This is a question posed to me from SpeechPathology.com as a follow-up to the on-line seminar I taught for them on the lateral lisp:

What do you think is the biggest hurdle that a child with a lateral lisp faces?

I think there are three really big hurtles the client and the SLP must face in changing a lateral lisp.

First, the client has to learn a new motor pattern. We ask ourselves, “How can I create this new movement?” This can be a big challenge for some clients, but there are relatively easy ways to go about it. I discussed developing the new motor pattern in the recorded 1-hour SpeechPathology.com seminar from October 1, 2009.

Second, the client must learn to habituate the new pattern by learning to self-monitor out in the real world. We ask ourselves, “How can I help this client remember to do this all the time?” This is a matter of carryover. [EDIT 2010: I have published a new book, Carryover Techniques in Articulation and Phonological Therapy, which covers this topic extensively.]

Third, the client faces changing his perception of himself. Speech patterns are integrally related to self-perception. The client has to learn to see himself in a new way as he operates in the real world. Some clients fear this change. The SLP has to be both teacher and counselor. We help our clients gain enough confidence to try their new skill with safe people. We help clients identify the safe people, we help them develop a list of target words, and we help them write a simple script for the interaction. We expect to talk about his experience in the next session in order to make more plans to broaden their experiences.