Areas Addressed in Speech Therapy



Articulation is the process by which sounds, syllables, and words are formed when your tongue,jaw, teeth, lips, and palate alter the air stream coming from the vocal folds.  A person has an articulation problem when he or she produces sounds, syllables. or words incorrectly so that listeners do not understand what is being said or pay more attention to the waythe words sound than to what they mean (ASHA Brochure, February 7, 2000).


children should use these sounds
in words by these approximate ages

by 3 yrs

by 4 yrs

by 6 yrs

by 7 yrs

by 8 yrs

p, m, h, n, w

b,d, k, g, f, y

t, ng, l

ch, sh, j, th

s, z, v, th, zh, r


Types of Errors*


– substitution of one phoneme (sound) for another
– eg. thoup for soup

– distortion (misarticulation) of a standard sound
– a phoneme does not sound right, but sounds something

like the intended sound
– eg. ship or zip for sip

– a sound (phoneme) is left out
– eg. kool for school

– extra sound is added
– eg. galue for glue

Receptive and Expressive Language

A language disorder is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary and inability to follow directions. One or a combination of these characteristics may occur in children who are affected by language learning disabilities or developmental language delay.  Children may hear or see a word but not be able to understand its meaning. They may have trouble getting others to understand what they are trying to communicate. An SLP may work with children on improving their semantics, morphology/syntax, and/or pragmatic skills.

Vocabulary – Semantics

refers to acquisition of words and their meaning. Vocabulary can be either “receptive” – what you understand, or “expressive – what you are able to use. Some instructional areas might be one or two word concepts, using or understanding verbs, adjectives, prepositions, categorization, definition, words with multiple meanings, analogies, figurative language and implied meanings.

Syntax – Morphology

refers to using correct word order and grammar. Some language problems require step by step instruction of plurals, possessives, verb tense, pronouns, Wh-questions, or sentence construction.

Pragmatics – Social Communication

refers to actually using language to communicate. Students might need direct instruction on listening, question comprehension, problem solving, conversational skills, taking turns, and exchanging information.


What is stuttering?

Stuttering is the condition in which the flow of speech is broken by abnormal stoppages (no sound), repetitions (st-st-stuttering), or prolongations (ssssstuttering) of sounds and syllables.  There may also be unusual facial and body movements associated with the effort to speak (ASHA Brochure, February 7, 2000).

What causes stuttering?

We still do not know for a fact what causes stuttering.  It may have different causes in different people, or it may occur only when a combination of factors comes together.  It is also quite possible that what causes stuttering is quite different from what makes it continue or get worse.  Possible influences include incoordination of the speech muscles; rate of language development; the way parents and others talk to the child; and other forms of communication and life stress (ASHA Brochure, February 7, 2000).

At what age does stuttering usually appear?

Stuttering typically begins at a very early age (usually between 2 and 5 years), but will occasionally appear for the first time in a school-age child and, more rarely, in an adult (ASHA Brochure, February 7, 2000).

What should I do when I hear a child stutter?

Children may be unaware that they are speaking disfluently.  DO NOT call attention to the disfluent speech pattern.  DO NOT say “Stop and start over,” “Think before you talk,” “Talk slower,” or “Cat got your tongue?”  Listen patiently and carefully to what the child is saying, and DO NOT focus on how it is being said (ASHA Brochure, February 7, 2000).

What should I do when I hear an adult stutter?

Adults who stutter need the same patience and attention to their ideas as speakers who do not stutter.  DO NOT look away and DO NOT hurry them or fill in words.  This attempt to help can create anxiety and self-consciousness and make the problem worse (ASHA Brochure, February 7, 2000).


What is a “normal” voice?

A normal voice is judged according to whether the pitch, loudness, and quality are adequate for communication and suit a particular person.  A person may use a pitch which is too high or too deep, too loud or too soft, too hoarse, breathy, or nasal.  Sometimes a voice may seem inappropriate for an individual, such as a high pitched voice in an adult male (ASHA Brochure, February 7, 2000).

What is a “problem” voice?

Voice is a problem when the pitch, loudness, or quality calls attention to itself rather than to what the speaker is saying.  It is also a prolem if the speaker experiences pain or discomfort when speaking or singing (ASHA Brochure, February 7, 2000).

What causes a voice problem?

There are a varitey of causes of voice problems.  Persons can become hoarse temporarily by cheering at a baseball game, or an individual can sustain an injury that causes a paralysis of a vocal fold.  Misuse of the voice, such as talking too loudly or using a pitch level that is too high or too low, can result ina  voice problem.  So can an improper breating pattern.  Other voice disorders occur without apparent cause and are thought to be neurologic in origin (ASHA Brochure, February, 2000).

What are the early signs of a voice problem?

Hoarseness, voice change, or discomfort that lasts for more than ten days in the absence of an allergy or cold can indicate a voice problem(ASHA Brochure, February 7, 2000).