referral from a GP.

Speech Therapy targets the sounds in error by using a systematic articulation approach, that targets sounds in isolation, syllables, words, phrases, sentences and connected speech; and provides necessary cues, or the visual, verbal and tactile, for proper placement of articulators.

Some Of The Tactics And Tools Used In Speech Therapy For Articulation Disorders:

Here, the target sound is found out and it is discriminated from the error sound, known as Minimal pairs.

Here, cotton balls are used to practice plosive sounds, like p/b, t/d

Visual modeling is something where a mirror is used so as to allow the child to observe self while making the proper sounds.

Sensory activities are also a part of speech therapy. Here, flavored tongue depressors may be used to provide extra sensory information for the tongue placement.

Tactile cues are used in speech therapy tactics. Here, the SPL places the child’s hand in front of the therapist’s mouth so that the child can feel the air produced for h, p,t, and f sound production. Apart from this, the child is also said to put the hand on the throat so as to feel the vibration that is produced during the voiced sounds.

Here, oral placement cues are used or oral prompts are used to achieve proper placement.

In order to demonstrate how to correct airflow to discourage a lateral lisp, straws could be used.

Even some negative practices help in correcting articulation disorder in some children.

For example;

Child: While grabbing a pen; if says” I have the ben”

Therapist: So you have the ben?

Child: No, I have the pen.

In such case, the child self-corrects to produce the p” sound in pear.

There are several apps and books related to speech therapy that can be used to correct errors in the sound in children having an articulation disorder.

In all the above tactics or tools that a speech therapist would be using, the child needs to have strict home practice so as to ensure a better result.

So, articulation disorder is something that could be treated with effective speech therapy. If your child or any known ones has this disorder, do visit an SLP who can evaluate the condition and find out the cause of the problem and advice you with the best possible tactics or tools of speech therapy for controlling the disorder.

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