Q: I have a client in grade five who has a frontal lisp. She can make a good /s/, but her jaw slides forward when we do word and sentence drills, and when we engage in conversation. The speech work, especially conversation, seems too fast to allow for her to get her jaw in the right position to keep the tongue in. Suggestions?

Your client already can do a correct /s/ with a good jaw position, but she is not holding it during the increasing demands of speech at the word, phrase, sentence, paragraph and conversational level. Simply teach her to do so.

Have your client bite down on a straw at the molars to stabilize the jaw in its up position. Place the straw between the upper and lower teeth on one side, placed along the length of the teeth from a molar in the back to the canine in the front. Have the client bite down gently into the straw to hold it in place. This will bring the jaw up into position.

Then do the speech work with the straw in place. Work on words, phrases, sentences, paragraphs, and conversation.

Teach your client to listen carefully so she can hear how much better she sounds when her jaw is up and the tongue is in.

More importantly, have her watch in a mirror to see how much better she looks when she keeps her jaw high and her tongue in. Make minor adjustments to these positions as suits the acoustic quality of her sound.

Then talk gently and carefully about how babies talk with their jaws low and their tongues out, while big girls talk with their jaw’s high and their tongues in.