What Are Speech Sound Disorders?
Speech sound disorders (SSDs) are the most frequently diagnosed communication disorder in children, affecting approximately 8–9% of preschool-aged children. An SSD is present when a child has difficulty producing speech sounds at an age-appropriate level, resulting in reduced intelligibility—how well others can understand them. These disorders range from mild, isolated sound errors to severe patterns that render a child's speech largely unintelligible to unfamiliar listeners.
At Front Range Speech in Greeley, Colorado, we provide thorough diagnostic evaluations to identify the specific nature of each child's speech sound difficulties and develop targeted, evidence-based treatment plans. Understanding whether a child presents with an articulation disorder, a phonological disorder, or a combination of both is essential for selecting the most effective intervention approach.
Articulation Disorders
Articulation disorders involve difficulty with the motor production of individual speech sounds. The child may substitute one sound for another, omit sounds, add extra sounds, or distort the target sound. While some sound errors are developmentally appropriate at younger ages—a 3-year-old saying "wabbit" for "rabbit" is within normal limits—errors that persist past expected developmental milestones warrant evaluation and, often, intervention.
Traditional articulation therapy remains one of the most well-researched and effective approaches for motor-based sound errors. Treatment follows a systematic hierarchy: the child first learns to produce the target sound in isolation, then in syllables, words, phrases, sentences, and finally in spontaneous conversation. Each level builds on the motor accuracy established at the previous stage, ensuring the child develops stable, automatic production of the target sound.
/r/ Distortions (Rhotacism)
The /r/ sound is one of the most complex sounds in American English and one of the last to be acquired, with mastery typically expected by age 7–8. Rhotacism—distortion of /r/ and its vocalic variants (/ar/, /er/, /ir/, /or/, /air/, /ear/, /rl/)—is one of the most common reasons school-age children are referred for speech therapy. The /r/ sound can be produced with either a bunched or retroflexed tongue position, and determining which configuration works best for each child is a key part of our assessment process.
Treatment for /r/ distortions at Front Range Speech uses visual, auditory, and tactile feedback to help children find and stabilize correct tongue positioning. We utilize tools such as visual biofeedback, spectral analysis, and systematic shaping techniques. Because /r/ appears in so many phonetic contexts—prevocalic, postvocalic, and in blends—therapy must address each variant individually. Families in Greeley, Fort Collins, Windsor, and throughout Northern Colorado rely on our specialized expertise with this notoriously challenging sound.
/s/ Distortions and Lisps
Distortions of /s/ and /z/ are commonly referred to as lisps. An interdental (frontal) lisp, where the tongue pushes forward between the teeth during /s/ and /z/ production, is a normal developmental pattern in children under 4–5 years of age. A lateral lisp, where airflow is directed over the sides of the tongue rather than down the center, produces a "slushy" sound quality and is not considered a typical developmental stage—it will not resolve without direct intervention.
Our approach to lisp treatment begins with establishing correct tongue placement and central airflow for /s/ and /z/. We use tactile cues, visual models, and auditory discrimination training to help children distinguish their error production from the target sound. Once the child can produce a clear /s/ in isolation, we systematically move through the articulation hierarchy to build automaticity in connected speech.
Phonological Disorders
Phonological disorders are distinct from articulation disorders in that they involve systematic, rule-based patterns of sound errors rather than difficulty with individual sound production. A child with a phonological disorder may be physically capable of producing a sound correctly in some contexts but consistently applies an error pattern across their speech. Common phonological processes include fronting (replacing back sounds like /k/ and /g/ with front sounds like /t/ and /d/), stopping (replacing fricatives like /f/ and /s/ with stops like /p/ and /t/), cluster reduction (simplifying consonant blends), and final consonant deletion.
While many phonological processes are a normal part of early speech development, they are expected to resolve by specific ages. When these patterns persist, they can significantly impact intelligibility and require targeted phonological intervention.
Minimal Pairs Approach
The minimal pairs approach is a linguistically based treatment that targets phonological processes by presenting the child with word pairs that differ by only one sound—the child's error sound and the target sound (e.g., "tea" vs. "key" for a child who fronts /k/ to /t/). When the child produces the error, communication breaks down, creating a natural motivation to modify their production. This approach is particularly effective for children who use a single phonological process consistently and has strong research support for producing system-wide change in a child's phonology.
Cycles Approach
The cycles approach, developed by Dr. Barbara Hodson, is designed for children with highly unintelligible speech who use multiple phonological processes. Rather than targeting one pattern to mastery before moving to the next, the cycles approach rotates through target patterns on a cyclical schedule—typically spending 2–4 sessions on each pattern before cycling to the next. This method mirrors the gradual, overlapping way children naturally acquire phonological patterns and is particularly effective for children with severe phonological disorders who need exposure to multiple targets.
Tongue Ties and Speech Production
Ankyloglossia, commonly known as tongue tie, occurs when the lingual frenulum—the tissue connecting the underside of the tongue to the floor of the mouth—is abnormally short, thick, or tight, restricting the tongue's range of motion. The relationship between tongue ties and speech is nuanced: not every tongue tie causes speech difficulties, and not every speech difficulty in a child with a tongue tie is caused by the restriction.
Sounds most likely to be affected by a functionally significant tongue tie include those requiring tongue tip elevation (/t/, /d/, /n/, /l/) and tongue retraction or bunching (/r/, /sh/, /ch/). At Front Range Speech, we conduct functional assessments of tongue mobility in the context of speech production—not just passive range of motion—to determine whether a tongue tie is contributing to a child's speech sound errors. When a frenectomy is indicated, we coordinate with oral surgeons and pediatric dentists in the Greeley and Northern Colorado area and provide pre- and post-operative speech therapy to maximize outcomes.
Our Evaluation Process
A comprehensive speech sound evaluation at Front Range Speech includes standardized articulation and phonological testing, a connected speech sample analysis, an oral mechanism examination, stimulability testing to determine which sounds the child can produce with cueing, and an assessment of how the child's speech errors impact their intelligibility and participation in daily activities. For children with suspected tongue ties, we include a functional lingual frenulum assessment.
This thorough evaluation allows us to differentiate between articulation and phonological disorders, identify any motor speech components, and develop a treatment plan that targets the patterns and sounds that will produce the greatest improvement in intelligibility.
What to Expect from Treatment
Speech sound disorder therapy at Front Range Speech is structured, goal-oriented, and designed to produce measurable progress. Sessions incorporate high-repetition practice, systematic cueing hierarchies, and activities that motivate children to engage with their target sounds. We track accuracy data at every session and adjust targets and approaches based on the child's response to treatment.
Serving Greeley and Northern Colorado Families
Front Range Speech provides expert speech sound disorder therapy to children and families throughout Greeley, Evans, Garden City, Fort Collins, Loveland, Windsor, Johnstown, Milliken, and the greater Northern Colorado region. Whether your child has difficulty with a single sound or presents with a complex pattern of speech errors, our speech-language pathologists have the training and experience to help. Contact us to schedule a comprehensive speech sound evaluation and take the first step toward clearer communication.