Improve that lateral lisp-maybe it’s not so hard

Mar 26, 2012 by

Improve that lateral lisp-maybe it’s not so hard

In the 25+ years of being a Speech Language Pathologist, I’ve done my best to avoid students who need work on their lateral /s/**. Pawning them off on other therapists was always good ploy. It also helped that some of the school systems I worked with felt that if articulation did not effect school performance articulation was not addressed. So honestly if the lateral /s/ kids were out there, they were never brought to my attention. Now I’ve landed myself at a school that actually wants articulation therapy for their students.

Since I hadn’t really worked on articulation for years, I had to get creative. Last year I took an articulation workshop with Char Boshart. Guess what I learned? That articulation therapy hasn’t changed in 30 years. Many of the techniques and even the tools are the same. It was a nice refresher. One thing Ms. Boshart was big on was getting the mouth into a good rest position. Which is a good starting point for /r/ and /l/ but a little more invasive than I usually like to do. You have to understand this is tricky with older kids. Honestly, I’ve never seen much success with /r/ even with other therapists. I think it is a real speciality and you have to be comfortable with. Another new trend is shorter more frequent sessions. Now that makes sense, more supervised practice. The bigger challenge is getting teachers and administration on board with this. Missing teaching time even 5 minutes is a problem these days when test scores are such a priority.

Now for my lateral lisp student. I never thought I could get a good /s/ from a lateral in isolation but I did! I was easy. /s/ in general is produced like /t/. The tongue is basically in the same place. Have the student produce t-t-t-t-t-t-t then slide into /s/. I got that juicy tidbit during an internet search. Don’t know why that technique didn’t occur to me sooner.

So my 3rd grade student who has a lateral /s/ is on his way to changing his /s/ production. As I listen to him spontaneously read, his correct /s/ production is about 30% without any prompting. During therapy he tells me it’s hard but I think it’s him being a little dramatic. He is able to hear the difference in the sounds, feel the difference with placement and self correct with a reminder. He needs practice an investment, which will come with maturity. I predict he will eventually change his /s/ production complexly. Never thought I could get anyone to do that.

**A lateral lisp is where the air comes out of the sides of the tongue when producing /s/, rather than the front. A lateral lisp might also be called a “slushy /s/”

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17 Comments

  1. Ralph Parker

    Fun read..personal stuff faced in schools is a challenge…nice job…thanks!

  2. When I initially commented I clicked the “Notify me when new comments are added” checkbox and now each time a comment is added I get three emails with the same comment. Is there any way you can remove people from that service? Thanks a lot!

  3. Anon

    As a fellow speech pathologist I am really surprised to read that you don’t treat phonological processes at all, nor do you keep up to date with current research

    • Teresa Sadowski MA/SLP-ccc

      I don’t know how you got that from a fun little story about articulation. I’ve done this a long time and my point was articulation treatments haven’t changed much at all. I learned that theories might change but actual treatments are similar. We all cringe when we have an /r/ or lat /s/ student. What has changed is that schools don’t give us enough time with the kids to make effective progress when they have dyspraxia or atypical errors. I’ve also observed more atypical and long lasting errors as phonics training/teaching has decreased in schools. My opinion is that the lack of phonics in schools is also causing more auditory perceptual issues in general.

      As therapists we have a lot to keep current on and honestly articulation takes a back burner when you work with older kids. Articulation often isn’t even treated in schools any more unless it keeps the student from participating in class. I don’t agree with that rule but it is happening. Are you able to keep current on everything in our field?

      This was meant to be a fun little article about a funny little boy I work with.

      • Alycia

        It is our job, role and responsibility to keep current on current techniques and research. Also, articulation is most definitely treated in schools.

    • Teresa Sadowski MA/SLP-ccc

      Thanks for looking at my blog and taking the time to comment.

  4. dominicb

    Hello Teresa, I cam across your blog whilst searching information on correcting a lateral s that my 7 year old daughter has just be told she “suffers” from. We have just engaged with a local speech therapist near where we live but we want to try to understand what we can do to help outside of the therapy. I think having short video’s of what you are suggesting would be great from a parents perspective as we need to “hear” examples of the exercises. Are you able to point me to any online resource like this? many thanks in advance.

    • Teresa Sadowski MA/SLP-ccc

      Hello
      Thanks for taking a look at my blog. Working with a speech therapist is the best step to take. I would not recomment working on your child’s sound production until you get the ok from your therapist. I never send work home to practice until I know the student can practice the sound correctly. If you practice the sound incorrectly it may be counter productive. I wrote this story because it was unusually easy to correct that particular students lateral lisp. I had not had that kind of success in the past. A lateral lisp can be a very challenging sound to correct. A question to ask her therapist is…”how close is she to being able to approximate a correct /s/ sound?” I am currently working with a lateral lisp student about the same age who is far from being able to approximate a correct /s/ at this point no matter what I try.
      Teresa

  5. Mary

    Teresa,
    I’m working with an 11 yr old with lateralized /s/ and /z/ and I think the “lazy t” is a good place to start. I did find information on this technique online and since nothing else seems to elicit any correct /s/ production I am planning on trying this.
    Thanks for sharing your story!

  6. Hokunani

    Your article was very enlightening for me. My 4 year old son has a lateral lisp. I’ve noticed it since he was
    At least 2, he would say les for yes. I’ve tried to get help for him since he wAs 3, but it is as you stated, schools
    Not concerned with articulation, and there are few to no speech therapists where I live in Hilo. I’m wondering now
    If the reason I can’t find help is that, like you, speech therapists just find it too challenging, and would rather pass
    The buck on to another therapist. That’s discouraging for me, as I’m starting to research articulation therapy to work
    With him, myself, but at the same time, it’s encouraging to hear you say it wasn’t as difficult as you’ve thought, after all.
    With that in mind, are there any websites, or books you could recommend for the parent therapist?

    • Teresa Sadowski MA/SLP-ccc

      Hi Hokunani,
      Not being able to hear and observe your son’s articulation production it is difficult for me to comment. Using an l/y sound is a typical and developmental substitution we hear in young children. A lateral lisp will sound more like a slushy sh sound with air coming out the sides of the tongue rather than the front. That would be considered atypical production. Schools may not pick up a young child when they have difficulty with later developing sounds until they are older. I probably wouldn’t pick up an /s/ only student at age 4 but I would need more info before making that decision. Some schools will not pick up children, even young ones, if their articulation does not significantly impact their ability to communication (I am hearing that more and more from therapists). If you continue to have concerns, I would consult again with the Speech Language Pathologist at your school. You can always ask for another evaluation or screening, you are within your rights to do that. If you are not pleased with the results, ask the therapist the reasoning behind her decision. Most therapists are happy to do that. The only other piece of advice I would give is to look at your schools curriculum and ask specifically if they have a strong phonics componet. I feel that a strong phonics program can helps all students but especially those with developmental articulation errors. Good luck and let me know how you make out in the futrue. I’ve attached a link to a chart I found that explains at what age certain sound are acquired.
      Teresa

  7. Julie

    Please help! My son will be 13 next month and still exibits a lateral lisp when he speaks. We’ve done speech therapy since he was very young, and it ha s been a tremendous help with all other ariticulation issues he was experiencing. But then the issue of the slushy /s/….most times we’d end up battling about how and when he should practice, to the point that it became unproductive for both of us. So I let it go and figured he would grow out of it. Wrong!!!! As many SLPs have told me, and I have come to see for myself, it becomes more of a habit as the child gets older, as this is how he’s learned to speak. Now older, he is definately more aware of his lateral lisp. More aware thanks to some children at school blatantly pointing it out to him and poking fun at him, combined with oral presentations in class that he absolutely hates, to trying out for a part in the school play and being placed with a part that has less lines (not to blame this on the fact that he does have a lisp, but try telling that to a 13 year old). I’m worried that he will become even more self conscious and end up staying in his shell because of lack of self confidence he now has in himself. I feel like such a failure as mother, and not to make this about me at all, but if I had of just pushed him more, maybe we could have turned this around before it got to this point. He asks me all the time, mom why did I have to be born with this problem? And no matter how much I encourage him or try to relate things from my childhood to him or try to reassure him, he is still very bothered by it. I blew my knee out in January and I tell him all the time, it’s like my knee, no one can fix it but me. I always tell him I can help him and try to seek advice, but the fact of the matter is, he is more frustrated than I am. I want to help him so badly, my eyes well up with tears as I write this, but I feel so stuck and don’t know how to help him anymore. Please advice, encouragement, something…on how to help my frustrated, self concious preteen! He’s a smart boy, I know he can do it, I just feel like he has given up and as a mom it’s my job to make sure he doesn’t!!!! Thank you for reading my concerns….

    • Teresa Sadowski MA/SLP-ccc

      There is probably no quick fix for his articulation at this point. I think my advice would be first to gently talk to him about it. He knows it bothers you but ask him if it bothers him? If it does bother ask him if he wants to work on it (a fix is never a guarentee). The tricky part is finding the right therapist. I would suggest a private therapist outside of school. The only thing worse than having an articulation error in middle school is being pulled out to work on it in a group setting. You need to find someone with experience working with middle schoolers/teenagers, someone who understands that population. More important is that the therapist must have a lot of experience with oral motor functioning. Have the therapist discuss the situation with your son, especially in regards to how much practice it will take on his part. Being smart has little to do with the whole process. It is also very understandable why he is discouraged. Look into private practices in your area, hospitals that have speech and language clinics or The American Speech Hearing and Language Association (ASHA) might be able to provide you with a list of private therapists in your area.
      Good luck and please post a follow up in the future.

      Teresa

  8. Helen

    Hi Teresa,
    I found your blog while looking for information for an on-line friend whose six year old has a lateral s. This was related to a conversation about tongue tie, on a tongue tie facebook group, as the boy had a tongue tie revision done at 11 months, although imo it needs another look. I am a lactation consultant, and have been amazed at the belief that it is better to spend years in therapy correcting an articulation problem rather than have a tongue tie assessed and treated by an ENT or other specialist which would give the tongue full range of movement. My own child who had a lateral s I strongly suspect of tongue tie, and my own lateral s seems to have corrected itself after a tongue tie release at age 65, two years ago. I always had to be careful saying “s”, but never knew why, nor that it was so apparent in my speech that a friend thought I had some kind of regional accent. I hope you are open to looking at tongue function or lack there of, while you are doing your therapy, and mentioning this to parents of students who might benefit from seeing a specialist. I’m finding it very odd that as a volunteer breastfeeding helper in a peer support group, with international accreditation as a lactation consultant, that I am spotting posterior tongue ties and being told they don’t affect breastfeeding (or speech, apparently). Thanks for the blog; I passed it on to my friend, to share with whomever works with her son’s speech when his name gets to the top of the waiting list.
    Helen
    Helen
    Helen

    • Teresa Sadowski MA/SLP-ccc

      Thank you for this reminder. Sometimes it slips my mind to look for a tight frenulum. Perhaps I don’t see it much because it is often picked up when they are infants because of difficulty with feeding. I can imagine that with a tight frenulum, infants will have difficulty with maintaining a tight suction. I was just wondering what this looks like with bottle feeding. Do infants with a tight frenulum tend to lose a lot of formula while bottle feeding?

  9. Ang Kelly

    I’m in Los Angeles and you are correct regarding articulation therapy in public schools. According to the California Ed Code an articulation disorder is defined as having a negative impact on education, drawing adverse attention, requires multiple speech sounds and can’t be corrected without speech intervention. The student must meet all four criteria. As we all know most kids do not meet all four of the criteria. Some therapist qualify them and others don’t
    .

    • Teresa Sadowski MA/SLP-ccc

      It’s been my experience that it is usually school policy that dictates qualifying for arctic services. This is usually for the older kids who have a left over /r/ or /s/. I always qualify the younger kids (sometimes using a 504 or building based plan) even if their articulation errors appear to be developmental in nature. When they have quick success it makes me look good:). I know that is not the right way to use a 504 but some schools use it that way. I like using a building based plan but only if the school system has a coordinated model.
      T

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