Correcting a Frontal Lisp

Posted by Heather | Filed under Articulation

A friend of mine recently asked me to listen to her little boy’s speech because she was concerned about him having a frontal lisp. His lisp never bothered her until someone outside of their family commented on “how cute” his little lisp was!

Any mom would be less than thrilled to hear someone else noticed that their child sounded differently – even if the difference was cute! His mom and I met him briefly outside of his classroom where I got to see and hear him speak. He did have a mild frontal lisp. Lisping is the habitual protrusion of the tongue between the upper and lower teeth when making the /s/ and /z/ sounds.  This means he was producing a sound similar to the /th/ sound in place of the /s/ and /z/ sounds.
A “frontal lisp” may also be called an “inter-dental lisp.” For some children, the frontal lisp is developmental until around age 4 or 4 ½. If the lisp does not go away on its own by then, it is a good idea to seek out a speech-language pathologist’s assistance. For other kids, it does go away on its own by age 4 – 4 ½ and is not a concern any longer.
The best thing to do is to see what your SLP says about your child’s speech production, and if it is recommended, begin to correct it.  This habit gets harder and harder to break the longer it is left untreated. Ideally, if your child is ready and you as the parent are concerned, working on correcting the sound at 4 ½ is a great idea.

What Does a Frontal Lisp Sound Like?

 
Usually kids who are demonstrating a frontal lisp will substitute a sound close to the voiceless /th/ for the /s/. You may hear words that sound like this:

Lisp on the /s/ sound at the beginning of a word:  ”Saw” sounds like ” thaw”
Lisp on the /s/ sound in the middle of a word:  ”Grasshopper” sounds like  ”grathhopper”
Lisp on the /s/ sound at the end of a word:  ”Class” sounds like “clath”

A child who lisps when saying the /z/ sound substitutes a sound similar to a voiced /th/; as in the word “mother”.

Lisp on the /z/ sound at the beginning of a word: “Zoo” sounds like  ”thoo”
Lisp on the /z/ sound in the middle of a word:  ”Busy” sounds like “bithey”
Lisp on the /z/ sound at the end of a word:  ”Days” sounds like “dathe”

 

What type of Speech Disorder is a Frontal Lisp? Is There Something Wrong With My Child’s Mouth?

 
A frontal lisp is referred to as a functional speech disorder. A functional speech disorder simply means that the origin or cause of the speech error pattern is unknown. There is no known structural or related cause that can be blamed for the distortion or error pattern. Some examples of known causes of an articulation or speech sound disorder might be if the child is an obligatory mouth breather (can’t breathe adequately through the nose), has low muscle tone (you may see that the child drools or has an open mouth resting posture), has a cognitive delay, or has a genetic syndrome causing the jaw and facial bones to develop atypically, not allowing for the necessary contact between the child’s articulators (tongue, lips, and jaw). If these are occurring along with a frontal lisp, other more individualized techniques and strategies may need to be applied; however, those types of structurally based speech disorders will not be discussed here. This post is just aimed at discussing the functional speech disorder.

Does a Frontal Lisp Impact my Child’s Speech Intelligibility?

 
If only one or two sounds are distorted by the lisp, then the child’s speech intelligibility may not be affected at all; or be affected very minimally. A frontal lisp can range from mild to severe depending on the amount of forward tongue protrusion. Usually, the child is understood fairly well despite the lisp.
Lisping on the /s/ and /z/ sounds may draw unwanted attention to the child’s speech because it sounds odd and is visually atypical. For example, a severe frontal lisp may be visually distracting as the tongue is moving forward and extending beyond the front teeth.
 

How Do I  Correct the Lisp and Teach a Good /s/ and /z/ Sound?

 
The focus of speech therapy for a frontal lisp is primarily on re-training the tongue to assume a more back posture instead of a more frontal or inter-dental posture. The goal is to achieve a precise sounding /s/ and /z/ by stabilizing both sides of the back of the tongue and directing the tongue tip to stay just behind the upper teeth.  Here is the order of articulation therapy I would follow.  This is a very basic description of what to do.  It is always recommended that you consult your local speech-language pathologist to help with correct diagnosis and treatment.

Step 1: Auditory Awareness/Discrimination

 
You want to first begin with auditory discrimination activities in order to bring awareness to the difference between the /s/ and /z/ sounds and the /th/ sound they are using. Some kids have been lisping for so long, they really don’t know that it is inaccurate. It all sounds the same to them! So start with some listening activities.
It might look something like this.  Say to your child:
ADULT:     “We are going to learn how to say two very cool sounds! They are the /ssss/ and /zzzz/ sounds. I just want you to watch and listen to me.  You are going to give me a thumbs-up when you see and hear a good ssssssss and a good zzzzzz.  If you hear a funny or slushy sound, give me a thumbs-down!  Got it? Okay, here we go!”

sssssssssssssssssss – how did that sound? Good?

CHILD:  Yeah! (Child gives a thumbs-up)

ADULT:  Right, good listening!  That was a good ssssssssssss sound.  Now, lets see if I can make a good /z/ sound.  Ready?

zzzzzzzzzzzzzzzzzzz – how did that sound ? Good?

CHILD:  Yeah!  (Thumbs-up)

ADULT:  Wow, great listening.  You were right.  Those were both good ssssss and zzzzzz sounds.
Now go ahead and say the following words – be sure to mix it up so that the first word isn’t always the correct production. You don’t want them to anticipate a pattern and respond based on that! The goal is listening and discrimination of the difference between a correct /s/ and /z/ and an incorrect /th/ substitution.

“Recess” – (child listens and gives a thumbs up)
“Retheth” – (child listens and gives a thumbs down)
“Bicycle” – (child listens and gives a thumbs up)
“Bithicle” – (child listens and gives a thumbs down)
Etc.

Step 2: Eliciting the Correct Tongue Position

 
(I use a traditional articulation therapy approach for working on the /s/ and /z/ sounds and correcting a lisp)

1. Let’s Play Copy Cat!!

 
See if your child can imitate or copy you as you demonstrate how to make a correct /s/ and /z/ sound with your teeth closed and your tongue behind the teeth. They may be able to copy you and that would make it much easier to then move to the next level of difficulty…the /s/ and /z/ sounds in syllables.
If your child can’t imitate you, get a mirror and use visual feedback to help them direct their tongue tip just behind the upper teeth. Use verbal cues to explain where the tongue tip goes. You can even use a popsicle stick, or tongue depressor if you have one, to lightly tap the tongue tip and then tap just behind the upper teeth and have your child make those two touch.
Verbal cues I like to use for /s/ are:
“the /s/ is the hissing snake sound”
“it’s a sharp /ssss/ sound!”
“smile and keep your teeth closed and say /sssss/!”

Verbal cues I like to use for /z/ are:
“the /zzzz/ sound is the noisy brother of /s/”
“your tongue is in the same spot for /ssss/ but you just turn on your motor…/zzzz/”

 

 

2. Syllables!!

 
Once the child is able to say an accurate /s/ and /z/ sound at least 20 times in a row by itself and without too many reminders for tongue placement, I move onto silly syllables.
This just means you have them say their “good /ssss/ and good /zzzz/ sounds with vowels. I begin with the short vowels and then use the long vowels. I will go through all positions. Usually I start with broken syllables (s + a) and then move to blended syllables (sa).

/s/ + a

/z/ + a

a + /s/

a + /z/

a + /s/ + a

a + /z/ + a

3. Words!!

 
Once the child is able to produce the /s/ and /z/ in blended syllables, I move onto words. There are some printable /s/ and /z/ worksheets you can download and use to practice at this level! These are great for kids and are colorful and show both the picture for pre-readers and the word for kids who want to read also.
Make sure you practice the /s/ and /z/ sounds in the beginning, middle, and end of words. Here are some examples:

beginning:               some  -   zipper
middle:                     missing  -    business
end:                            class   -   close
 

 

4. Sentences!!

 

 
The next level I would target is sentences. Use all those words you practiced, and new ones too, in short phrases and then longer sentences!
 

 

5. Reading!!

 
If the child can read, I like to have them practice using their good /s/ and /z/ in reading! Just about any book will do!
 

 

6. Conversation!!

 
I have my students tell me a story about something that happened and I tell them I’m going to listen for their good /s/ and /z/ sounds! They love sharing stories.   As you do this at various times during the day (short conversations are best) producing their new /s/ and /z/ sounds should become more and more natural and automatic.  The final stage would be when they can maintain the correct production of /s/ and /z/ with very minimal errors.  They should be able to produce their /s/ and /z/ sounds effortlessly during all spontaneous speech!
 

 

Tip for Parents:

Research shows that a very effective tool in encouraging correct sound production is the “re-cast.” This technique is so simple and is highly effective! Here is how it works!
When your child says, “I thaw that thame one yethterday!” you would respond by saying,
“ Really, you SAW that SAME one yeSterday??” As you repeat their sentence, you are providing a correct model of the sounds that were in error while just slightly emphasizing the correct way to say the /s/ or /z/ sound. You are not demanding that the child repeat every sentence and word he distorts.

Please let me know how your home therapy is going and if you have any questions!

More great resources on correcting a lisp:

• LISPING
  When /s/ and /z/ Are Hard to Say
  Copyright 1999 Caroline Bowen 

 

• Baby Center.com
  Can I help Correct My Child’s Lisp??

 

Heather G.
M.S.CCC-SLP

Comments (11) | May 27th, 2011