Q: My 12-year-old client is bright but has a lateral lisp. He has a gap between his side teeth. How can I tell if the dental gap is causing the lateral lisp, and how should I precede? I stuck cotton between the side teeth but it didn’t help.

The dental problem may have contributed to the lisp, OR the lisp may have contributed to the dental problem. This is a chicken-and-egg situation that usually has no clear answer. But it doesn’t matter. The client should be able to make a midline airstream sibilant even with this type of dental problem.

You were on the right track with the cotton, but let me help you see this differently.

We do not need to block the airstream with an object: We need to get the tongue to block it.

A sibilant is made when the sides of the tongue elevate and the midline depresses to form a groove. Your client needs to learn to elevate the sides of his tongue primarily in the very back.

Therapy Procedures

The following simple steps may take 6-12 weeks for your client to learn. Go at his pace. Do not move forward until he conquers each step.

1. Tell him to bite down on his back lateral margins with his very back molars.
2. Then tell him to push those back sides up against the underside of the molars. This will cause him to lift the sides of his tongue (what I call the “butterfly position“).
3. Then tell him to hold that position and say Long E.  Eeeeeee.
4. Then tell him to whisper through that position. This tongue position for E is the exact same as that required for Sh. So once he whispers E he essentially is saying Sh.
5. The only movement he needs to add is to round the lips. He should be saying Sh.
6. Now work on Sh in syllables, words, phrases, sentences, paragraphs, and spontaneously.
7. Then have him hold that E position while he says T.
8. Then have him add aspiration to the T to form Ts.
9. Then work on words that end in Ts.
10. Now work on minimal pairs with Ts and S (E.g., lights / lice, nights / nice, etc.