Pronunciation change is a pathological symptom of dysphonia, mainly manifested as delayed and abnormal pronunciation, the development of pronunciation is lower than the corresponding age level, and the speech is slurred or mispronounced. The following is the differential diagnosis of articulation change. Normal children have unclear pronunciation: Before the age of 3 to 4 years old, many consonants are still not pronounced correctly, especially some complex consonants are not pronounced correctly. However, after 4 years old, they can gradually learn them. Some normal children still have mispronunciation even at school age. Unlike developmental dysphonia, they can correct their own mistakes or correct them soon after education. In contrast, children with developmental dysphonia make repeated errors and cannot correct them spontaneously. Organic dysarthria: laryngeal disorders, cleft palate, cleft lip, congenital tongue ulcer and other structural damage and defects of articulatory organs can cause slurred pronunciation and mispronunciation; neurological diseases cause damage to the cerebellum, medulla oblongata, extrapyramidal system and the nerves governing the movement of articulatory organs, which can cause uncoordinated movement of articulatory organs. The abnormalities can be distinguished from developmental dysphonia after detailed neurological examination and examination of the five senses. Speech abnormalities due to hearing impairment: In mild hearing impairment, dysphonia can occur. Because mild neurological deafness mainly damages the high-frequency part of hearing, the dysphonia also mainly focuses on high-frequency sounds, and there are abnormalities in the electrical audiometry examination. Specific language development disorder: the phenomenon of repetition of words or interruption of words during speech. The articulatory organs may show convulsive movements with spasms of various groups of muscles. Speech is produced by the common normal activity of the respiratory tendons of the diaphragm causing the vocal cords and the tongue, lips, and mouth coverings that make up speech. When almost all of these spasms occur and lose their free movement, slurred speech is formed. The patient’s breathing suddenly stops when he or she is speaking or when he or she has the intention to speak. There are also psychological disorders: fear, pessimism, negativity, and depression.