Phonological articulation disorder
Does your child omit sounds, replace sounds with other sounds, or is he/she difficult to understand? With a phonological disorder, the problem is not in the muscles, but in the sound system in your child's head.
What is a phonological disorder?
In a phonological disorder, a child struggles with the sound system of the language: the child does not yet (unconsciously) know well which sounds carry meaning and how they go together. It is therefore not about "not being able" to pronounce, but about the organization of sounds.
What does this mean in concrete terms? Your child omits sounds («toe» instead of «stoel»), systematically replaces sounds (e.g. all /k/ becomes /t/), or simplifies words. As a result, they are often difficult to understand, even for their own parents.
Important distinction. Unlike a phonetic articulation disorder (where a specific sound is produced incorrectly due to motor issues), this involves patterns: entire groups of sounds are replaced or omitted. This difference helps determine the approach and the reimbursement.
Mogelijke signalen
Do you recognize some of these signs? That does not automatically mean there is a disorder — an intake appointment helps to look together at what is going on.
- omits sounds or syllables
- systematically replaces sounds with others
- is difficult to understand for outsiders
- is sometimes frustrated because it is not understood
- speech clearly lags behind peers
When is help useful?
- Typical support question: «Other people — and sometimes ourselves — do not understand our child well.»
- Who refers: Kind & Gezin, the school, the CLB or the (family) doctor.
- Age: for toddlers, assessment is already useful; part of the sound errors is age-related and normal, which is why we look at what fits the age.
- Important: a hearing problem is first ruled out.
Step by step
- 1Registrationyou / parent
You contact the practice with your question.
- 2Medical prescription for the assessmentgeneral practitioner / specialist
A medical prescription for the speech therapy assessment.
- 3Intake & Speech therapy assessmentspeech therapist
Introduction, the support question and discussion of the medical history. A targeted assessment is carried out using standardized tests.
- 4Analysis & conclusionspeech therapist
The results are combined into a diagnostic picture. A report of the assessment is drawn up.
- 5Medical prescription for therapyspecialist
Have a medical prescription for the treatment signed by a specialist. The application form is sent to the health insurance fund.
- 6Decision of the advisory physicianhealth insurance fund
The health insurance fund approves the reimbursement.
- 7Tailored therapyspeech therapist + child + parent
Support of your child, together with you.
- 8Evaluation & extensionspeech therapist
Follow-up of progress, and continuation or completion.
Assessment & testing
We map out the complete sound system: which sounds does your child master, which patterns (processes) does it use, and how intelligible is the speech?
Sound system & error patterns
Speech therapist · Ja — criteriumwaarde per fiche
How well is your child understood
Speech therapist · Onderdeel bilan
Rule out hearing loss
ENT / audiologist · Voorafgaand vereist
A phonological disorder (a language/speech disorder) falls under the reimbursable disorders, unlike a pure articulation disorder. The speech therapist chooses the appropriate tests from the RIZIV list.
The therapy
- Goals
- Getting the sound system in order so that your child becomes understandable: teaching sounds and sound contrasts and generalizing them to spontaneous speech.
- Frequency
- Usually 1 to 2 sessions per week, within the RIZIV framework.
- Session duration
- 30 minutes (individual).
- Role of the parents
- Playing along and practicing in short, playful moments at home. We provide concrete tips.
- Evaluation
- Periodic; extension based on progress.
What does it cost?
A phonological disorder can be reimbursed under certain conditions via the RIZIV and your health insurance fund. In short:
You only pay the patient co-payment (±€2 with increased reimbursement). Your health insurance fund reimburses the largest part.
The full fee, e.g. when the RIZIV conditions are not met.
- a valid medical prescription (assessment + treatment);
- a prior hearing test;
- a speech therapy assessment (bilan) that meets the RIZIV criteria;
- approval by the medical advisor of your health insurance fund.
Please note the distinction: a phonological disorder is eligible for reimbursement, whereas a pure phonetic articulation disorder is not. As conventioned (official rates) speech therapists, we follow the official RIZIV rates. If you are eligible for reimbursement, you only pay the patient co-payment; otherwise, the full fee. The exact, annually indexed amounts and the full explanation can be found under "How a pathway works".
Indicative rates 2026 (30 min). You can find the exact, indexed amounts and the full explanation on the services page.
Frequently asked questions
Do I need a medical prescription from the doctor?
Not for the intake. For reimbursed therapy, a medical prescription is usually required — we will explain step by step which documents you need.
How long does a session last and how often do we come?
An individual session lasts 30 minutes. The frequency (usually 1 to 2 times a week) is agreed upon together, tailored to your child.
Can the therapy take place at school or at home?
In consultation, therapy at school is sometimes possible; home support is considered on a case-by-case basis.
What if my child does not (yet) have a diagnosis?
That is not necessary. During the intake and a potential assessment, we will look together at what is going on and what makes sense.
Ready for a first step?
Are you still in doubt whether this suits your child? Feel free to make an appointment — together we will calmly look into it.