As you already know, when children are very young, they don’t have good coordination between the body parts they need to form speech, namely their lips, tongue, teeth, velum (soft palate), hard palate, alveolar ridge, and jaw. For this reason, they often simplify words and phrases into something easier for them to say as they are learning to speak. These “articulation issues” are quite normal at very young ages. One classic example of this is for the child to drop the softer syllable(s) in a multi-syllabic word. Thus, “banana” is shortened to “nana” when that chubby little toddler hand reaches for the fruit basket.

While proud parents and doting grandparents find this cute, and it is of course, if articulation issues don’t automatically go away during the course of normal development, then a phonological disorder may be present. Generally speaking, most of what a child says should be clear and understandable by age four. However, children with phonological disorders will continue to have problems articulating words long after most of their contemporary playmates are speaking normally. For example, they may have problems saying double consonants so they end up dropping the second consonant in their speech. Thus, “thing” becomes “ting” and “spoon” becomes “soon.” They may also substitute consonants that are more difficult for them to say. Thus, the color “red” gets pronounced “wed” and “rabbit” becomes “wabbit.”

When parents get worried because they can’t understand their child, they will often take him or her to the doctor who then refers them to a more specialized clinician and or speech pathologist for detailed evaluation. At this point, these clinicians and speech pathologists must be able to distinguish between normal articulation issues for a specific age range and a bona fide phonological disorder. This can be very difficult to do without following a standardized assessment. Once they make a definitive diagnosis, it makes determining the underlying physical and or mental issues causing these problem easier to uncover. This is why it is often important that speech pathologists and clinicians work hand in hand to help a single patient. It is also why this process is facilitated if they work off the same assessments performed on the child.

Phonological disorders affect around three percent of preschool age children (less than six years old) and around two percent of children aged six to seven. It is more common in boys but girls can have a phonological disorder too. Many children with phonological disorders do overcome these challenges but in order to do that, they must be diagnosed fully and accurately.

Standardized assessments, such as the Arizona-4, help clinicians and speech pathologists more readily and accurately identify if the articulation issues a child is having actually rise to the level of a phonological disorder. This can help determine if the child needs therapy, and if so, what kind of therapy would be most helpful. It can also be helpful in designing a home program where the parents and other caregivers can practice specific exercises with the child to achieve better articulation and overall language skills. Assessments can also be used to evaluate improvements over time and to share with other specialists who may be brought in as part of a team to help the child. For example, if the child is hard of hearing, it may become necessary to add an audiologist to the team. If a standardized assessment is available, this can help the new team member get up to speed and work cooperatively with other team members to help the child.

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