Q: What do you tell parents when they ask what caused their child’s articulation disorder?

First I draw whatever conclusions I can from the child’s medical and physical history. For example, I explain how the child’s errors might be related to his positive history of ear infections, oral injury, structural deficit, neuromuscular disorder, sensorimotor dysfunction, and so forth.

Second, I draw conclusions from information I have about the client’s cognitive level. For example if the client is four-years-old, but he processes information like a one-year-old, then I help the parents understand that his articulation will be like that of a one-year-old. I help them understand what this means in terms of our expectations about speech sound development.

Third, I draw conclusions from his social, emotional, educational, and language history if there are any significant findings. For example, a child who is adopted from another country where he was in a less-than-optimum orphanage may have significant speech-language issues to overcome during the first few years after adoption.

Finally, if there are no obvious potential causes, I tell the parents that we may never know the cause of the articulation deficit.