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Kids Health QA: Speech Problems

Q. Our 3-year-old still mispronounces some words -- instead of "cocoa," he'll say "toto." Could he have a speech problem?

A. Odds are it's nothing to worry about. Speech isn't generally 100 percent intelligible until age 4. Some sounds are simply harder for kids to pronounce than others, too:

Many children don't master sh, th, s, z, l, r, sp, tr, or bl sounds until they're 6 or 7. My daughter Natasha had a terrible time with her l's and r's -- for a while there, I even found myself saying "yunch" instead of "lunch" -- but now, at 7, her speech is just fine (and I kind of miss the cute mistakes).

That said, it's worth keeping an ear on his errors. Sometimes mispronouncing words can be a sign of a hearing problem, or a developing speech or language difficulty. If you have any concerns about your child's hearing (for instance, if he doesn't always respond when called, says "What?" a lot, sits very close to the TV, or often wants the volume turned up), get it tested as soon as possible.

Otherwise, talk to your pediatrician about your son's speech slipups at his next general checkup. Chances are he's right on track.