Q: My client is 4;0 and has a combined frontal and lateral lisp. I have not taken any of your classes or read any of your books. Any suggestions as to how to proceed with treatment?

I have written volumes on this topic and it is somewhat difficult to describe in a quick QA.  But I will do my best.  The short and sweet answer to this question as I see it is as follows (and if you have not been exposed to my work this may seem like wacky info, but trust me…) —

All speech movements are made with an interplay of oral movement and oral stability. Both the frontal lisp and the lateral lisp are due to inappropriate oral stability.  That means that both the tongue and the jaw are out of their required stable position during speech.

The oral mechanism stabilizes itself in the following way: The jaw moves in a tiny up-down pattern during speech that is mostly high, and the tongue stabilizes itself at its back-lateral margins.

Long E is the closest thing we have to the stable position so…..

• Have your client produce an exaggerated Long E with a big smile.  While holding that position, teach her to make a T through a straw held outside the central incisors.
• If she can hold her tongue this way and make a T through the straw, then have her make a “Long T” (a Ts) through the straw.  But tell her not to make an S.  Tell her to make a T with more air.
• Assuming she can do each step correctly, she is now producing Ts with a correct S.  Begin to work on words that end in Ts––hats, cats, lights, boats, etc.