Speech Disorders


Articulation refers to how we say sounds. A child with articulation errors might substitute, omit, add or change sounds in words. These errors make it difficult for people to understand the child.  Articulation errors can be due to misplacement of the tongue and lips, difficulty in the planning and coordinating of movements to make the sounds, or using incorrect sound patterns. Every sound has a range of ages when a child should be able to make the sound in conversation. Children should be understood by most adults by 4 years old.


Fluency, also known as stuttering, is characterized by repetition of sounds, syllables, and phrases. Prolongations (stretching of syllables) and blocks or tense pauses can also occur. Physical reactions may occur during stuttering. Some stuttering is common as children learn new words and concepts. It is generally relaxed and does not significantly impact a child’s ability to express his or her thoughts.


Voice disorders refer to the way the voice sounds. Excessive hoarseness, breathiness, or rasping are common characteristics. An ENT (ear-nose-throat doctor) must be consulted for the diagnosis of a voice disorder.


Language Disorders


Receptive language is the ability to understand language. Children with receptive language difficulties might have trouble following directions, answering questions, understanding complex sentences, or participating in conversations. Difficulties in receptive language can impact spoken and written language. These children frequently appear to not be attending to spoken language. They often stick with conversational topics that are highly familiar and routine.


Expressive language is the ability to communicate wants, needs, thoughts, and feelings. A child with expressive language difficulties might have limited vocabularies, speak in short phrases or sentences, have difficulty asking questions or have difficulty using different types of words such as verbs or pronouns. They may also have difficulty using proper syntax, semantics, or morphology.   


Pragmatic language refers to social communication. This is the “what to say and when to say it” part of language. Pragmatic language includes turn taking in conversation and activities, introducing and staying on a conversational topic, and being aware of another person’s attention and interest.

Green Speech Language Services Baltimore Speech Language Pathologist Rebecca Green