By Pam Marshalla
Q: I am an SLP and my 12-month-old daughter is developing a lateral lisp on her first words! Help!!! I believe this to be one of the worst positions in which an SLP can find him- or herself. We can teach midline sibilants to very young children, even toddlers, if we approach the acquisition of frication/stridency the way an infant does. I would do these three things now –– 1. Teach her to make a lingua-labial raspberry. Put the tongue…
By Pam Marshalla
Q: In my therapy with kids who have the stopping process, I typically start with S-clusters and S in the postvocalic position. It seems they develop the idea of “fricative-ness” more easily this way and, from there, they more easily go on to prevocalic S. I find that starting with prevocalic S often leads to a lot of frustration because they learn “sock” as “stock,” and so forth. Can you comment on this? First, we have such a mess in…
By Pam Marshalla
Q: My client is beginning to use S-blends, but she does so with an interdental lisp. Do I treat the phonological process first and let her lisp, or treat the lisp first and then the process? Or should I do both concurrently? I am worried about reinforcing the lisp. I would work on the phonology first to stimulate the use of the phoneme within the language. Then I would address place of articulation. That’s the way I would organize it…
By Pam Marshalla
Q: I serve a female client with Down syndrome in school. She is bright and has done quite well in articulation therapy, but she cannot produce CH due to a severe underbite. This is her last articulation error. Her inability to say the sound is not due to poor oral control or cognitive issues. She simply cannot make this phoneme correctly because of the occlusal problem, but she is not going to receive orthodontia or oral surgery. The parents have…
By Pam Marshalla
Q: I have a third-grader who has a frontal lisp on /s/ and /z/. He has an underbite and produces these sounds with his tongue contacting the inside of his upper teeth. Should I discontinue therapy until he is seen by an orthodontist or is there something I should be doing in the meantime to help him compensate for his jaw and tongue positioning? I am really not sure if he’s capable of a more retracted tongue position or if…
By Pam Marshalla
Q: I have heard you say that jaw sliding to the left or right can cause one type of lateral lisp. I have also heard you say that this type of jaw instability is seen in children with dysarthria. Are you saying that a lateral lisp is a form of dysarthria? Excellent question! No. I am not saying that a lateral lisp is a form of dysarthria. I am saying that clients with expressive speech deficit often have problems in…
By Pam Marshalla
Q: I have a 3-year-old whose front teeth had to be pulled due to decay. He likely won’t have those teeth again for 2-4 years. Do I wait to treat S? This depends upon what you are trying to accomplish… First, if you are trying to bring stridency into the client’s phonological system, and are stimulating S to do that, I would do it now. In fact, I would stimulate for all the strident phonemes right away –– S, Z,…
By Pam Marshalla
Q: At what age should my school speech therapist begin working on my son’s “R” sound? Would you address it before “S,” “Z,” and “Th”? When do you address these errors? Do missing teeth affect the decision making in this process at all? Yours is a very simple yet complicated question. First, these are what we call “later-developing sounds.” When a child has errors on these sounds, most SLP’s in the public schools wait until the kids are 7, 8,…
By Pam Marshalla
Q: I have been using your cornerstone approach from Frontal Lisp, Lateral Lisp successfully with my students for /s/ and /z/. It has been very helpful! Thank you! However I have a couple of students who are left with a lateral Sh (“shoe”), Ch (“chop”), J (“jump”) and Zh (“beige”). I have been combing your book and working very hard doing oral motor for lateral margins and the bowl shape, but I am still having difficulty with sound production. Help!…
By Pam Marshalla
Q: What does an SLP call a distorted /s/ phoneme that whistles, like the gopher in Winnie-the-Pooh? Is it considered a lisp? The term “lisp” has gone through many changes throughout the centuries, and it depends upon whom you read as to what it means. In the 1800’s, some writers used the term “lisp” to refer to any problems with the sibilants. Others used the term to mean any and all speech deficits, including all problems of voice, resonance, prosody,…
