Articulations evaluations and therapy

What is articulation?

Articulation refers to the way that speech sounds are made. Children who have difficulty with articulation skills may:

  • Substitute sounds (ex. using “d” for “g” so “go” is produced as “do”)
  • Delete sounds in the beginning, middle or ends of words (ex. “ookie” for “cookie” or “ca” for “cat”)
  • Distort speech sounds (ex. a “lisp” for /s/).
  • Have difficulty sequencing the movements of the tongue, lips, soft palate and vocal folds to produce speech sounds in sequences (apraxia of speech).

Articulation milestones

In general, children should be using p, b, t, d, n, m, k, g, w, and h sounds by three years of age. By six years of age, most children will be using more complex sounds like s, z, f, v, sh, ch, dg, th, l and r correctly.

When is a speech evaluation recommended?

If a family is concerned about their child’s communication development, a consultation with a speech–language pathologist is recommended. General guidelines for when to schedule an articulation evaluation include when a child:

  • Does not use p, b, t, d, n, m, k, g, or w sounds by 3 years of age
  • Does not use s, z, f, v, sh, ch, dg, th, l or r correctly by 5-6 years of age
  • Does not use 50 words or 2-word phrases (ex. “more cookie”) by 24 months
  • Sounds “nasally” or too much air is leaking though the nose when talking
  • Is not understood at least 90% of the time by 4 years of age

What to expect during an articulation evaluation

During a 60-minute articulation evaluation, the speech-language pathologist will collect information about your child’s medical history, developmental milestones and your current concerns. Depending on your child’s age and communication skills, the speech-language pathologist may also:

  • Listen to your child talk during play activities
  • Engage your child in conversation to see how they produce sounds in sentences
  • Ask your child to read short paragraphs
  • Administer standardized articulation testing, which typically involves your child naming a series of pictures
  • Assess language development

Results and recommendations will be discussed at the end of the evaluation. If appropriate, speech therapy will be recommended and home activities will be discussed/demonstrated.

What to bring to an articulation evaluation

  • Speech-language intake packet (PDF)
  • Copies of previous evaluations, including the IEP/IFSP if your child is receiving services through the Birth to Three program or school.
  • Results from a recent hearing test (if available)

What to expect during articulation therapy

Based on the results of your child’s evaluation, articulation therapy may be recommended to address speech sound errors. Therapy activities typically include working on sounds in simple syllables (ex. “me”) then progressing to more complex words (ex. “mommy”), phrases, sentences and ultimately conversational speech. Many of our speech-language pathologist are also trained in PROMPT. Depending on your child’s age and abilities, activities may be completed during play or in more structured ways such as seated at a table.

At Children’s, we believe that it is very important for families to be involved in all aspects of their child’s care. Depending on the child’s needs, parents are encouraged to view the sessions via monitors, observation mirrors, or in the therapy room. In addition, your child’s speech-language pathologist will discuss progress, provide worksheets for home practice, and demonstrate beneficial therapy techniques to ensure maximum benefit is received from therapy.

Find additional information on articulation development as well as diagnoses commonly associated with articulation disorders: