If a child has intact phonemic contrasts but misarticulates, which diagnosis is most likely?

• A. phonological delay
• B. articulation disorder
• C. inconsistent phonological disorder
• D. apraxia of speech

Answer: (B)

When phonemic contrasts are intact and the child still misarticulates, the issue lies with motor production of speech sounds rather than with the sound system or phonological rules. That points to an articulation disorder, where the phonemes exist in the mental inventory and can contrast correctly, but the physical production of specific sounds is inaccurate.

In a phonological delay, the problem is with the organization and use of sound patterns, so you’d expect emerging or simplified phonological systems rather than preserved contrasts. An inconsistent phonological disorder would show highly variable errors across attempts, not a stable misarticulation with clear contrasts. Apraxia of speech involves planning and sequencing problems, often with inconsistent errors and groping in connected speech, which goes beyond a straightforward misarticulation despite intact contrasts.