Speech and Language Disorders in Children
Categories to distinguish
Know the difference between speech sound disorders (articulation/phonological), language disorders (developmental language disorder, DLD), fluency disorders, voice disorders, and disorders secondary to other conditions (hearing loss, autism, cerebral palsy, intellectual disability). Understand phonological processes (fronting, stopping, cluster reduction, final consonant deletion) and their expected suppression ages. Recognize childhood apraxia of speech (inconsistent errors, groping, difficulty with transitions) versus dysarthria (consistent weakness, slow rate, imprecise consonants). Know the markers of DLD: limited vocabulary, grammatical errors, difficulty with narratives, and social consequences.
Traps in questions
Questions often blur articulation (motor production of one sound) with phonology (rule-based pattern affecting sound classes). Another trap is confusing apraxia (planning) with dysarthria (execution). Do not over-diagnose autism from a language delay alone; social communication features must be present across contexts. Be careful with "late talkers"-some resolve, but persistent delay by 3–4 years warrants intervention.
Rule of thumb
Ask: is the problem with sounds, words, sentences, or social use? That answer drives the target of therapy.
Worked example: A 4-year-old says "tat" for "cat" and "do" for "go"-fronting and stopping; both are phonological processes expected to resolve earlier, so intervention targets the pattern, not just individual sounds.