Why Is My Child Hard to Understand? When to Consider Speech Therapy
If you can understand your child perfectly, but grandparents, teachers, friends, or other people are constantly asking, “What did they say?” you may be wondering whether this is something your child will grow out of or whether it is time to consider speech therapy.
This is a question I hear from parents often.
It is normal for children to make some speech sound errors while they are learning to talk. Children are not expected to pronounce every sound perfectly from the beginning. However, there is a difference between making a few age-appropriate speech sound errors and having speech that is consistently difficult for other people to understand.
Sometimes the concern is one particular sound, such as /r/ or /s/. Other times, there is a larger pattern affecting many words.
If you frequently find yourself translating for your child, your child becomes frustrated when people do not understand them, or you are simply wondering whether their speech sounds appropriate for their age, a speech-language evaluation can help determine what is going on.
Why Is My Child So Hard to Understand?
There isn't one reason a child may have unclear speech.
One child may have difficulty producing a particular sound. For example, they may say “wabbit” for “rabbit” or produce an /s/ sound that sounds distorted.
Another child may be able to produce many individual sounds but use patterns that change entire groups of words.
For example, a child might:
say “tat” for “cat”
say “top” for “stop”
say “ca” for “cat”
say “poon” for “spoon”
These types of changes can make a child's speech much more difficult to understand, especially when several patterns are occurring at the same time.
This is one reason I don't look only at which sounds a child can and cannot say. I also want to know what happens to those sounds when the child puts them into words, sentences, and conversation.
If you're interested in learning more about the difference between individual sound errors and broader speech patterns, you can read my article on speech sound disorders versus articulation disorders.
Why Can I Understand My Child When Other People Can't?
This is extremely common.
Parents hear their child's speech every day. You know what your child likes to talk about, what happened earlier that day, the names of their friends, what shows they watch, and what they are probably asking for when they point toward the kitchen.
All of that context helps you fill in the pieces.
Someone who doesn't know your child as well doesn't have those same clues.
For example, imagine your child runs into the room and says something that sounds like: “I pay wif Da at cool.”
You may immediately know they mean: “I played with Dan at school.”
A less familiar listener may have no idea what was said.
That difference is important. When I evaluate a child's speech, I want to know not only whether their parents understand them, but also how well they are understood by teachers, relatives, peers, and people who don't hear their speech every day.
Is It Normal for Children to Say Sounds Incorrectly?
Yes. Speech sound development happens gradually.
Children typically learn some sounds earlier than others, and some sounds continue developing later into childhood. This is why I am cautious about looking at one incorrect sound and immediately saying that a child needs speech therapy.
I also don't love relying on a giant “your child should say this sound by this exact age” chart by itself.
Speech sound development isn't quite that simple.
Different research studies have used different criteria when determining when a sound is considered acquired, and children do not all develop speech in exactly the same way.
The particular sound matters, but so do the child's overall speech patterns, how understandable they are, whether their errors are improving, and whether those errors are affecting their ability to communicate.
In other words, I care about the whole picture.
Articulation Errors vs. Phonological Patterns
This is an important distinction, but I promise it doesn't have to be as complicated as the terminology makes it sound.
Some children have difficulty with the actual production of a particular sound. This is often what parents think of when they hear the word articulation.
For example, a child may be able to say almost every sound clearly but consistently have difficulty producing /r/.
Other children use broader patterns that affect groups of sounds or change the structure of words. These are often called phonological patterns.
For example, instead of having difficulty with only /k/, a child might consistently replace sounds made toward the back of the mouth with sounds made toward the front:
“cat” → “tat”
“go” → “do”
A child might leave the final sound off many different words:
“cat” → “ca”
“bed” → “beh”
“dog” → “daw”
Or they may simplify consonant clusters:
“spoon” → “poon”
“stop” → “top”
When these patterns affect many words, they can make a child's speech much more difficult for other people to understand.
A child can also have both types of difficulties.
This is why determining whether a child has an articulation or phonological speech sound disorder can be important when deciding what to work on in speech therapy.
Does My Child Need Speech Therapy If They Are Hard to Understand?
Not necessarily.
A child being difficult to understand does not automatically mean that they have a speech sound disorder or need therapy.
However, I would consider talking with a speech-language pathologist when:
people outside of your immediate family frequently have difficulty understanding your child;
you find yourself regularly translating what your child says;
your child becomes frustrated or stops trying when people don't understand them;
teachers or other caregivers have mentioned concerns about speech clarity;
your child is noticeably harder to understand than other children around the same age;
your child leaves out or changes many sounds in words;
the same types of speech errors continue over time without much improvement;
you are concerned about a particular sound that doesn't seem to be improving; or
you aren't sure exactly what sounds different—you just know that your child can be difficult to understand.
You do not have to wait until your child's speech becomes a major problem to ask about it.
Sometimes I complete an evaluation and recommend speech therapy. Other times, a sound or pattern may still be developing appropriately and monitoring is all that is needed.
Either answer can give you a much better idea of what to do next.
What About a Lisp or Difficulty Saying R?
Sometimes a child is generally easy to understand, but one particular sound stands out.
Two concerns I see frequently are difficulty producing /r/ and a lisp involving /s/ or /z/.
For example, you may hear:
“red” → “wed”
Or your child's /s/ may sound different or distorted when they say words such as “sun,” “sister,” or “bus.”
These children may be fairly easy to understand overall, but the particular sound error continues to stand out.
If /r/ is your primary concern, I have a separate article explaining when children should be able to say the R sound and when speech therapy may help.
If you are noticing an unusual /s/ sound, you can also read more about lisps in children and lateral lisp.
These concerns are different from a child whose speech is difficult to understand because many sounds or word patterns are affected.
I work with both types of speech sound difficulties. The evaluation and treatment plan depend on what the child is actually doing with their speech.
Is My Child Just Talking Too Fast?
Sometimes parents tell me, “I think they would be easier to understand if they would just slow down.”
Speaking quickly can absolutely affect speech clarity. Sounds and words may become less distinct when someone is talking very fast.
But I would not automatically assume that rate is the entire problem.
If a child is difficult to understand, I want to listen carefully to determine whether the issue is primarily speech rate, particular speech sounds, broader speech patterns, language organization, or a combination of factors.
Telling a child to “slow down” over and over isn't particularly helpful if speaking quickly isn't actually the main reason people cannot understand them.
What Happens During a Speech Evaluation?
A speech evaluation involves much more than having a child name pictures and counting how many sounds they say incorrectly.
I want to hear your child in different situations.
Depending on the child and the concern, I may look at:
which speech sounds they can produce;
whether errors occur at the beginning, middle, or end of words;
whether there are patterns across multiple sounds;
how they produce consonant clusters and longer words;
whether their errors are consistent;
how understandable they are in conversation;
whether they can imitate a sound when given help;
whether certain sounds are easier in particular words or sound combinations;
the structure and movement of the lips, tongue, jaw, and palate;
relevant hearing history; and
whether there are concerns involving language in addition to speech.
I also want to hear spontaneous speech.
A child may say a word correctly when looking at a picture but produce that same word differently while telling me about school, explaining a game, or having a conversation.
Ultimately, I don't just want to know whether your child can say a sound correctly during a test.
I want to know how well they are understood when they are actually communicating.
You can learn more about my speech-language evaluations [and what to expect when determining whether speech therapy is appropriate.
What If My Child Speaks More Than One Language or Uses a Different Dialect?
Speaking more than one language does not cause a speech sound disorder.
A dialect or accent is also not a speech disorder.
This is an important part of evaluating speech correctly. A child's speech needs to be considered within the language or dialect they actually use rather than automatically comparing every child to one version of English.
There may be completely appropriate differences in pronunciation based on a child's linguistic background.
The question isn't simply: “Does this sound different from Mainstream American English?”
The more important question is whether the child's speech patterns are appropriate within their linguistic community and whether there is evidence of an actual speech sound difficulty.
How Does Speech Therapy Help a Child Who Is Hard to Understand?
Speech therapy should be based on why the child is difficult to understand.
A child who has difficulty producing /r/ does not necessarily need the same type of treatment as a child who leaves final sounds off many words.
For one child, I may work directly on how to position and move the tongue to produce a particular sound.
For another child, therapy may focus on helping them recognize that changing or leaving out a sound can change the entire word. For example: “bow” and “boat”
Those are two completely different words, and that final sound matters.
For a child with several patterns affecting their speech, I may prioritize the changes that are likely to make the biggest difference in how well other people can understand them.
As the child becomes successful, we work toward increasingly natural speech—moving from sounds or words into phrases, sentences, and ultimately conversation.
The goal isn't for a child to say a sound correctly once during speech therapy.
The goal is for clearer speech to carry over into real communication.
You can learn more about articulation and speech sound therapy and the types of speech sound difficulties I treat.
Should I Wait and See?
Sometimes monitoring is completely appropriate.
But if you have been wondering about your child's speech for a while, there is also nothing wrong with asking.
You don't need to figure out whether your child has an articulation disorder, phonological disorder, speech sound disorder, or something else before contacting a speech-language pathologist.
That's my job.
You can simply tell me what you're noticing:
“I understand him, but nobody else does.”
“Her teacher keeps asking her to repeat herself.”
“He leaves sounds off a lot of words.”
“She has always had trouble with her R's.”
“I don't know exactly what is wrong. She is just really hard to understand.”
Those are all perfectly reasonable reasons to reach out.
Speech Therapy for Unclear Speech in Skokie and the North Shore
I provide individualized speech therapy for children with articulation and speech sound difficulties in Skokie and surrounding North Shore communities. I also provide online speech therapy for families in Illinois and New York.
If you're concerned because your child is difficult to understand, you don't have to determine on your own whether their speech is developmentally appropriate.
Schedule a Free Consultation to tell me what you're noticing. I can help you determine whether a speech-language evaluation may be appropriate for your child.
Not sure whether you need to schedule an evaluation yet?
