An articulation disorder refers to the persistent difficulty in pronouncing speech sounds that may impact a person’s ability to be understood or accepted. Sounds may be substituted (e.g. “wabbit”/rabbit, “thpoon”/spoon), omitted (e.g. “ba”/bat, “geen”/green), distorted (e.g. when the “s” in soup sounds wet or slushy), or added (e.g. “cart”/car, “chiminey”/chimney).

Phonological processes are patterns of sound errors that children use to simplify their speech as they learn to coordinate their jaw, palate, lips, and tongue for clear pronunciation. For example, they may reduce consonant clusters to a single consonant (e.g. “poon”/spoon or “back”/black), substitute sounds made in the front of the mouth for those made in the back of the mouth (e.g. “dod”/dog, “tootie”/cookie), or delete the weak syllable in a word (e.g. “nana”/banana). A child with a phonological disorder may mispronounce or omit a sound in some words, yet pronounce it clearly in others.

CAS is a motor speech disorder involving difficulties in planning speech movements in the absence of muscle weakness or paralysis. The child knows what he wants to say, but the brain has difficulty coordinating the muscle movements necessary to say the words.

Children with CAS have problems saying sounds, syllables, and words. The may say a familiar word differently every time, put the stress on the wrong syllable or word, distort or change sounds, or say shorter words more clearly than longer words.

It is common for children with CAS to also have difficulty with fine motor skills, delayed language, or problems with reading, spelling, and writing.

Orofacial myofunctional disorders are disruptions in the growth and development of the bones and muscles of the face and the mouth. An OMD may result from anything that causes the tongue to be misplaced at rest, restricts the tongue’s movement within the oral cavity, makes it difficult to achieve acceptable lip closure, or reduces or impedes the ability to obtain and maintain correct oral rest postures.

Individuals with an OMD may have problems with speaking, swallowing, or breathing through their nose. Certain speech sounds, such as /s/ in “see”, /sh/ in “shoe”, or /j/ in “jump”, may be mispronounced. The front or sides of the tongue may push out beyond the teeth while at rest, while swallowing, or when speaking (a tongue thrust). Eating may be relatively slow, quick, or messy compared to others in the family. It may be difficult for lips to close during a swallow, or they may close with excessive pressure. An over-bite, under-bite, and/or other dental problems are common. Upper airway obstruction and open-mouth posture may be present.

Prosody refers to the variations in melody, intonation, pausing, stress, intensity, vocal quality, and accents of speech. A person may have difficulty controlling their pitch and volume, have poor vocal quality, demonstrate increased pause duration, or may have uncommon stress patterns. Some people have difficulty understanding how subtle changes in prosody effect meaning.