Phonological articulation disorder
Does your child omit sounds, replace sounds with other sounds, or is it 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 combine. So it is not about «not being able» to pronounce something, 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/ sounds become /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. That difference helps determine both the approach and the reimbursement.
Mogelijke signalen
Do you recognize any of these signs? That does not automatically mean there is a disorder — an intake interview helps to see together what is going on.
- omits sounds or syllables
- systematically replaces sounds with others
- is difficult to understand for outsiders
- sometimes gets frustrated because they are not understood
- speech is clearly lagging behind peers
When is help useful?
- Typical request for help: «Other people — and sometimes we ourselves — don't understand our child well.»
- Who refers: Kind & Gezin, the school, the CLB, or the (family) doctor.
- Age: assessment is already useful for preschoolers; some speech sound errors are age-related and normal, which is why we look at what is appropriate for the age.
- Important: a hearing problem is excluded first.
Step by step
- 1Registrationyou / parent
You contact the practice with your question.
- 2Prescription for the assessmentGP / specialist
A medical prescription for the speech therapy assessment.
- 3Intake & Speech therapy assessmentspeech therapist
Introduction, request for help, and discussion of history. A targeted assessment is conducted using standardized tests.
- 4Analysis & conclusionspeech therapist
The results are combined into a diagnostic profile. A report of the assessment is prepared.
- 5Prescription for therapyspecialist
Having a prescription for the treatment signed by a specialist. The application form is sent to the health insurance fund.
- 6Decision by the advisory physicianhealth insurance fund
The health insurance fund approves the reimbursement.
- 7Tailored therapyspeech therapist + child + parent
Guidance for your child, together with you.
- 8Evaluation & extensionspeech therapist
Monitoring progress, and continuing or concluding therapy.
Assessment & testing
We map out the complete sound system: which sounds your child masters, which patterns (processes) they use, and how intelligible their speech is.
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 reimbursable disorders, unlike a pure articulation disorder. The speech therapist selects the appropriate tests from the RIZIV list.
The therapy
- Goals
- Getting the sound system in order so your child becomes intelligible: teaching sounds and sound contrasts and generalizing them to spontaneous speech.
- Frequency
- Typically 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 under certain conditions be reimbursed via the RIZIV and your mutual fund. In short:
You only pay the co-pay (±€2 with increased allowance). Your health insurance fund reimburses the major part.
The full fee, e.g. when the RIZIV conditions are not met.
- a valid medical prescription (examination + treatment);
- a prior hearing test;
- a speech therapy assessment that meets the RIZIV criteria;
- approval by the advisory physician of your mutual fund.
Note the distinction: a phonological disorder is reimbursable, a pure phonetic articulation disorder is not. As convention-bound speech therapists, we follow the official RIZIV rates. If you are eligible for reimbursement, you only pay the co-pay; otherwise, the full fee. You can find the exact, annually indexed amounts and the complete explanation under "How a trajectory 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 doctor's prescription?
Not for the intake. For reimbursed therapy, a medical prescription is usually required — we will guide you step by step through the documents you need.
How long does a session last and how often do we come?
An individual session lasts 30 minutes. We will agree on the frequency (usually 1 to 2 times a week) together, tailored to your child.
Can the therapy take place at school or at home?
In consultation, therapy at school is sometimes possible; home guidance is assessed 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?
Still doubting whether this suits your child? Make a non-binding appointment — together we will calmly look at it.