Causes, Signs and Symptoms, Diagnosis, Treatment and Prognosis of Phonological Disorder
Before I explain phonological disorders, we need to clear up the confusion between phonological disorders and articulation disorders. Both of these conditions are speech disorders that result in speech sound errors. However, an articulation disorder occurs at the phonetic level (the individual speech sounds that are specific to a language), while a phonological disorder is based on errors at the cognitive or linguistic level (the pattern of sounds in a language).
A child with an articulation disorder knows where each sound is supposed to be placed in a word, but he or she has trouble making the sounds correctly with the articulators (lips, tongue, teeth, jaw, and velum). On the other hand, a child with a phonological disorder can produce the sounds correctly, but the sounds are used in the wrong places in words (fire becomes pire) or omitted completely (book becomes boo-). Both disorders adversely affect speech intelligibility (how well the listener understands the child), and a child can have both disorders at the same time.
There are a variety of patterns of errors, called phonological processes, such as fronting, backing, stopping, and gliding (see below for more details). Some of these processes are normal at young ages but should be outgrown by a certain age, while other processes are only heard in the speech of a child with a phonological disorder.
It is important to note that young children who are learning to talk make many speech mistakes. This is not necessarily a cause for concern. You should have your child evaluated by a speech-language pathologist (SLP) only if your child does not produce any sounds or seems to make more errors than his or her same-aged peers. If you are concerned, talk to your pediatrician or consult an SLP.
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