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What is Speech Sound Therapy?

A speech sound disorder refers to inaccurate and/or unclear production of speech sounds, resulting in difficulty with communication. Speech sound disorders may affect as little as one sound and up to several, or all, sounds. ​​

Are there different types of speech sound disorders?



Articulation disorders refer to inaccurate motor productions of specific sounds, such as a frontal/lateral lisp, distortions, etc.. Although some articulation errors are due to unknown origins, some are linked to structural differences, such as cleft palate. Articulation disorders may affect one or all of the articulators required for speech: lips, teeth, tongue, alveolar ridge, hard palate, soft palate, and jaw.

Phonology refers to patterns in speech sound errors. Phonological patterns are typical in a child’s speech development (e.g. “Lello/Yeyo” for “Yellow,” or “Fum” for “Thumb). A phonological disorder occurs when a pattern persists past a developmentally appropriate age, or if patterns that aren’t typically seen during development occur (e.g. initial consonant deletion or atypical sound substitutions). 

Motor speech disorders occur from a neurological origin. These include dysarthria (i.e. difficulty with the execution of speech) and apraxia (i.e. difficulty with the planning of speech production). 

When should I get a screening or evaluation?


The first step to determine if a speech screening or evaluation is warranted is to get a hearing check from your healthcare provi er. If there is difficulty with the auditory perception of sound, speech sound errors may be secondary to a hearing impairment. 


After a hearing impairment is ruled out, it’s recommended to reach out to a speech language pathologist (SLP) if your child is: 

  • Having difficulty producing speech sounds past their typical age of mastery (*Please see the table below for typical ages of mastery for each sound*) 

  • Producing phonological patterns that are not typical in speech development

  • Speaking with low intelligibility (i.e. the amount they are understood).

For reference, intelligibility is typically 50-75% for a familiar listener and ~50% for unfamiliar listeners at 2 years, ~75%-100% for familiar listeners and ~75% for unfamiliar listeners at 3 years, and ~100% for both familiar and unfamiliar listeners around age4 (yet some speech sounds are not fully developed until age 6).

Certain factors may put your child a higher risk for a speech sound disorder, including but not limited to family history of a speech disorder, extended thumb-suck and/or pacifier use, developmental and acquired disorders, and structural differences.

What does a speech sound therapy session look like?


Speech therapy is not one-size-fits-all!


Each child will have an individualized plan that works best for them. There are several evidence-based approaches that may be used during speech sound intervention. Regardless of the approach, motivation is a priority at our clinic!


Speech sessions are set up to be engaging and playful and incorporate the child's interests. This is directly opposed to compliance-based intervention and strictly drilling words. 

Are there specific approaches your team uses?

  • The Cycles Approach: Cycling through targets for a set amount of time until the child is producing the sound accuratel  at the conversational level. 

  • Minimal Pairs: Practicing word pairs that differ by one sound (e.g. “Rake” and “Wake”). The word pairs chosen typically represent the target sound (R in “Rake”) and the sound the child typically produces instead (W in “Wake”). 

  • Multiple Oppositions: Targeting multiple sounds at the same time. This approach is often used for children who have a preferred sound. 

  • Maximal Oppositions: Practicing word pairs that are produced in very different ways in regards to place and manner of articulation. 

  • The Empty Set: Practicing word pairs containing sounds the child has trouble producing. Like the maximal opposition approach, these word pairs are also produced in very different places and manner. 

  • The Complexity Approach: Practicing later developing sounds (e.g. “r,” “s,” “th”) in a consonant cluster (e.g. “thr-”). 

  • Naturalistic Speech Intelligibility Intervention: Modeling accurate productions during motivating activities. This is done without the expectation of the child repeating the word back each time. 

  • Core Vocabulary: Choosing a set of individualized words the child would use most frequently. This approach is most often used for children who have low intelligibility and/or produce words inconsistently. 

  • Contextual Utilization: Practicing target sounds in words in which it’s easier to produce the target sound due to the adjacent sounds. 

  • The Metaphon approach: Focuses on teaching the child awareness and knowledge of the speech system.

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