Quick Answer:
Most children with severe speech difficulties go on to develop clear, understandable speech with consistent, early therapy.
If your little one has severe speech difficulties, you may feel worried about whether they’ll ever be understood. Many parents are surprised when I tell them: with speech therapy, nearly all children will have normal speech, and no one will ever know how much they once struggled.
So why does everything sound the same like “dee”? And what does this mean for their future?
Why So Many Words Sound the Same
When children are in the early stages of speech development, there are many sounds children can’t yet make or they have rules that make them change sounds and often many sounds can be said as just one. It is not uncommon for children to have five or more issues making their speech difficult to understand. For example, they might replace:
- t, d, k, g, s, z, sh, ch, j
- and even clusters like st, sk, sl ,sn, kl, gl, tr, dr
all with the sound /d/.
They might also leave off the last sound in words. That means tea, key, see, she, cheese, jeep, sleep, steep, sneak, tree, dream, green, clean can all come out as “dee.”
To a parent’s ear, it can feel like their child only says one word for everything. But what’s really happening is that their child knows the word, but doesn’t yet have the tools to pronounce it differently.
The Good News: Therapy Works With Practice
Speech is like any other skill, practice matters! With therapy that starts early and focuses on the right building blocks (listening, sound contrasts, mouth movements), children usually make steady progress.
And here’s the encouraging part: most children with severe speech difficulties catch up completely with therapy. Their speech becomes clear, and in time, you’d never guess how hard it once was for them.
What’s Typical for Speech Clarity?
It helps to know what’s “normal” for speech intelligibility:
- By 18 months – parents may understand ~25% of what their child says.
- By 2 years – around 50% is clear to familiar adults.
- By 3 years – about 75% is understood.
- By 4 years – a child should be clear to strangers most of the time.
If your child isn’t reaching these milestones, early assessment makes a big difference.
Understanding the Difference: Articulation, Phonology, Dyspraxia and Dysarthria
When children have trouble speaking clearly, parents often hear different terms, articulation, phonological disorder, childhood apraxia of speech (dyspraxia) or dysarthria and it can feel confusing. These words describe different reasons why speech may sound unclear.
Articulation Difficulties
Articulation is about the physical movements needed to make a sound.
A child with an articulation difficulty may know what they want to say, but can’t quite get their lips, tongue, or jaw to move the right way.
For example, they might say “wabbit” instead of “rabbit” or “thoup” instead of “soup.”
With focused practice and feedback, articulation difficulties easily resolve as a child learns where to place their tongue or how to move their mouth more precisely.
Phonological Disorders
Phonology is about the sound patterns of language, the rules that tell us when and how to use sounds.
A child with a phonological disorder can make all the sounds correctly, but uses them in the wrong places or leaves them out entirely.
That’s when key, see, she, cheese, and jeep all sound like “dee.”
It’s not a muscle or mouth problem. It’s a pattern-learning problem.
Therapy helps children learn to hear the differences between sounds and use them correctly in words, step by step.
Childhood Apraxia of Speech (Dyspraxia)
Dyspraxia (or childhood apraxia of speech) is different again. Firstly, it is quite rare with only 1 to 2 children per 1,000 (i.e. 0.1 % to 0.2 %).
The challenge isn’t the muscles or sound patterns. It’s the planning and coordination of movements for speech.
Children with apraxia often know what they want to say but have trouble getting their mouth to follow the right sequence of movements.
Speech may sound inconsistent. Sometimes clear, sometimes not and longer words are usually much harder.
Therapy for dyspraxia focuses on repetition, rhythm, and building reliable motor plans for each sound and word.
What is Dysarthria?
Dysarthria is a motor speech disorder. The muscles we use for speaking (like the tongue, lips, or voice box) don’t move as strongly, smoothly, or accurately as they should. It’s caused by neurological differences or injury, such as cerebral palsy, brain injury, or certain genetic or neuromuscular conditions.
Children with dysarthria know what they want to say, but their speech can sound slurred, quiet, strained, or flat because their muscles tire easily or don’t coordinate well. It’s different from apraxia (which affects planning the movements for speech) dysarthria affects the execution of those movements.
In the general population, dysarthria is quite rare, but among children with neurological conditions (like cerebral palsy), it’s much more common. The focus of therapy is to make speech as clear and efficient as possible, strengthening muscles, improving breath control, slowing the rate of speech, and using strategies or technology to help children be understood.
In Simple Terms
- Articulation → difficulty making a sound. Your child can’t say the sound after you eg lisp saying the s sound with their tongue between their teeth or saying the f sound with their bottom teeth on the top lip instead of using their top teeth
- Phonology → difficulty using sounds correctly in words. Your child can say the sound and may even be able to copy the word but when talking use the wrong sound eg tar for car
- Dyspraxia → difficulty planning and sequencing speech movements.
- Dysarthria → difficulty with clear speech because the muscles used for talking are weak or hard to control.
It is not uncommon for children to have a combination of speech difficulties, especially articulation and phonology. Understanding which one applies helps guide therapy and gives parents confidence that there’s a clear path forward.
Helping Your Child Be Understood: How to Work Out What They’re Saying
When your child’s speech sounds unclear, especially when everything sounds like “dee” it can be hard to know what they mean. But there are clues! By tuning in and looking for patterns, you can often piece together their message and support their confidence along the way.
Here are some simple strategies that really help:
1. Listen for the Vowel, It’s Often the Most Accurate Part
Even when consonants are mixed up, vowels are usually stable.
If you listen carefully to the middle of the word, the vowel often gives the biggest clue to what your child’s trying to say.
For example, “dee” with a long “ee” might mean tea, see, key, sheep, jeep, cheese…
“dah” might mean car, star, jar, dark.
2. Use the Situation for Clues
Think about what’s happening around you.
If you’re at the table, “dee” might be tea or seat.
If they’re holding a toy car, “dee” might be key or steer.
Children often use context long before clear speech to communicate effectively.
3. Watch Their Gestures and Eye Gaze
Many children naturally point, look, or act out what they’re talking about.
Their body language and facial expression often fill in the missing sounds.
4. Repeat and Model, Don’t Correct
If your child says “dee” and you know they meant “tea”, respond naturally:
“Yes! Tea! You want your tea.”
This gives them a clear, correct model without pressure or discouragement.
5. Discover the Pattern for their Sounds
Start with what sounds they can say.
Then look for the pattern of errors. This will help you know what the word attempt could be.
6. Give Them Time and Attention
Slow down, make eye contact, and show that you’re really listening.
When a child feels heard, they keep trying and those extra attempts are what create progress.
Remember
Even when words aren’t clear, your child’s message is.
By tuning in to vowels, context, gestures, and your own intuition, you’re helping them build the bridge from “dee” to “tea,” “key,” “see,” and beyond.
The Long-Term Picture: Why Early Support Matters
Severe speech difficulties aren’t “just speech.” Research shows that up to 80% of children with ongoing speech disorders go on to face literacy difficulties at school.
Their challenges extend beyond speech itself and they can face social, emotional and academic difficulties into adolescence and beyond. A study published in the American Journal of Speech-Language Pathology (via PubMed Central) highlights how early intervention and targeted therapy can make a lasting difference.
That’s because the same part of the brain for speech is also responsible for important phonological awareness skills in sound awareness, segmenting and blending which are the foundation for reading and spelling.
When we support speech development early, we’re not only helping children be understood today, we’re giving them a stronger foundation for learning tomorrow.
Final Thoughts for Parents
If your child says “dee” for everything, you’re not alone and it doesn’t mean they’ll always struggle. With the right support, children with severe speech difficulties can make remarkable progress.
The key is early, consistent help. The earlier we start, the more likely it is your child will develop clear speech, confidence in communication, and strong literacy skills for school.
Because speech therapy isn’t just about words. It’s about opening doors to learning, friendships, and the world.
Continue Reading
Therapy Progress Isn’t a Straight Line – why growth isn’t always smooth, and how plateaus build mastery.
The Power of Belief – how what we believe shapes what’s possible in speech therapy.