Phonological Disorder

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KEY POINTS

• Phonological disorder causes problems such as leaving out sounds, adding sounds, or changing sounds when speaking.
• The most common treatment for this disorder combines language and speech therapy. Many public schools have a speech therapist or tutor who works with children diagnosed with this disorder.
• Your child’s therapists can help you learns ways to work with your child at home.

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What is phonological disorder?

Phonological disorder causes problems making the right sounds for letters or words. Children with this disorder make 3 types of mistakes:

• Replacing one sound with another (saying "bat" instead of "cat")
• Leaving out a sound (saying "dess" for "dress")
• Adding a sound (saying "plaper" instead of "paper")

This disorder can go away by itself by the time a child is around 8 years old. However, the earlier speech therapy is started the better. Children who start therapy before age 3 usually improve faster and do better than older children.

What is the cause?

Several kinds of problems may cause this disorder:

• Problems with the roof of the mouth or the tongue, such as cleft lip and palate
• Nerve problems that cause the muscles of the mouth to have trouble forming sounds
• Hearing problems
• Being exposed to chemicals that can affect the brain
• Physical changes in parts of the brain

Parents who have speech problems have a higher risk of having children who develop speech problems. It is more common in boys than girls.

What are the signs?

Symptoms may include:

• Not being able to speak as well as expected for your child's age
• Replacing one sound with another
• Leaving out or adding extra sounds

Parents usually notice this disorder when their child is about 3 years old. Do not wait to see if a problem goes away by itself. Your child may miss many months of helpful therapy.

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child will also have hearing and vision tests.

If your healthcare provider thinks your child may have a speech disorder, your child may need to see a specialist. They can do more testing and advise you about treatment. Your school district may also provide testing services for your child.

How is it treated?

If your child also has a hearing problem or other medical condition, the medical condition is treated first.

The most common treatment for this disorder combines language and speech therapy. These kinds of therapy can:

• Help your child to understand and use words
• Increase the number of words that your child knows
• Help relax face and mouth muscles by teaching your child breathing and relaxation exercises

Many public schools have a speech therapist or tutor who works with children diagnosed with this disorder.

Children who attend public preschool, elementary school, or secondary school may be eligible for free assistance. The school must develop an Individualized Educational Plan (IEP) for each child who needs special education. This plan includes:

• Educational goals
• Class placement
• A plan to check progress
• Any other special services, such as therapy or transportation

Both the parent and the school must agree to the plan. You may want to visit public schools in your area to see the type of program they offer.

How can I help my child?

• Find out what services are offered through your school district to help children with learning disabilities.
• Your child’s therapists can help you learns ways to work with your child at home.
• Children learn words and the rules for using them by listening to others talk. Therefore, what you say and how you say it is important. Talking is a natural part of many daily routines such as mealtime, bath time, and dressing. Encourage your child to ask for items, make choices, and answer questions. Encourage him to tell stories and share information.
• Try to avoid putting pressure on your child. Do not say "You can't have it unless you say it first." Praise your child for his efforts and for any improvement, however small.
• Look for your child’s strengths. No one knows what your child may be able to do in time, so don’t set your expectations too low. Encourage your child to try new things.
• Be specific when you talk to your child. Tell your child in simple steps what you want him to do. It also helps to show your child how to do something rather than just tell him.
• Be patient with your child. He may not be able to put his needs and feelings into words. Watch your child’s body language for signs that he is upset or that something is wrong.