At the end of early childhood children are often assessed in terms of their ability to speak properly. By first grade, about 5% of children have a notable speech disorder (Medline Plus, 2016c).

Fluency disorders: Fluency disorders affect the rate of speech. Speech may be labored and slow, or too fast for listeners to follow. The most common fluency disorder is stuttering.

Stuttering is a speech disorder in which sounds, syllables, or words are repeated or last longer than normal. These problems cause a break in the flow of speech, which is called dysfluency (Medline Plus, 2016b). About 5% of young children, aged two-five, will develop some stuttering that may last from several weeks to several years (Medline Plus, 2016c). Approximately 75% of children recover from stuttering. For the remaining 25%, stuttering can persist as a lifelong communication disorder (National Institute on Deafness and other Communication Disorders, NIDCD, 2016). This is called developmental stuttering and is the most common form of stuttering. Brain injury, and in very rare instances, emotional trauma may be other triggers for developing problems with stuttering. In most cases of developmental stuttering, other family members share the same communication disorder. Researchers have recently identified variants in four genes that are more commonly found in those who stutter (NIDCD, 2016).

Articulation disorder: An articulation disorder refers to the inability to correctly produce speech sounds (phonemes) because of imprecise placement, timing, pressure, speed, or flow of movement of the lips, tongue, or throat (NIDCD, 2016). Sounds can be substituted, left off, added or changed. These errors may make it hard for people to understand the speaker. They can range from problems with specific sounds, such as lisping to severe impairment in the phonological system. Most children have problems pronouncing words early on while their speech is developing. However, by age three, at least half of what a child says should be understood by a stranger. By age five, a child’s speech should be mostly intelligible. Parents should seek help if by age six the child is still having trouble producing certain sounds. It should be noted that accents are not articulation disorders (Medline Plus, 2016a).

Voice disorders: Disorders of the voice involve problems with pitch, loudness, and quality of the voice (American Speech-Language and Hearing Association, 2016). It only becomes a disorder when problems with the voice makes the child unintelligible. In children, voice disorders are significantly more prevalent in males than in females. Between 1.4% and 6% of children experience problems with the quality of their voice. Causes can be due to structural abnormalities in the vocal cords and/or larynx, functional factors, such as vocal fatigue from overuse, and in rarer cases psychological factors, such as chronic stress and anxiety.