What is Initial Consonant Deletion?

This episode of the Speech and Language Kids Podcast is a short Speech Spotlight on Initial Consonant Deletion (ICD).  ICD is when a child consistently leaves off consonants from the beginning of words.  For example, “stick” becomes “ick” and “tree” becomes “ee”.  While young children often leave consonants off of the ends of words, it is not common for children to delete beginning consonants.  For this reason, ICD is considered an atypical speech error.  Children with ICD would benefit greatly from being evaluated by a speech-language pathologist.

How to Treat Initial Consonant Deletion

Initial Consonant Deletion (ICD) is considered a phonological disorder.  This means that the child has developed a rule in his/her head for how sounds will be used.  For this particular phonological disorder, that rule is that all consonants at the beginning of words will be deleted.  Keep in mind that the child is not doing this on purpose.  That is just his brain’s way of making words easier for him to say.  We just need to re-train his brain to overwrite that rule.

Here are the steps to treating ICD:

1. Find minimal pairs of words that are exactly the same except that one has an initial consonant and one does not.  Examples would be “up” and “cup” or “off” and “cough”.  You can download my word list or make up your own.

Click Here to Download the Initial Consonant Deletion Minimal Pairs Word Lists

2. Get Pictures of Those Words: You will need to show the child pictures of those words.  You can find pictures using Google Image Search, take your own pictures, or draw pictures.

3. Show and Label Two Pictures: Show the child one pair of pictures.  Tell the child what each picture is called (“This is cup, this is up”).

4. Ask the child to point to one: Say “point to ___” and say one of the words.  See if the child can hear the difference between the two words.  You may need to play games to get the child to do this.  Listen to the episode for ideas.

5. When the child can point to the correct one 80% of the time, have the child say the words.

6. Say the Words in Sentences

7. Use initial sounds in structured conversation

8. Reinforce initial consonants throughout the day


If the child is struggling, try these tips:

  • Focus on one initial consonant at a time
  • Focus on a few highly preferred functional words
  • Go back to more listening activities
  • Over-exaggerate initial sounds in conversational speech
  • Try non-sense words like sound-effects and animal noises to elicit initial consonants

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