Q: My client had a xyanotic episode at 4-days of age. She had no verbal language until about 24 months. She is now 33 months and is talking quite a bit with delay. But what is throwing me for a loop is that she has changed “mommy” from “Mee-mee” to “Mah-mee” and now to “Hah-mee.” She also substitutes H for other M words. I’ve never seen this. Can you explain it?

I don’t have all the info I would need to say this for sure, but my guess would be that this child is in the process of gaining stridency/affrication, and she is doing so with H.

If she had no fricated sounds before this, and H is the first one she is gaining, then I would say for sure that she is pulling frication in and using it inappropriately, which she should for a little while.

Research reveals that typical children gain MANNER before they gain PLACE. Therefore they begin to gain strident sounds and they mix them all up for a while.

My own observations are that clients with severe motor speech disorders bring in MANNER before PLACE like typical children, but they also OVER-USE the manner before it settles on the right group of phonemes.  Even if she had a few other fricated sounds beforehand, I still would view it this way.

Children with motor speech disorders do not seem to follow straight lines of phonological development.  They blaze their own trail through the forest of phoneme and phonological acquisition.

Follow her lead.  If she is gaining the hissing element, go with it and allow her time to make mistakes.