Speech Sound Disorder

Speech sound disorder is a communication disorder in which children have persistent difficulty saying words or sounds correctly. Speech sound production describes the clear articulation of the phonemes (individual sounds) that make up spoken words. Speech sound production requires both the phonological knowledge of speech sounds and the ability to coordinate the jaw, tongue, and lips with breathing and vocalizing in order to produce speech sounds. Children with speech sound disorder may have difficulty with the phonological knowledge of speech sounds or the ability to coordinate the movements necessary for speech. These communication difficulties can result in a limited ability to effectively participate in social, academic, or occupational environments.


A speech sound disorder is diagnosed when speech sound production is not at the level that would be expected for a child’s age and developmental stage. In typically developing children, approximately half of speech should be intelligible by age 2 and most speech should be intelligible by age 4. If a child is not correctly producing most sounds or words after this age, a speech sound disorder may be present.

The most common signs and symptoms of a speech sound disorder include the following:

  • Difficulty with speech sound production
  • Trouble getting others to understand what they are trying to communicate
  • Persistent problems with articulation (lisping, saying “wight” for “right”)
  • Leaving out sounds where they should occur (saying “poon” for “spoon”)
  • Distorting sounds
  • Substituting an incorrect sound for a correct one

Symptoms can be mild and affect a child's ability to produce only one or two sounds, or the child may make so many errors that speech is unintelligible.


The cause of speech sound disorder is not well understood in many cases. Children who develop speech sound disorder often have family members with a history of speech or language disorder, indicating a genetic component of this condition.


Treatment for speech sound disorder primarily consists of speech and language therapy. A speech-language pathologist can develop a treatment plan that helps children identify and correct the sounds or words they have difficulty saying. The speech-language pathologist can show the child how to move their tongue and lips to produce sounds correctly and provide opportunities to practice these skills.

In most cases, children with speech sound disorder respond well to treatment and speech difficulties improve over time. When a language disorder is also present, however, the speech disorder has a poorer prognosis and may be associated with specific learning disorders.


  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing
  • Child Mind Institute

Last reviewed 02/16/2018