Phonological delay

Also called Phonological processes, Immature speech patterns, Fronting, Stopping, Cluster reduction

Speech patterns that belong to a younger child: what fronting, stopping and cluster reduction are, when they should have gone, and what home practice actually looks like.

What it is

Phonological delay is a speech sound disorder in which a child's speech follows the simplifying patterns that every child uses when they're learning to talk, but for longer than expected. The mouth can make the sounds. The child's system for organising them is running a year or two behind.

The patterns have names, and knowing them helps. Fronting: sounds made at the back ("k", "g") come out at the front ("t", "d"), so "car" is "tar". Stopping: long sounds ("s", "f") become short ones, so "sun" is "tun". Cluster reduction: two consonants together lose one, so "spoon" is "poon". Final consonant deletion: "cat" is "ca".

Who it can help

Children between roughly two and six whose speech is noticeably harder to understand than their peers', and whose errors are consistent: the same word comes out the same wrong way every time. Consistency is a good sign here because it means the system is orderly and can be taught.

It's not the entry for inconsistent, effortful errors (childhood apraxia) or for a child whose vocabulary and sentences are behind as well as their sounds.

How it works

Each pattern has an age by which most children have stopped using it. Final consonant deletion and stopping of "f" and "s" usually go by around three. Fronting of "k" and "g" goes by about three and a half. Cluster reduction lasts longer, to around four, and some clusters later still. A child using a pattern a year past its usual age is delayed; a child using one no typical child uses is disordered, and therapy is planned differently.

Therapy aims at the pattern rather than each word, which is why it works: fix fronting and dozens of words correct themselves. The main tools are minimal pairs, where the child sorts or says pairs that differ by one sound ("tea" and "key"), so they discover that the difference carries meaning. Auditory bombardment, listening to many correct examples, comes first. Saying the sound comes later.

A child's phonological system is also the base of phonics and spelling. A pattern that persists into reception can show up in their writing, which is one reason for not waiting.

Getting started

Get a hearing check and a speech and language therapy referral, via the health visitor, GP or school. Ask the therapist which pattern to target first and for a minimal pair list to use at home.

Practice is a game, five minutes a day. Say the word back correctly without asking for a repeat. Play "which one did I say" with two pictures. Sort pictures into "k" words and "t" words. Sound-by-sound work on a phonics keyboard lets the child hear a word built in order and hear the letter they're missing.

Tell nursery or school which pattern you're working on so they can listen for it and respond the same way.

Where to get help

NHS speech and language therapy, via the GP, health visitor or school; the RCSLT explains the route. Speech and Language UK has a helpline and an age-by-age guide. Afasic supports families through the wait and beyond it.