Speech sound disorders occur when a child has difficulty making certain sounds correctly. This can include articulation errors (trouble with individual sounds) and phonological patterns (simplifying or substituting groups of sounds). These challenges can make a child’s speech hard to understand.

It’s normal for young children to make some sound errors as they learn to talk, but by about age 4, most can say nearly all sounds clearly and are understood by people outside the family. If your child’s speech is still unclear or difficult to follow, speech therapy can help.

Common signs include:

• Replacing one sound with another (“tat” for “cat”)

• Leaving out sounds (“poon” for “spoon”)

• Simplifying word patterns (“gog” for “dog”)

• Unclear or “mumbled” speech

• Frustration when others can’t understand them

How speech therapy helps:

• Evaluates whether sound errors are age-appropriate or need support

• Teaches correct tongue, lip, and jaw placement for clear sounds

• Uses fun, play-based activities and repetition to build accuracy

• Improves overall speech clarity, confidence, and communication success

Children use language every day — to share ideas, follow directions, learn new concepts, and connect with others.
When language skills don’t develop as expected, a child may have difficulty understanding or using words effectively.

Receptive language is how your child understands what others say.
Expressive language is how your child uses words to express thoughts, needs, and feelings.

A language disorder may look like difficulty with:

• Following directions

• Understanding questions or stories

• Learning and using new vocabulary

• Forming complete, grammatically correct sentences

• Thinking of the right words to say

• Telling stories that make sense and stay on topic

• Sequencing events or retelling what happened

• Remembering information or details

How speech therapy helps:

• Builds listening and comprehension skills

• Strengthens vocabulary and sentence structure

• Improves storytelling, conversation, and academic language

• Supports overall confidence in communication and learning

Strong language skills form the foundation for learning to read and write.
When a child has difficulty understanding or using language, they may also struggle with early literacy skills such as recognizing sounds, learning letters, and comprehending stories.

A Developmental Language Disorder (DLD) is a communication disorder that affects how a child learns, understands, and uses language. It is more common than many people realize—about 1 in 14 kindergarteners are affected.

Language and literacy challenges may include:

• A history of delayed language development

• Difficulty learning letter sounds or reading new words

• Limited vocabulary or overuse of vague words like “stuff” and “thing”

• Trouble expressing thoughts clearly or organizing ideas

• Disorganized storytelling (retelling events or stories from books)

• Frequent grammatical errors

• Difficulty following directions or answering “who,” “what,” “where,” “when,” and “why” questions

How speech therapy helps:

• Strengthens vocabulary, grammar, and sentence structure

• Builds early literacy skills like phonological awareness (hearing and manipulating sounds in words)

• Improves storytelling, reading comprehension, and written expression

• Supports confident communication across home and school settings

A late talker is a child between 18–36 months who has a delay in spoken language, even though other areas of development (such as understanding, motor skills, and play) are on track.

Because the brain grows and develops rapidly before age 3, early intervention is especially important to support communication and future learning.

Early signs of a late talker may include:

• By 1 year: Limited babbling or imitation of gestures

• By 18 months:

  • Fewer than 10 true words

  • Not using several consonant sounds

  • Difficulty following simple one-step directions

• By 2 years:

  • Fewer than 50 words

  • Not combining two words (like “more milk”)

  • Not using words to communicate wants or needs

• By 3 years:

  • Fewer than 300 words

  • Not combining two to three words

  • Minimal use of grammar or word endings

How speech therapy helps:

• Encourages early communication through play and interaction

• Teaches strategies for building vocabulary and combining words

• Coaches parents on how to model and expand language at home

• Builds confidence and connection through positive communication experiences

Early Intervention provides support and services for infants, toddlers, and their families to help build strong foundations for learning, communication, and connection.

Who it helps:

• Children from birth to age 5 who may be experiencing developmental or communication delays

What it includes:

• Coaching and teaching caregivers practical strategies to enhance their child’s language and overall development

• Play-based, family-centered therapy focused on everyday routines and activities

Local resource:
Families in the Portland area may qualify for free in-home Early Intervention services through the Multnomah Early Childhood Program (MECP).

Social communication (also called pragmatic language) is how children connect, share, and build relationships with others through language, gestures, and play.
These skills allow children to express themselves, understand others, and participate meaningfully in their world.

For young children, play is the foundation of communication.
Through play, they learn how to:

• Take turns and share space

• Work together and problem-solve

• Express thoughts, emotions, and ideas

• Interpret facial expressions, body language, and tone of voice

• Build friendships and confidence in social settings

Challenges with social language may include:

• Difficulty starting or maintaining conversations

• Trouble understanding nonverbal cues (facial expressions, gestures)

• Limited play skills or trouble joining group play

• Difficulty interpreting social situations or emotions

How speech therapy helps:

• Uses play-based activities and role-play to practice real-world social situations

• Teaches children how to recognize and respond to social cues

• Builds confidence in conversations and peer interactions

• Helps children develop the skills to form meaningful connections and lasting friendships

Gestalt Language Processing (GLP) is a style of language development — not a disorder or diagnosis. Some children learn language in larger “chunks” or memorized phrases (called scripts, echolalia, or gestalts) before breaking them down into individual words.

This is simply a different way of learning language, and recognizing it helps a speech-language pathologist tailor therapy to best support your child’s communication growth.

Children who are gestalt language processors may:

• Use memorized phrases from favorite shows, songs, or movies

• Repeat whole phrases that might seem out of context

• Label many objects but struggle to use words flexibly to communicate

• Repeat questions instead of answering them (e.g., “Do you want a snack?” → child says, “Do you want a snack?”)

How speech therapy helps:

• Identifies your child’s current stage of language development

• Teaches strategies to move from memorized scripts to flexible, original language

• Uses play, modeling, and natural conversation to support meaningful communication

Stuttering is a speech pattern that affects the flow, rhythm, and ease of talking. Many children go through periods of normal disfluency as their language grows, but persistent stuttering can make communication feel frustrating or effortful.

Common signs of stuttering include:

• Repeating sounds, syllables, or words (e.g., “b-b-ball”)

• Stretching out sounds (“ssssun”)

• Pausing or getting “stuck” on a word (called a block)

• Visible tension or struggle behaviors such as blinking, facial movement, or tightness when trying to speak

How speech therapy helps:

• Teaches strategies to support smooth, confident speech

• Increases understanding of stuttering and how to manage it

• Builds self-awareness and reduces tension during speech

• Encourages positive communication experiences in a supportive, pressure-free environment

Childhood Apraxia of Speech (CAS) is a motor speech disorder that affects how messages travel from the brain to the muscles of the mouth. These messages tell the lips, tongue, and jaw how and when to move to make sounds and words.

In children with apraxia, those messages don’t always get through correctly—so even though a child knows what they want to say, the words may come out unclear, distorted, or inconsistent.

Common signs of Childhood Apraxia of Speech:

• Words may sound different each time they’re said

• Speech may have unusual rhythm or stress on the wrong syllables

• Vowel sounds may be distorted or inconsistent

• Shorter words are often easier to say than longer ones

• Delayed language development

• Difficulty with fine or gross motor coordination (for some children)

• Uses gestures or familiar phrases to communicate instead of new words

How speech therapy helps:

• Targets the specific speech motor patterns needed to produce clear, consistent sounds

• Uses repetition, visual cues, and tactile feedback to strengthen brain–mouth coordination

• Builds functional communication while supporting confidence and frustration tolerance

• Provides families with tools and activities to practice at home

Because apraxia is a motor-based speech disorder, early and frequent intervention from a licensed speech-language pathologist is key to helping your child make steady progress.

Oral motor skills involve the movement, strength, and coordination of the muscles in the mouth, jaw, tongue, lips, and cheeks. These muscles are essential for both feeding and speech development.

When oral motor skills are weak or uncoordinated, a child may have difficulty eating, drinking, or producing speech sounds clearly. A tongue thrust—when the tongue pushes forward during swallowing or speech—is a common pattern that can affect articulation and feeding.

Possible signs of oral motor difficulties include:

• Limited food preferences or difficulty with certain textures

• Excessive drooling

• Visible tongue thrust when swallowing or speaking

• Trouble sucking, chewing, swallowing, or blowing

• Poor articulation or unclear speech

• Messy eating or food falling from the mouth

How speech therapy helps:

• Strengthens and coordinates the muscles needed for speech and feeding

• Teaches correct tongue and lip placement for improved clarity

• Provides fun, engaging oral motor activities to build control and endurance

• Promotes safe, efficient eating and confident communication

AAC stands for Augmentative and Alternative Communication — it includes all the ways someone communicates besides talking.
AAC can help children who have difficulty using spoken words express their thoughts, needs, and ideas effectively.

Types of AAC:

• No-tech / Low-tech: Gestures, facial expressions, writing, drawing, spelling words by pointing to letters, or pointing to photos, symbols, or words on a board or book.

• High-tech: Using an app on a tablet (like an iPad) or a speech-generating device that produces spoken words through a computerized “voice.”

How speech therapy helps:

• Determines which AAC tools are most appropriate for your child

• Teaches your child and family how to use AAC to communicate confidently

• Promotes language growth and connection — with or without spoken words

Executive functioning refers to the set of mental skills that help us plan, organize, remember, and manage our behavior to reach goals. These skills are essential for success in school, relationships, and daily life — and they strongly influence a child’s ability to communicate, learn, and self-regulate.

Executive functioning challenges may include difficulty with:

• Starting or stopping tasks (initiation and inhibition)

• Sustaining and shifting attention between activities

• Organization and planning

• Processing information quickly and accurately

• Remembering and following through on directions

• Completing multi-step tasks independently

• Problem solving and flexible thinking

• Perspective taking and understanding others’ points of view

How speech therapy helps:

• Teaches strategies for organization, planning, and self-monitoring

• Builds attention, working memory, and processing skills through engaging activities

• Supports flexible thinking, perspective taking, and emotional regulation

• Helps children communicate effectively, follow routines, and build independence

Feeding therapy supports children who have difficulty eating a variety of foods, managing textures, or maintaining a balanced diet. It is a trust-based, child-led approach that helps children feel safe and confident as they learn to explore and enjoy new foods.

Feeding challenges can affect more than just mealtime — they can impact nutrition, growth, and family routines. Understanding the signs early can help you seek the right support.

Common signs of feeding difficulties include:

• Eating fewer than 20 different foods

• Avoiding specific textures, temperatures, or food groups

• Frequent gagging, coughing, or choking during meals

• Poor weight gain or unexpected weight loss

• Ongoing vomiting or distress at mealtime

• Trouble transitioning to purees by 10 months

• Difficulty eating table foods by 12 months

• Not drinking from a cup by 16 months

How feeding therapy helps:

• Builds comfort and trust around food in a supportive environment

• Encourages sensory exploration and gradual expansion of accepted foods

• Improves oral motor skills for safe chewing and swallowing

• Supports families with individualized strategies for mealtimes at home

Orofacial Myofunctional Disorders (OMDs) affect the way the muscles of the face, mouth, and tongue move and work together. These patterns can interfere with speech, swallowing, breathing, and dental development in both children and adults.

When oral muscles don’t rest or move properly, they can impact how a person eats, talks, and even how their teeth and jaw grow.

Common signs of OMDs include:

• Difficulty talking, swallowing, or breathing through the nose

• Tongue thrust — pushing the tongue forward when talking, eating, or swallowing

• Messy eating or drinking due to tongue position or movement

• Drooling beyond age 2

• Difficulty closing lips to swallow

• Tongue resting or pushing against the teeth even when not speaking

• Overbites, underbites, or other dental alignment issues

• Speech sound distortions or articulation difficulties

How speech therapy helps:

• Evaluates oral muscle strength, coordination, and breathing patterns

• Teaches correct tongue and lip placement for speech and swallowing

• Supports proper oral rest posture to promote healthy growth and function

• Collaborates with dental and orthodontic professionals when needed