Speech Disorder Diagnosis

Why is it so important to get it right?

The correct speech disorder diagnosis for any child with a speech sound disorder is crucial! The etiology of the disorder must guide treatment. 

We know this! However, it can be time consuming and daunting to keep up with all the latest research. So, I am here to help!

Importance of speech disorder diagnosis

As you can see by the graph above, there are many different speech sound disorders. Each one differs by etiology and can be diagnosed with a comprehension speech sound disorder evaluation completed by a speech language pathologist. 

We must KNOW the exact disorder of the child in order to choose the right research-based treatment program. 

If we don't get it right from the beginning, progress may be SLOW or non-existent.

Speech Sound Disorder Evaluation

A comprehensive speech sound disorder evaluation is crucial. Here is my quick overview of what it entails.

  1. Case History - Start with a thorough case history to check for important information such as frequent ear infections, surgeries, medications, family history, previous therapy, etc...
  2. Oral Mechanism Evaluation - Evaluating anatomy at rest and in movement will give imperative information on strength, movement, and coordination. The differential diagnosis really starts here. 
  3. Standardized Assessment - There has been some discussion on the usefulness of standardized assessments lately; however, they are still quite needed in this case. We need standard scores for qualification for services, and the errors in the assessment can be use in more in-depth tools such as SPACS or phonology process checklists. More on that later. 
  4. Speech-Language Sample - Observing a child's speech ability at the conversational speech level is necessary. A single word test is a very focused, unnatural sampling of a child's speech. They may perform better than they do in "real life." Observing and noting errors in a speech-language sample will give valuable information on their error patterns and other factors such as fatigue, motor planning, fluency, and more!
  5. Stimulability Testing - Once you can have a picture of the child's errors, test for what they are stimulable for. This will be necessary for almost any treatment approach you chose. Some start with sounds the child is stimulable for and some start with sounds the child ISN'T stimulable for. 
  6. Further Assessment - Depending on how the child performs on steps 1-5, you may be done. For example, if a child has a lateral /s/, you are done. However, if a child has many errors and/or many suspected phonological patterns, he/she may have a phonology delay, consistent phonology deviant disorder, or inconsistent phonology deviant disorder. Further testing such as SPACS will be crucial in deciding diagnosis and treatment.

To learn more about the components of a speech sound disorder evaluation, please click here.

Speech Disorder Diagnosis Overview

For my purposes, I divide speech sound disorders in the following categories. I try to make my explanations as parent friendly as possible. No jargon here!

Motor Speech Disorders -difficulty making/planning speech movements

  • Childhood Apraxia of Speech (CAS)
    • difficulty planning speech movements
    • delayed and atypical errors
  • Dysarthria 
    • difficulty making speech movements
    • muscle weakness

Phonemic- difficulty organizing sound patterns/sound omission & substitution

  • Phonology Delay
    • rule-based errors
    • phonological rules persist, typical of a younger child
  • Consistent Deviant
    • consistent errors
    • errors: typical & atypical of phonological delay
  • Inconsistent Deviant
    • inconsistent errors
    • errors: typical & atypical (>40%) of phonological delays

Phonetic - difficulty saying certain sounds/sound distortions

  • Articulation Disorder
    • difficulty producing a few sounds correctly
    • sound distortions
  • Articulation Disorder (structurally based)
    • i.e., cleft palate, dental issues, etc...

Speech Sound Disorders Treatment

Once you get your diagnosis, now the research-based treatment options have narrowed a bit. This takes out some of the stress when you are writing goals and planning. 

All the different treatment approaches based on diagnoses is too much to write here.

Due to the immense amount of questions I have been receiving, I will be updating this section every 2-4 weeks with links to my favorite research-based therapy techniques so bookmark it or sign up for weekly emails so you don't miss a thing. There will be free materials included!

Parent Handouts/Reference Sheets

As part of Speech Therapy Talk's Membership site, I updated the parent handouts sections with a handout of the chart above. 

I kept it concise, minimal colors for easy printing, and places to make notes.

Most parents have already be scouring the internet before they come to see me, and more often than not, this leads to confusion. Therefore, after an assessment, I like to show this handout to parents when explaining the results of the evaluation. Then, I make notes on treatment and goals right on the handout.

Click the image to get grab your copy if you are a member!

Join Membership To Grab Your Materials

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