In medical contexts, rhotacism () is the inability to pronounce or difficulty in pronouncing the sound "r." Many speech pathologists call this problem "de"-rhotacization, because the sounds lose their rhotic quality rather than becoming rhotic.

The rhotic sounds are usually the last ones a child masters. Some people never learn to produce them; they substitute other sounds, such as the velar approximant, the uvular approximant (often called the French "R"), and the uvular trill.

In English, the most common occurrence of this type is a pronunciation perceived as closer to [w] (typically, though, actually the labiodental approximant ), which is known as "r"-labialisation. This form of rhotacism has often been used in English-language media for comedic effect, since it evokes among English speakers a childlike way of pronouncing the letter R, an example being Elmer Fudd's pronunciation of "rabbit" ] as "wabbit" ] in Looney Tunes cartoons.