Q: I am working with an eight-year-old boy who has a lateral lisp as well as orthodontic problems and oral habits. He has severe lip-licking and nail-biting habits, and he has a narrow palate that will need expansion. I am thinking that he may do better in therapy once the palatal expander is removed. What are your thoughts?

One could approach this problem from many angles, but this would be my basic line of thinking:

• A lateral lisp is a problem of tongue movement.
• A palatal expander will fix palate shape, but not tongue movement.
• I would wait to fix his tongue movement and speech sounds until after the expander has been removed because its presence distorts the acoustic quality of the sibilant phonemes.
• I would use the waiting period to help him rid himself of his oral habits.

Also, I suppose a client could fix his tongue movement and phoneme problems on his own as a result the palate re-shaping with the expander, but I have never seen such a client. However, that would be because a client like that would not end up in an SLP office. 🙂

These books of mine may help in this process:

• How to Stop Thumb Sucking – The advice has application to all oral habits, including lip-licking and nail-biting.
• Frontal Lisp, Lateral Lisp – Discusses the relationship between sibilant productions and dentition, and contains many techniques for the lateral lisp.