Sounds are produced by oral-facial structures that are commanded by the brain. Speech requires a high level of co-ordination and precision to make the rapid oral transitions in running speech. We use developmental norms that tell us at what age children acquire each sound to identify problems very early. Some problems are due to delayed development and may resolve spontaneously, while others are more physiological such as difficulties in the brain (the articulation command center: dyspraxia) or difficulties with poor oral-motor strength and coordination (dysarthria).