Why a Child Might Be Hard to Understand

Having a child is exciting...  You can’t wait for all the things your little one will say, all the ideas they’ll have, and everything they’ll become one day.  

When your child's speech is unclear, it's natural to turn to Google — and quickly run into terms like phonological processes, apraxia, and dysarthria. It can feel overwhelming. This post breaks down the most common reasons a child might be hard to understand, what they actually mean, and what you can do about it.

Causes of Hard-to-Understand Speech

• Structural differences (lip, tongue, palate)

• Articulation disorder

• Phonological processes

• Childhood apraxia of speech

• Dysarthria

• Ear infections and hearing loss

When your child is less easy to understand than others their age, you might begin to wonder... Are you venturing through a dark forest, full of things hidden around every corner?  Instead of lions and tigers and bears, you run into new terms like phonological processes, apraxia and dysarthria. What do these things mean? How can they impact your child? What can you do about it? The unknown can be scary… but this blog will help to make the uncertainties clearer…

Speech Delay

You'll hear 'speech delay' used a lot, but it's actually a broad term that simply means a skill is developing later than expected. It doesn't tell you why. Let's look at the specific causes that can make a child's speech hard to understand.

Structural Differences (lip, tongue, palate)

Clear speech requires the structures in and around the mouth — the lips, tongue, jaw, and palate — to move freely and work together. When something like a cleft palate, tongue tie, or muscle weakness affects those structures, it can change how speech sounds. Even subtle structural differences can add up across an entire sentence.

Articulation Disorder

An articulation disorder happens when a child has difficulty with specific speech sounds.  Everything is fine and you can probably understand a good part of what they say, but certain sounds are hard for them to say and it’s noticeable.  Maybe it’s the “R” sound, maybe it’s the “L” sound.  It could also be the “S, Z or TH” sound. 

Generally speaking, a sentence that doesn’t contain the “hard sounds” is clear and easy to understand if the problem is strictly articulation-based.  All that being said, some sounds are more difficult than others and speech therapists know when each sound should be clear and easy to say.

Phonological Processes

A phonological process isn't about one specific sound — it's a pattern that affects a whole category of sounds. For example, a child might leave the final sound off every word, or replace all sounds made in the back of the mouth with sounds made in the front. These patterns are considered typical up to a certain age, but when they persist beyond that point, an atypical pattern becomes apparent.

For a long time, phonological processes were thought to be purely language-based. More recent research suggests that some of these patterns may also involve motor-based speech challenges — which changes how they should be treated.

Childhood Apraxia of Speech

Childhood Apraxia of Speech (CAS) is a neurological motor speech disorder. The child knows what they want to say, but their brain struggles to coordinate the movements needed to say it clearly. It's not a problem with intelligence, language, or muscle strength — it's a motor planning issue.

CAS requires specialized evaluation and a different treatment approach than other speech sound disorders. If you suspect your child may have apraxia, it's important to work with a therapist who has specific training in CAS.

Learn more about childhood apraxia of speech therapy at Cheerful Chatter →

Dysarthria

Dysarthria is another type of neurological speech disorder.  However, in this case, there is a problem with the nervous system’s ability to activate the muscles.  So, the person knows what they want to say and they’ve planned the movements necessary to say it, but their muscles are effectively too slow or too weak to do what they need to do. Dysarthria is less common in children than other causes of unclear speech, but it's important to rule out through a proper evaluation.

Ear Infections & Hearing Loss

Speech clarity depends on more than just the mouth. If a child can't hear sounds clearly, it's very hard to learn to produce them accurately.

During a child’s first year of life, the speech sounds used during play and other interactions are being learned. Those that do not appear to have meaning in their environment are effectively being tuned out.  If, at this time, a child is also experiencing chronic fluid in their ear, ear infections or a hearing loss, to them it sounds like the world is under water, at best.  The clarity and specificity of each speech sound is lost and therefore becomes very difficult to learn.  Between a child’s first and second birthdays, they begin to use those sounds purposefully.  Now, their brain is focused on how similar or different their speech is to those around them.  Again, accurate speech sounds depend on good hearing.

Can You Have More Than One Speech Sound Disorder?

Yes, absolutely.  The presence of one type of speech sound disorder does not rule out the presence of another, though life would be easier if it did.  This is why speech therapists take their time to fully understand exactly what is happening when a child is difficult to understand.  Because, just like there are different types of speech sound disorders, there are different treatment strategies and they are not all created equal. A good therapist will select the approach that fits the root cause.

How Can I Help My Child With Their Speech Clarity?

Speech clarity is generally not something parents should work on without guidance from a licensed speech-language pathologist. There's a hierarchy to what should be addressed first, and practicing the wrong things can sometimes reinforce the problem.

Working on speech sounds with a tutor, teacher, or ABA therapist isn't the same as working with an SLP who understands the full range of speech sound disorders, the motor system, and how to match the right approach to the right diagnosis.

It’s Time to Ask an Expert

If you took the time to read all of this, chances are that you’re worried about your child’s speech.  Simply put, waiting has never – and will never – help a child who is truly struggling or falling behind.  So, ask a question or leave a comment below. For more detailed information on speech and language disorders, a good resource is the American Speech-Language-Hearing Association (ASHA).

Schedule a free consultation with us at Cheerful Chatter if you're in New Jersey, Pennsylvania, or Georgia. We specialize in speech clarity for kids who are hard to understand and childhood apraxia of speech therapy for children who need specialized motor speech support.

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