Developmental Phonological Disorders

What are developmental phonological disorders?
Developmental Phonological Disorders (also called “phonological impairments” or “phonological disorders”) are a group of language disorders that affect children’s ability to develop easily understood speech by the time they are four years old, and, in some cases, their ability to learn to read and spell. 

Phonological disorders involve a difficulty in learning and organising all the sounds needed for clear speech, reading and spelling.  They are disorders that tend to run in families.  Developmental phonological disorders may occur in conjunction with other communication disorders such as stuttering, specific language impairment, or childhood apraxia of speech.

What is involved in learning to speak clearly?
The emergence in children of a properly organised speech sound system is called phonological development. Phonological development involves three aspects:

  • The way the sound is stored in the child’s mind.
  • The way the sound is actually said by the child.
  • The rules or processes that map between the two above.

Are these three aspects important in therapy?
They are very important. Phonological therapy always takes into account these three aspects, and the fact that phonological development is a gradual process for all children, whether they have phonological problems or not. There is a range of evidence based (“scientific”) approaches to phonological therapy.

Do all children with phonological disorders need therapy?
No, some children simply need a little extra time to catch up with their peers.

Most children with phonological disorders need more time and speech-language pathology intervention (speech therapy).

Assessment by a speech-language pathologist helps determine what the particular needs of an individual child are.

What are the characteristics of phonological disorders?
Some children with developmental phonological disorders have other speech and language difficulties such as immature grammar and syntax, stuttering or word-retrieval difficulties. However, many of them just have a ‘pure’ developmental phonological disorder, involving any of the following:

  • A problem with speech clarity in the preschool years, with no subsequent reading and spelling problems.
  • A problem with speech clarity in the pre-school years, and, in the early school years, difficulty learning to read, and difficulties with reading comprehension.
  • Speech and reading problems as described above, plus difficulty with spelling.
  • Speech and spelling problems (i.e., no reading difficulties).
  • Speech clarity problems in the pre-school years, and difficulties with written expression in primary school.

Can the problems be treated?
Certainly! No matter what combination of difficulties a child with a developmental phonological disorder has, appropriate speech-language pathology treatment is usually successful in eliminating or at the very least, reducing the problem.

Why are reading and spelling problematic?
Speech-Language Pathologists are constantly asked the following two questions:

(1) “Why do some children, who have apparently overcome their developmental phonological disorder, in that their speech now sounds quite all right, have reading and spelling problems?”

(2) “Why do they have difficulty with, or slowness in, acquiring the pre-literacy skills that are a necessary foundation for learning to read fluently with understanding, spell, and produce written work?”

As parents and professionals we are finally beginning to get some answers to these important questions. 

Current research is showing that it is because these children have poor phonological awareness in particular; and poor metalinguistic ability generally. 

Phonological awareness is the ability to recognize and manipulate the sounds and syllables used to compose words. Metalinguistic ability is the capacity to think about and talk about language.

This is important!
Children with phonological impairments do not necessarily go on to experience literacy problems, but children who still have phonological disability in the form of speech errors (especially those at the severe end of the scale) when they start school, are very much at risk for difficulties learning to read and spell. This is one reason for wanting to treat them early, at three or four years of age.

The other main reasons for treating children with phonological disorders early are that it can be frustrating, socially isolating, detrimental to self-esteem and confidence, and unpleasant generally, to have speech that is difficult to understand compared with the majority of children of similar age.