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Dyslalia in children: burr, lisp and correction of sound pronunciation

Other names: Дислалия, картавость, шепелявость, ребёнок не выговаривает букву р, нарушение звукопроизношения, сигматизм, ротацизм

Dyslalia is a violation of the pronunciation of individual sounds in a child with normal hearing and intact functioning of the nervous system. The most famous manifestations are burring, when the “r” sounds incorrectly, and a lisp when whistling and hissing sounds are disturbed. Sounds may be skipped, distorted, or replaced by others. Until the age of 4–5 years, many inaccuracies in pronunciation are considered the age norm, because the articulatory apparatus is still maturing. The causes of dyslalia include improper imitation of the speech of others, structural features of the jaws and teeth, short frenulum of the tongue, and phonemic hearing disorders. Dyslalia itself is not dangerous to health, but it can interfere with communication, cause ridicule from peers and difficulties with writing. It lends itself well to correction in classes with a speech therapist.

🧾 МКБ-10: F80.0 🏥 Where it is treated: 8 Individual sounds sufferUp to 5 years – often the normWell adjusted
👨‍⚕️ Which doctor
Speech therapist, orthodontist, ENT doctor, pediatrician
🔬 Diagnostics
Speech therapy examination, hearing test, examination of the oral cavity and bite
💊 Treatment
Articulatory gymnastics, production and automation of sounds; if necessary, frenuloplasty, orthodontic treatment
📈 Prognosis
Favorable: most children learn correct pronunciation
⚠️ At risk
Short frenulum of the tongue, malocclusion, frequent otitis media, incorrect speech of others
⏱ When to see a doctor
Planned

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

  • Ребёнок плохо реагирует на звуки или часто переспрашивает
  • Невнятна вся речь, а не только отдельные звуки
  • Слюнотечение, трудности жевания и глотания
  • Звуки после постановки не закрепляются, несмотря на занятия
  • Ребёнок перестал говорить или стал избегать общения
  • Постоянно открытый рот, храп, носовой оттенок голоса

What is dyslalia and when is it normal?

Sounds appear in a child’s speech gradually, from simple to complex. Vowels and labial consonants are mastered early, whistling ones usually by 4–5 years, hissing and “l” by 5 years, and the sound “r” appears in many children by 5–6 years. Therefore, replacing “r” with “l” in a three-year-old child is not considered a violation. Dyslalia is said to occur if, after 5 years, sounds are pronounced incorrectly or the distortion has become entrenched. Burr and lisp in adults are the same dyslalia, which can also be corrected.

  • Rhotacism - violation of the sound "r"
  • Lambdacism - violation of the sound "l"
  • Sigmatism is a disorder of whistling and hissing sounds.
  • Functional dyslalia - with normal structure of the speech organs
  • Mechanical dyslalia - with structural defects
  • Monomorphic and polymorphic - one or more groups of sounds suffer

Reasons

With functional dyslalia, the speech organs are structured normally, but the child has acquired articulation incorrectly. This happens when imitating the incorrect speech of adults or older children, “lisping” in the family, insufficient mobility of the tongue and lips, poor discrimination of similar sounds by ear. Mechanical dyslalia is associated with anatomical features: short frenulum of the tongue, malocclusion, absence or incorrect position of teeth, high narrow palate, massive tongue. Frequent ear infections at an early age make it difficult to hear sounds accurately. Prolonged use of a pacifier and thumb sucking can contribute to malocclusion.

  • Imitating the incorrect speech of others
  • Insufficient mobility of the tongue and lips
  • Phonemic hearing disorder
  • Short frenulum of the tongue
  • Malocclusion and dental anomalies
  • Frequent otitis media and hearing loss
  • Long-term use of the pacifier

How it manifests itself

Sound impairment can look different. The child misses a sound (“yba” instead of “fish”), replaces it with another (“lyba”, “sapka” instead of “hat”), or pronounces it distortedly: a throaty “r”, an interdental or lateral pronunciation of “s” with a squelching tint. Substitutions in which the child does not distinguish sounds by ear later turn into errors in writing. With mechanical dyslalia, bite features or limited tongue elevation are often visible. Otherwise, the child’s speech is developed according to his age: vocabulary, grammar and understanding do not suffer.

  • Skip sounds
  • Replacing some sounds with others
  • Distorted throaty "r"
  • Interdental pronunciation of sibilants
  • Side “squelching” sound
  • The tongue does not rise well to the roof of the mouth

What examinations are needed

The speech therapist examines sound pronunciation in different positions - in syllables, words, phrases, evaluates the mobility of the tongue and lips, the structure of the organs of articulation and phonemic hearing. It is important to make sure that the child hears well: if in doubt, have your hearing checked by an ENT doctor or audiologist. An orthodontist evaluates the bite and position of the teeth and decides on the need for orthodontic treatment. If a speech therapist sees signs of erased dysarthria - general slurredness, drooling, awkward movements - the child is referred to a pediatric neurologist.

  • Speech therapy examination
  • Phonemic hearing test
  • Examination by an ENT doctor, hearing test
  • Examination by an orthodontist
  • Tongue frenulum assessment
  • Consultation with a pediatric neurologist according to indications

Correction

The correction takes place in several stages. First, the speech therapist, using articulation gymnastics, strengthens the muscles of the tongue and lips and develops phonemic hearing. Then he puts the correct sound, fixes it in syllables, words and phrases and teaches how to distinguish it from similar sounds. The duration of classes depends on the number of sounds disturbed and the regularity of home exercises: usually from several weeks to several months. If there is a short frenulum that interferes with the elevation of the tongue, the dentist or surgeon performs plastic surgery. Malocclusions are corrected by an orthodontist.

  • Daily articulation exercises in front of the mirror
  • Classes with a speech therapist 1–3 times a week
  • Doing homework
  • Don’t imitate or force someone to repeat it
  • Talk to your child clearly and slowly
  • Plastic surgery of the frenulum of the tongue for medical indications
  • Orthodontic treatment of bite

Services and prices for this diagnosis

Based on official price lists of Tashkent clinics. The exact cost is determined after examination.

💊 Treatment

Frequently asked questions: Dyslalia (burr, lisp)

At what age should a child pronounce “r”?+
The sound “r” is one of the most difficult and appears in many children by the age of 5–6 years. Before this, replacing with “l” or “th” was considered a variant of the age norm. If after 5 years there is no sound or it is distorted, for example, in the throat, it is worth showing the child to a speech therapist, since the incorrect version is quickly fixed.
Is it necessary to trim the frenulum of the tongue?+
Not always. Frenuloplasty is performed if it really limits the rise of the tongue and prevents you from pronouncing sounds, despite gymnastics. The decision is made jointly by the speech therapist and the dentist or surgeon. Frenum stretching exercises are often sufficient.
Is it possible to correct burr in an adult?+
Yes, dyslalia can be corrected at any age, but in adults it takes longer, since the usual articulation is firmly fixed. Regular classes with a speech therapist and independent exercises are needed. For anatomical reasons, the help of a dentist or surgeon may be needed.
Does dyslalia affect writing?+
If a child does not distinguish similar sounds by ear and replaces them in speech, he can transfer these replacements into writing. Distorted pronunciation without impaired auditory discrimination affects writing less often. Therefore, it is advisable to correct sound pronunciation before learning to read and write.
Is it possible to work with a child at home without a speech therapist?+
Articulation gymnastics, reading, and playing with sounds are useful for all children. However, it is difficult to set the sound correctly without a specialist: it is easy to fix the wrong version. It is better to be examined by a speech therapist, and at home do his tasks every day for 10–15 minutes.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.

Where it is treated dyslalia в Ташкенте

Помимо логопеда, ребёнку с нарушением звуков может понадобиться осмотр ЛОР-врача и стоматолога. Clinics Ташкента, где принимают эти специалисты:

st. Mirzaeva 50, Yunusabad 17, Yunusabad district, Tashkent Landmark: opposite the Nazar M...
M Turkiston 🚶 1.5 km
M Yunusobod 🚶 2.0 km
M Shahriston 🚶 2.8 km
🚌 Nearest bus stop 🚶 100 m · buses: 7
Mon–Fri:09:00–18:00
Closed now
Mukimiy street 144/1, Chilanzar district, Tashkent Landmarks: Novza metro station (former...
M Novza 🚶 400 m
M Mirzo Ulug'bek 🚶 650 m
M Milliy bog' 🚶 1.3 km
🚌 Nearest bus stop 🚶 170 m · buses: 9Т, 56
Mon–Fri:09:00–18:00
Closed now
Branch No. 3: Birlashgan street, opposite the 4-City Clinical Hospital
M Tuzel 🚶 750 m
M Yashnobod 🚶 800 m
M Texnopark 🚶 1.4 km
🚌 Nearest bus stop 🚶 200 m · buses: 22
Пн–Sat:07:00–20:00
Closed now
P

Phlebo Service

Private · Yakkasaray district

Sharshara passage, 114, Yakkasaray district, Tashkent Landmarks: shopping center "Next" ("...
M Mustaqillik maydoni 🚶 1.5 km
M Paxtakor 🚶 1.5 km
M Xalqlar Do'stligi 🚶 1.6 km
🚌 Nearest bus stop 🚶 370 m · buses: 11, 32, 47
Пн–Sat:10:00–18:00
Closed now
Tashkent, Mirabad district, st. Oybek, 34d
M Toshkent 🚶 550 m
M Oybek 🚶 850 m
M Kosmonavtlar 🚶 1.3 km
🚌 Nearest bus stop 🚶 150 m · buses: 22
Tashkent, Yakkasaray district, st. Sh.Rustaveli, 109 A
M Oybek 🚶 2.4 km
M Kosmonavtlar 🚶 2.6 km
M Novza 🚶 2.9 km
🚌 Nearest bus stop 🚶 70 m · buses: 2, 11, 12, 40, 45, 47
Пн–Sat:08:00–17:30
Closed now
Tashkent, Khamza district, M. Ulugbek Ave., 5d
M Mashinasozlar 🚶 1.1 km
M Do'stlik 🚶 1.1 km
M Hamid Olimjon 🚶 1.6 km
🚌 Nearest bus stop 🚶 50 m · buses: 28
Mon–Fri:09:00–17:00
Closed now
Tashkent, Chilanzar district, st. Foziltepa, 40d
M Olmazor 🚶 3.2 km
M Chilonzor 🚶 3.2 km
M Mirzo Ulug'bek 🚶 3.6 km
🚌 Nearest bus stop 🚶 320 m · buses: 13, 17T, 33
Mon–Fri:09:00–17:00
Closed now

ICD-10 code

Official international classification codes — these are used in medical records and statistics.

Other diseases: Speech therapy

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