This advice-column-style blog for SLPs was authored by Pam Marshalla from 2006 to 2015, the archives of which can be explored here. Use the extensive keywords list found in the right-hand column (on mobile: at the bottom of the page) to browse specific topics, or use the search feature to locate specific words or phrases throughout the entire blog.
Tongue-Tip Protrusion
By Pam Marshalla
Q: I notice that kids who come to me for frontal lisp often have the tongue-tip protruding on T, D, N, and L as well. Should I address these errors too?
I always fix tongue-tip problems on T, D, N, and L before I work on S and Z.
From a motor develop perspective, correct tongue movement on S and Z is an outgrowth of tongue movement on T, D, N, and L.
There is no reason why you can’t work on all six lingua-alveolars at the same time. Make the lessons be: “The tongue stays in all the time when we make T, D, N, L, S, and Z.”
Thanks so much for this post. To follow up – would you say that lingual protrusion for /t, d, n/ is ever developmentally normal? If so, when is it expected to resolve (i.e., when is tongue tip discrimination / elevation supposed to develop?)
I think that lingua protrusion on the lingua-alveolars is still considered normal until age 6-8.
This is a place to rely on the old developmental norms 🙂
Hi Pam, thanks for your clarifying that lingua protrusion on the lingua-alveolars is still considered normal until age 6-8. Could I please have a reference for this? I am just wanting to use this on a report. Thanks!
May,
I am terribly sorry, Pam passed away in 2015. I wish I could give more information.
All the best,
Shanti M.
May she rest in peace and light..I am very sorry to hear this.
Warmest regards,
May
What about a child who produces frontal lisp, tongue tip protrusion on /l/, and then also seems to over-protrude the tongue for /th/. Should you attempt to bring the tongue further in for the /th/?
Depends on the age, cognitive level, and neuromuscular status of the client.
If this is an elementary child with no cognitive or neuro issues, I probably would do all of it.
Sort-of related question: I have a little guy who has a frontal lisp /s z/ but (initially) was also stopping affricates and had a frontal lisp for /sh/. He is now producing “dge”, “ch”, and “sh” accurately, but is having great difficulty with placement for /s z/. Any suggestions would be very helpful!
What does he do wrong with S and Z– Frontal? Lateral? Weak? Whistle-y?
Please look through all my blog posts on the lisps. There are many ideas already posted.
In spontaneous speech it’s a frontal lisp. However, when he tries to make the “snake sound” with teeth closed, it’s now more like an “sh”. He used to produced “sh” with a frontal lisp However, “sh” is now 100% correct. He has some success with the long T, when putting dental floss around the central incisors, and some with the straw/pretzel stick between the teeth, but it’s not consistent. His best is “tsss”. Is there anything more I should be doing? Thank you so much!
You are on your way. Take your time. Patience. You don’t need to do anything else right now, just keep doing this.
This is my message for every reader- STOP WORRYING ABOUT INITIAL S WITH LITTLE GUYS. Establish the motor pattern with Sh and Ts, and take these into phrases, sentences, paragraphs. Initial S will be the LAST thing he will gain. 🙂