Two different things that sound similar

Speech pathologists separate articulation difficulties, where a child cannot physically make a particular sound, from phonological difficulties, where a child can make the sound but is using a pattern that simplifies their speech — leaving off the ends of words, for example, or swapping every back sound for a front one.

The distinction matters because the two are treated quite differently. A third pattern, where a child knows exactly what they want to say but has trouble planning and sequencing the movements to say it, is called childhood apraxia of speech and needs a different approach again. Working out which one you are dealing with is the first job of an assessment.

Signs you might notice

People outside the family often cannot understand your child
Your child is still leaving sounds off the ends or beginnings of words
Particular sounds are consistently substituted — “tat” for “cat”, “wabbit” for “rabbit”
Longer words come out differently each time they are said
Your child gets frustrated, gives up, or says “never mind” when not understood
Siblings or you find yourselves translating for them
Your child has started avoiding certain words, or talking less around people they do not know

How our speech pathologists help

Once we know the pattern, treatment is targeted. For an articulation difficulty we teach the sound directly, starting wherever your child can already succeed and building up through syllables, words, phrases and conversation. For a phonological difficulty we work on the pattern rather than one sound at a time, often using pairs of words that differ by just that sound so your child hears why it matters. Apraxia needs frequent, repetitive practice of movement sequences.

Progress in this area depends heavily on practice between sessions, so we keep home practice short, specific and realistic — a few minutes most days beats an hour on a Sunday. This sits within our wider speech pathology service.

What sessions might look like

Expect games with a purpose. Fishing games, board games, bowling, hiding cards around the room — all of it built around getting a high number of accurate practice attempts without your child noticing they are working. We give clear feedback about what their mouth is doing, use mirrors and touch cues where they help, and build up the difficulty only once a level is solid. Sessions run in our Springfield clinic or at home, kindy or school.

What an assessment involves

A speech sound assessment works out exactly which sounds and patterns are affected, how much it is holding your child back, and which approach will work fastest. It usually takes one appointment.

Your history and concerns. When speech started, whether it has changed, how often your child is misunderstood, and who struggles to follow them.
Single-word speech testing. Your child names pictures covering every speech sound in English in different positions in words, so we can map precisely what is happening.
Connected speech sample. We listen to your child in conversation or while telling a story, because speech often breaks down more in running speech than in single words.
An intelligibility estimate. A practical measure of how much of your child's speech an unfamiliar listener would understand — this is often the number families find most useful.
Stimulability testing. We check which sounds your child can produce when shown how, which tells us where to start for the quickest win.
An oral motor check. A quick look at how the lips, tongue and palate move, to rule out a physical cause.
A hearing check. Recommended if it has not been done recently, since even mild or fluctuating hearing loss affects which sounds a child picks up.

We will explain what we found, what is age-appropriate and what is not, and give you a realistic sense of how long things usually take.

Where we see children

In our Springfield clinic
At home
At daycare, kindy or school
In the community

Frequently asked questions

How much should I understand of my child's speech at their age?

A rough guide used widely is that an unfamiliar listener should understand around half of what a two-year-old says, three quarters of a three-year-old, and nearly all of a four-year-old. If your child sits well below that, an assessment is worthwhile.

What is the difference between articulation and phonological difficulties?

An articulation difficulty means your child cannot physically produce a sound. A phonological difficulty means they can produce it but are applying a simplifying pattern across many words. They look similar from the outside but need different treatment, which is why assessment comes first.

Will my child grow out of it?

Some sounds genuinely do sort themselves out, and later-developing sounds like ‘r’, ‘th’ and ‘s’ blends can be fine to wait on. Others do not resolve and become harder to change once established. An assessment tells you which situation you are in rather than leaving you guessing.

Ready to make your child easier to understand?

We’ll partner with you to create a plan that works for your family — with access, empathy and hope.

Request an appointment Speech pathology

Or call 0480 841 300 · hello@accesstotherapy.com.au

Speech sound difficulties in children