Articulation disorders involve substitutions of one sound for another (“w” for “r” as in “wabbit” for “rabbit”), leaving out sounds (“daw” for “dog”), or sound distortions, such as a frontal or lateral lisp. Children typically say almost all sounds correctly by the age of 5 or 6.

Phonological disorders are when a child continues to exhibit patterns of sound substitutions or omissions. For example, children with the phonological pattern of “fronting” consistently produce sounds made with the back of the tongue (like “k”) with the front of the tongue (like “t”). Therefore, a child says “tea” for “key.”  

If a 3- year-old is not able to be understood by strangers about 75% of the time (90% for 4-year-old, 95% for 5-and 6-year old), then a speech evaluation should be recommended. 

Children who are experiencing speech sound delays when it is time to start school are most at risk of having literacy difficulties.

For free downloadable speech sound sheets for practice at home, go to

For short videos to help kids learn how to say individual sounds and how to practice them, go to

Childhood Apraxia of Speech (CAS) is a rare motor speech disorder. Children with CAS have problems saying sounds, syllables, and words not because of muscle weakness or paralysis, but because the brain has problems planning movements of speech. The child knows what they want to say, but their brain has difficulty coordinating and planning muscle movements necessary to say those words. Children with CAS are often extremely difficult to understand. CAS is often confused with other speech sound disorders and should only be diagnosed by a speech-language pathologist. For more information about evaluation and treatment of children with apraxia of speech, go to


A language delay is when a child has difficulties understanding and/or using spoken language. Your child may have a language delay if they don’t meet the language developmental milestones for their age. Their language abilities may be developing at a slower rate than most children’s. Delays in language are the most common types of developmental delay.

For excellent parent videos such as Teach Me to Talk and Play, go to

A receptive language disorder is a condition in which a child has trouble understanding and processing the messages and information that they receive from others. Children struggle with the meaning of language and may respond in ways that don’t make sense to others. This can make it hard to connect with people and may cause children to withdraw socially. Their challenges aren’t related to hearing loss or intelligence.

An expressive language disorder is a condition in which a child has trouble using language to convey or express information by speaking or in writing. The child may be able to understand what other people say but has a hard time using words to share their thoughts or ideas.

Click Here for more information about Typical Speech and Language Development in Children from the American Speech-Language-Hearing Association (ASHA).

Selective Mutism (SM) is a disorder of childhood characterized by an inability to speak in certain settings, such as school or public places, despite speaking in other settings, such as at home with family. SM is associated with anxiety and may be an extreme form of social phobia according to researchers and clinicians familiar with SM. It is best understood as a childhood social communication anxiety disorder. SM is much more than shyness and most likely on the spectrum of social phobia and related anxiety disorders. SM is NOT a child willfully refusing to speak.

Click Here for more information on Selective Mutism from the Selective Mutism Association. SMA has an expansive collection of resources available for families and individuals with selective mutism.


Stuttering is a speech disorder where a person may repeat parts of words (repetitions), stretch a sound out for a long time (prolongations), or have a hard time getting a word out (blocks). Stuttering may also include physical tension in the body and negative feelings about talking. A person may avoid certain words or situations. Stuttering can vary from day to day. Risk factors for stuttering include a family history of stuttering, stuttering that begins after a child is 3.5 years old, and stuttering that has persisted for more than a year. Other factors include having poor articulation abilities, a sensitive temperament, and being male.

Click Here for more information about Typical Speech and Language Development in Children from the American Speech-Language-Hearing Association (ASHA).

For free on-line resources, services, and support for those who stutter and their families, go to for information from The Stuttering Foundation.

Thumb sucking

If you have questions about thumb and finger sucking, please check out the Thumb Sucking Clinic’s website. It is a great resource for parents. Oral habits that persist for too long can cause problems with jaw and face growth, orthodontic problems, eating and speech difficulties, problems with the growth of the mouth and airways, and difficulties with nose breathing. Generally, if your child still sucks their thumb after the age of three, then you should definitely begin to discourage the habit and monitor their oral development and health.


If you think your child may have a speech or language delay, check with your child’s pediatrician, day care provider, or teacher. You may also find it helpful to check out the expected speech-language milestones link below.

Click Here for more information about Typical Speech and Language Development in Children from the American Speech-Language-Hearing Association (ASHA). is a great resource to learn the warning signs of communication disorders. Speech and language disorders are treatable, and early detection is a major contributor to speedier recoveries, shortened treatment periods, and reduced costs for parents.


Before your appointment, please print and fill out the following forms. This gives pertinent background information regarding your child’s speech and language development. Filling this paperwork out prior to the evaluation saves time and is greatly appreciated.
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