Q: My 19-month-old cannot produce O. She is smart and has no other speech or developmental problems, but it interferes with intelligibility.

My guess is that your daughter will learn to round her lips within a few weeks or months all on her own without any help. She is only one year old and has lots of time to gain this simple skill. If you were to come to my office about this, and this was the only problem, I would tell you to leave her alone. She is bright and articulate and way above average, and there is about a 99.9% chance that this will go away all by itself.

If you need to teach lip rounding to her eventually, or to an older child, or to a child with a motor speech disorder, the most effective way is to use resistance and gently push the lips back as the child pushes them forward. Your fingers teach her, through tactile and proprioceptive means, what to move and in which direction to move––

• Use your two thumbs
• Place one on each side of the lips, at the corners.
• Gently stretch the lips back toward the ears.
• Tell the child to push her lips forward, kiss mommy, kiss the teddy bear, make an Ooo, or make a tiny mouth.
• Model lip rounding so she can see it.
• Work in front of a mirror so she can see what she is doing.