Dyslalia: Causes, Symptoms and Effective Treatment

Dyslalia is a speech problem that prevents children from pronouncing certain sounds correctly. This article will help you understand its causes, identify the symptoms and explore the most effective treatments.

Key Points

• Dyslalia is a speech disorder in children, characterised by difficulty pronouncing phonemes correctly, and early detection is crucial to avoid future emotional and academic problems.
• There are several types of dyslalia: developmental, functional, auditory and organic, each with its own specific causes and treatment needs.
• Treatment of dyslalia involves a combination of speech therapy, home exercises and school support, with the active participation of parents being essential to the success of the process.

What is dyslalia?

Dyslalia is a speech disorder that affects the correct articulation of phonemes in children. This disorder is characterised by:

• The inability or difficulty in pronouncing certain sounds properly.
• It can significantly interfere with communication and language development.
• The word "dyslalia" comes from Greek and literally means "speech anomaly", which perfectly reflects the nature of this disorder.
• It is important to note that dyslalia is not a problem of language comprehension, but rather a difficulty in the production of specific sounds.

The prevalence of dyslalia in children is surprisingly high. Approximately 5-10% of children experience some form of dyslalia, with a peak incidence of 15% in pre-school children. Typically, dyslalia manifests itself between the ages of three and five, although it can persist up to the age of eight in some cases. Experts recommend that if a child cannot articulate a phoneme correctly from the age of four, it is advisable to seek  professional assessment.

Early detection and timely treatment are essential to prevent potential emotional and academic difficulties in the child's future, as mentioned in this article.

Types of dyslalia

In the world of dyslalia, not all articulation difficulties are the same. In fact, there  are several types of dyslalia, each with its own characteristics and underlying causes. Understanding these different types is crucial for accurate diagnosis and effective treatment.

Below, we will explore the four main types of dyslalia in detail:

1. Developmental dyslalia
2. Functional dyslalia
3. Audiogenic dyslalia
4. Organic dyslalia

Each of these types presents unique challenges and requires specific approaches to treatment.

Developmental dyslalia

Developmental dyslalia, also known as physiological dyslalia, is perhaps the most common and least worrisome form of this disorder. This type of dyslalia is characterised by articulation errors that occur naturally during childhood language development. It is important to understand that until the age of four, these pronunciation errors are considered a normal part of growing up, attributed to the immaturity of the nervous system and phonoarticulatory apparatus.

The good news is that, in most cases, developmental dyslalia resolves on its own as the child matures and develops greater control over his or her speech skills. However, if errors persist beyond this age, it may be indicative of other types of dyslalia that require professional attention.

Functional dyslalia

Functional dyslalia represents a more complex challenge in the spectrum of speech disorders. In this case, the problem lies in an incorrect use of the articulatory organs, despite the fact that there is no apparent physical abnormality. Imagine a pianist with perfectly healthy fingers but who, for some reason, cannot coordinate them correctly to play a melody. Similarly, in functional dyslalia, organs such as the tongue and lips do not move properly to produce the correct sounds.

This type of dyslalia can manifest itself in a variety of ways, from the substitution of one sound for another to the omission or distortion of certain phonemes. Unlike developmental dyslalia, functional dyslalia does not usually resolve spontaneously and generally requires speech therapy intervention for correction due to the impairment present.

Audiogenic dyslalia

Audiogenic dyslalia plunges us into a world where sound plays a crucial role in speech development. This type of dyslalia is caused by auditory problems that prevent the child from correctly picking up and imitating the sounds of language. Imagine trying to learn a foreign language by listening to a recording with constant interference; this is how children with audiogenic dyslalia perceive the world of sound.

Difficulty in auditory discrimination of different phonemes leads these children to confuse them and thus pronounce them incorrectly. For example, they may have trouble distinguishing between similar sounds such as "p" and "b", or "f" and "v". This lack of auditory clarity translates directly into pronunciation errors, creating a vicious circle where the child not only cannot hear correctly, but also cannot produce the sounds properly.

Treatment of audiogenic dyslalia usually involves first addressing the underlying auditory problems before focusing on speech correction.

Organic dyslalias

Organic dyslalias, also known as dysglossias, represent the more physical side of articulation disorders. Unlike other types of dyslalia, they are rooted in structural abnormalities of the speech organs. Imagine trying to play a guitar with a broken string or a piano with missing keys; similarly, malformations or lesions in articulatory organs such as the lips, tongue or palate can significantly hinder the correct production of certain sounds.

For example, a child with cleft lip or cleft palate may have specific difficulties in pronouncing certain phonemes. Treatment of organic dyslalia often requires a multidisciplinary approach, which may include surgical interventions to correct the physical abnormalities, followed by intensive speech therapy to help the child adapt his or her articulation to the new structure of his or her vocal organs.

Causes of dyslalia

The causes of dyslalia are as diverse as they are fascinating, ranging from genetic factors to environmental influences. One of the most intriguing aspects is how genetic predisposition can manifest itself in the form of anxiety, tension and insecurity when speaking, contributing to the development of this disorder. It is as if some children are born with a 'breeding ground' for dyslalia, which can flourish under certain conditions. In addition, the socio-cultural environment plays a crucial role. Imagine a garden that does not receive enough water or sunlight; similarly, insufficient linguistic stimulation in the child's environment can lead to inadequate development of psychomotor and language skills, laying the foundation for dyslalia.

In the specific case of audiogenic dyslalia, hearing impairment emerges as the main cause. It is like trying to learn to play a musical instrument without being able to hear it properly; hearing-impaired children struggle to pick up and reproduce speech sounds accurately. But the causes of dyslalia are not just limited to physical or environmental factors. Interpersonal relationships and the child's social context can also play a significant role. For example, traumatic experiences, family conflicts or excessive pressure can create an emotional environment that interferes with normal speech development. It is as if emotional stress creates "noise" in the child's communication system, making it difficult to articulate sounds clearly and accurately.

Symptoms of dyslalia

The symptoms of dyslalia manifest as an out-of-tune symphony in the child's speech, where certain sounds fail to find their proper place. One of the most common signs is sound substitution, where one phoneme is replaced by another that the child finds easier to pronounce. Imagine a little chef who, lacking the exact ingredient, substitutes a similar one; thus, a child with dyslalia might say "chaleta" instead of "maleta". This substitution is not random, but follows specific patterns that a trained speech therapist can identify and address.

Another common symptom is sound omission, where  the child simply deletes the phoneme that is difficult to pronounce. It is as if the child is editing his own language, cutting out the parts he finds challenging. For example, he might say "ota" instead of "pelota". In addition, sound distortion is another key feature of dyslalia. In this case, the child produces the sound, but in a way that is not entirely correct. A classic example is the distorted "r", which may sound more like a "g" or a "d". These symptoms can vary in severity and can affect one or several sounds, creating a unique pattern of pronunciation difficulties for each child.

Diagnosis of dyslalia

Diagnosing dyslalia is a painstaking process that requires the expertise of specialised professionals, mainly speech therapists. It is like a linguistic detective looking for clues in the child's speech to identify specific patterns of pronunciation errors.

The speech assessment usually begins with an informal conversation about topics of interest to the child. This relaxed approach allows the professional to observe the child's spontaneous speech, noting any irregularities in the pronunciation of certain phonemes. It is like watching a dancer move freely to detect any unnatural or forced movements.

In addition to spontaneous speech, the speech therapist will perform a series of more structured tests. One of these is the intraverbal assessment, where specific questions designed to elicit articulation of certain problematic phonemes are asked. The motor skills of the tongue are also assessed by asking the child to perform specific movements such as moving the tongue from side to side or vibrating the tongue. This is crucial to determine if there are any physical limitations that may be contributing to the dyslalia.

Finally, the child's auditory discrimination is tested, assessing the child's ability to identify and differentiate between various sounds and noises. This part of the diagnosis is particularly important to rule out or confirm the presence of auditory dyslalia. This entire diagnostic process is like putting together a jigsaw puzzle, with each piece of information helping to form a complete picture of the child's speech abilities and challenges.

Treatment of dyslalia

Treating dyslalia is a journey that requires patience, dedication and a multi-faceted approach. The cornerstone of this process is early intervention by a specialised speech therapist. These professionals are like personal speech coaches, designing personalised exercise programmes that help strengthen and coordinate the muscles involved in sound production. Treatment usually involves a combination of in-clinic therapy, home exercises and, in many cases, additional support in the school environment.

It is crucial to understand that the success of treatment depends not only on the speech therapist, but also on the active participation of the parents and the child him/herself. As we will see in the following sections, each component of treatment plays a vital role in overcoming dyslalia.

Therapy with a speech therapist

Therapy with a speech therapist is at the heart of dyslalia treatment. These specialised professionals use a variety of techniques and exercises specifically designed to address each child's unique challenges. The process begins with a detailed assessment to identify exactly what sounds are causing problems. From there, the speech-language pathologist develops a personalised treatment plan.

This plan may include praxis exercises, which are specific mouth and tongue movements designed to improve the coordination and muscle strength necessary for proper articulation. In addition, work is done on breathing and murmur, which are fundamental elements for clear and controlled pronunciation. Speech therapy is like intensive training for the speech muscles, combining repetition, guided practice and immediate feedback to  help the child overcome articulation difficulties.

Home exercises

Home exercises are an essential complement to professional therapy, acting as a bridge between sessions with the speech therapist. Parents play a crucial role at this stage, becoming "speech therapist assistants" in the home.

One of the most effective activities is tongue and lip praxia games, which help to improve flexibility and control of the muscles involved in speech. For example, parents can guide the child in exercises in front of the mirror, making funny faces or trying to touch the nose with the tip of the tongue.

Blowing exercises are also essential; activities such as blowing balloons or bubbles are not only fun, but also help to develop the breathing control necessary for clear articulation.

It is important that these exercises are done regularly and playfully, making them a natural and enjoyable part of the child's daily routine.

School support

School support is a fundamental pillar in the comprehensive treatment of dyslalia, acting as a bridge between professional therapy and the child's everyday life. In this context, close collaboration between the school and speech therapists becomes crucial.

Teachers, especially those specialised in hearing and speech, play a vital role in the early detection and continuous monitoring of dyslalia. They can implement specific strategies in the classroom to support the child's progress, such as phonological awareness activities or language games that reinforce problematic sounds. In addition, they can provide an inclusive learning environment where the child feels comfortable practising his or her speech skills without fear of judgement or ridicule.

This synergy between the school environment, therapists and parents creates a supportive ecosystem that maximises the child's opportunities for improvement, ensuring that the gains made in therapy translate into more effective communication in all aspects of the child's life.

Consequences of not treating dyslalia

Failure to treat dyslalia can have significant repercussions on a child's academic and social development. One of the most immediate consequences is seen in learning to read and write. Children with untreated dyslalia tend to reproduce in these areas the same mistakes they make in speaking. Imagine trying to write a story when the words in your mind sound different from how they should; this can lead to spelling mistakes and difficulties in reading comprehension. As a result, overall academic performance can be negatively affected, reflected in lower grades and possible  frustration with the learning process.

Beyond academics, untreated dyslalia can have a significant impact on a child's emotional and social development. Difficulty communicating effectively can lead to feelings of frustration and insecurity. Children may become self-conscious about their speech difference, which can lead to decreased self-esteem and reluctance to participate in social activities. In some cases, this may result in the child becoming a target for teasing by peers, further exacerbating these emotional problems. This situation can create a vicious cycle where the child avoids speaking out to avoid embarrassment, which in turn limits their opportunities to improve their communication skills.

It is important to note that the effects of untreated dyslalia can extend beyond childhood. In some cases, if not properly addressed, dyslalia can persist into adulthood, potentially affecting career opportunities and personal relationships. In addition, parental response to dyslalia can also have long-term consequences. Overprotection, however well-intentioned, can lead to the development of high sensitivity and dependency in the child. This underlines the importance of finding a balance between support and encouraging independence in the management of dyslalia.  Ultimately, addressing dyslalia early and effectively not only improves the child's communication skills, but can also prevent a cascade of academic, social and emotional challenges in the future. 

Prevention of dyslalia

Prevention of dyslalia is a proactive process that begins early in a child's life. One of the most effective strategies is early language stimulation. This involves:

• Creating an environment rich in linguistic stimulation from birth.
• Speaking clearly to the child.
• Reading stories aloud to the child.
• Responding positively to their attempts to communicate.

It is like preparing fertile ground for language to flourish naturally. In addition, it is crucial to pay attention to speech development milestones and to act quickly if delays or persistent difficulties are observed.

Another key aspect of dyslalia prevention is the correction of inappropriate oral habits. This includes prolonged dummy use beyond the recommended age, thumb sucking, or mouth breathing. These habits can affect the normal development of the articulatory organs. Parents can work in collaboration with paediatricians and paediatric dentists to address these habits early and effectively.

In addition, it is important to create a stable and caring emotional environment, as stress and family conflict can interfere with normal speech development. Prevention of dyslalia is not just about specific exercises, but about creating a holistic environment that supports healthy language development in all its aspects.

Neuropsychological profile of children with dyslalia

The neuropsychological profile of children with dyslalia reveals a fascinating picture of how the brain processes and produces language. One of the most significant findings is that these children often have marked deficits in immediate, visual and logical memory. This suggests that dyslalia is not simply a problem of articulation, but may be related to how the brain stores and retrieves linguistic information. Imagine trying to put together a jigsaw puzzle where some pieces momentarily vanish; this is how these children may experience the process of formulating and articulating words.

Particularly interesting is the observation that auditory immediate memory is often impaired in children with dyslalia. This difficulty in retaining and sequencing phonemes in short-term memory may explain why these children struggle to reproduce certain sounds correctly, even when they can hear them clearly. It is as if the "mental echo" of the sounds fades too quickly for them to process and reproduce them properly. However, it is important to note that not all forms of memory are equally affected. Remote memory and shape memory often remain intact, suggesting that the problem lies more in the immediate processing than in the long-term storage of information.

In addition to memory challenges, children with dyslalia often exhibit attentional problems similar to those seen in children with brain damage or psychomotor disorders. This may manifest as difficulty maintaining concentration during speech tasks or a tendency to be easily distracted during articulation exercises. Alterations in kinaesthesia and stereognosia, which are crucial for awareness and control of the oral movements necessary for accurate articulation, have also been observed. These findings underline the importance of a thorough neuropsychological assessment in cases of dyslalia, as aspects of memory and attention play a significant role in oral language development. Understanding this neuropsychological profile not only aids in accurate diagnosis, but also guides the development of more effective and personalised treatment strategies.

Behaviour and characteristics of children with dyslalia

The behaviour and characteristics of children with dyslalia go beyond mere pronunciation difficulties, encompassing emotional and psychological aspects that can significantly influence their overall development. One of the most notable features is the tendency to show tension and insecurity, especially in situations requiring verbal communication. These children may be more likely to lose emotional control, as if the frustration of not being able to express themselves clearly manifests itself in other forms of behaviour.

It is important to understand that these reactions are not whims, but manifestations of the internal struggle they experience in trying to communicate effectively through their emotions and thoughts. 

In many cases, children with dyslalia develop an acute awareness of their speech disorder, which can lead to inhibited and anxious behaviours. Imagine being in a foreign country where you are not fluent in the language; that feeling of insecurity and fear of making mistakes is similar to what these children may experience in their daily lives. This self-consciousness can result in mental distraction and absence, especially in social or academic settings where they feel they might be judged or teased for the way they speak. As a result, some children may choose to speak less or avoid certain social situations, which can negatively impact their social and emotional development.

In addition, it is common to observe high levels of frustration in children with dyslalia, particularly when they try to communicate and are not understood. This frustration can manifest itself in a variety of ways, from emotional outbursts to social withdrawal. In some cases, children may develop compensatory strategies, such as using gestures or pointing to objects instead of naming them, to avoid the difficulty of pronouncing certain words.

It is crucial to recognise that psycho-affective factors such as anxiety, stress and insecurity are not only consequences of dyslalia, but can also exacerbate the disorder, creating a cycle that requires both speech and emotional attention. Therefore, a holistic approach that addresses both speech skills and emotional well-being is fundamental to the effective treatment of dyslalia.

Play activities to improve dyslalia 

Play activities play a crucial role in the treatment of dyslalia, transforming what could be a tedious therapy into a fun and engaging experience for children. One of the most effective tools in this playful arsenal is the use of songs and poems. These are not only entertaining, but also promote correct articulation in a natural and rhythmic way. Imagine a child happily singing a song that, without realising it, is helping him to practise the sounds he finds difficult. Rhymes and repetitions in songs and poems act as an articulation exercise disguised as play.

Another effective activity is the guessing game, which is not only fun but also therapeutic. This game can be specifically designed to work on sounds that the child finds challenging. For example, if a child has difficulty with the "r" sound, riddles containing words with this sound can be used. Tongue twisters, although they may seem challenging, are another excellent tool. These verbal games not only help to improve pronunciation, but can also be a source of laughter and fun, reducing the anxiety associated with speech difficulty.

In the digital age, interactive internet games have become valuable allies in dyslalia therapy. These games can offer structured practice of specific words and sounds in a way that is engaging for technologically native children. In addition, activities such as playing with onomatopoeia, imitating animal sounds, can be particularly effective. This type of play not only helps children identify and produce specific sounds, but can also be a fun way to practice as a family.

Repetition play, where points are scored for each correct repetition of chants or phrases, adds an element of friendly competition that can further motivate the child. Finally, activities such as the object and vowel game, where vowels are worked on using the names of everyday objects, help to integrate speech practice into the child's daily life. All these play activities not only improve speech skills, but also help to build confidence and reduce the anxiety associated with dyslalia.

Summary

Throughout this journey through the world of dyslalia, we have explored its many facets, from its causes and symptoms to the most effective strategies for its treatment and prevention. We have learned that dyslalia is not simply a pronunciation problem, but a complex disorder that can significantly affect a child's academic, social and emotional development. From developmental dyslalia, which usually resolves naturally over time, to more persistent forms such as functional or auditory dyslalia, each type presents its own challenges and requires a specific treatment approach.

The key to successfully addressing dyslalia lies in early detection and a comprehensive approach that combines professional therapy with support at home and at school. Play activities and specific exercises not only help to improve articulation, but can also make the treatment process a positive and enriching experience for the child. Let us remember that each child with dyslalia is unique, with his or her own strengths and challenges, and deserves a personalised and compassionate approach. As parents, educators and health professionals, we have the opportunity to make a significant difference in the lives of these children, helping them to overcome their speech difficulties and develop their full communicative potential. With the right support and timely intervention, children with dyslalia can not only overcome their speech challenges, but also flourish in all aspects of their lives, becoming confident and effective communicators.

Frequently asked questions

At what age should a parent be concerned if their child shows signs of dyslalia?

Parents should be concerned if their child shows signs of dyslalia from the age of 4, as at this age it is important to seek assessment by a speech and language therapist to determine if treatment is needed.

Can dyslalia affect a child's school performance?

Yes, dyslalia can significantly affect a child's school performance, causing difficulties in learning to read and write, and potentially leading to poor grades and frustration in the academic environment.

What is the difference between developmental and functional dyslalia? 

The difference between developmental and functional dyslalia is that developmental dyslalia is a normal part of speech development and usually resolves before the age of 4, while functional dyslalia persists beyond this age and requires professional intervention. It is important to be aware of these signs in order to seek specialist help if necessary.

What kind of activities can I do at home to help my child with dyslalia?

You can do play activities such as tongue praxia games, blowing exercises, singing songs and using interactive online games to help your child with dyslalia. These activities can be very helpful for their development.

Can dyslalia have an emotional impact on children?

Yes, dyslalia can have a significant emotional impact on children, which can cause frustration, anxiety and low self-esteem. It is important to address both the speech and emotional aspects of treatment.