Articulation disorders are speech sound disorders characterized by difficulty physically producing specific speech sounds (phonemes). In an articulation disorder, a child knows what word they want to say but cannot execute the precise movements to produce certain sounds correctly at the mouth. These errors are motorically based or peripheral – for example, consistent distortion of /s/ with a lisp or inability to produce an /r/ sound. Articulation disorders are sometimes termed phonetic speech disorders, distinguishing them from phonemic (phonological) disorders that reflect language-based pattern errors.
A classic articulation disorder involves errors such as substitutions, omissions, distortions, or additions of extra sounds. These errors occur on certain consonants regardless of word context, indicating an inability to achieve the correct articulatory placement or manner. Articulation disorders can range from a single sound error (e.g., a child who cannot produce “R”) to multiple errors affecting speech intelligibility. Importantly, in pure articulation disorders, the child’s overall language system is intact; it is the motor execution of speech sounds that is impaired.
Articulation disorders can arise from a variety of causes. Many cases are functional, meaning no clear neurological or structural cause is found – the child simply has not mastered the correct motor pattern for certain sounds, often noted with residual speech errors like persistent /r/ or /s/ misarticulations. Other cases are organic, resulting from identifiable physical conditions: examples include structural anomalies such as cleft palate or dental malocclusion, hearing loss which impairs auditory monitoring, or neuromotor disorders such as dysarthria in cerebral palsy.
There are also developmental articulation delays where a child follows the typical sequence of sound acquisition but at a much slower rate. Clinicians often classify errors by type: common types include lisps (interdental or lateral distortions of sibilants), rhotacism (errors on /r/ sounds), and distortions of affricates (e.g., imprecise “ch” or “j”).
Another categorization is based on severity or impact on intelligibility: mild articulation disorders might involve one or two sounds, while severe cases can make speech largely unintelligible. Articulation disorders are confirmed when the difficulty is at the phonetic/motor level rather than in the child’s knowledge of sound patterns.
Articulation disorders can affect a child’s speech intelligibility, especially if multiple sounds are misarticulated or if the errors involve commonly used sounds. Even a single sound distortion can attract negative attention. Children with articulation disorders often become aware of their speech differences by school age, which can affect classroom participation and social interactions. However, isolated articulation errors typically have less impact on academic achievement than language-based disorders.
One significant consequence of untreated articulation problems is the potential for persistence into adolescence or adulthood as “residual speech errors,” which can affect vocational choices and quality of life. These residual errors may lead to embarrassment, frustration, and social anxiety. Additionally, articulation disorders may be symptomatic of larger issues, such as hearing impairment or orofacial anomalies, which can bring associated challenges like reading difficulties or feeding issues. Early identification is critical to address both the speech disorder and any underlying conditions.
Farag, H. M., Eldessouky, H., Shahin, E., & Atef, M. Phonological awareness training and phonological therapy approaches for specific language impairment children with speech sound disorders: a comparative outcome study. Bulletin of the National Research Centre, 47(1), 167. (2023).
Namasivayam, A. K., Pukonen, M., Goshulak, D., et al. Speech motor function in children with speech sound disorders. Journal of Speech, Language, and Hearing Research, 56(6), (2013).
Preston, J. L., Brick, N., & Landi, N. Ultrasound biofeedback treatment for persistent childhood apraxia of speech. American Journal of Speech-Language Pathology, 22(4), (2013).
