Frontal Lisps

Description:

There are two main types of lisps that we deal with: frontal lisps and lateral lisps.  A frontal lisp, also known as an interdental lisp, occurs when a child says the /s/ and /z/ sounds with the tongue pushed too far forward. This causes /s/ and /z/ to sound more like “th”.  Children who have a lisp may have difficulty being understood by adults and peers.  This may impact their social relationships and affect their teacher’s ability to assess knowledge.  Lisps can also affect reading and writing skills if not corrected.  Here are some resources to help you treat lisps.

Overview:

Listen to this podcast episode by Carrie Clark over at Speech and Language Kids to learn more about treating frontal lisps

Task Analysis (How To):

Now comes the fun part!  Here’s where we break this larger skill down into manageable, bite-size pieces.  Here’s how to break this skill down for therapy:
  1. Assess /s/ and /z/ Words: First, let’s find out if the child can say any /s/ or /z/ words without lisping.  Some children will naturally have a facilitating context where they can already say the word.  For this, just have the child say a big long list of /s/ and /z/ words.  
  2.  Sound in Isolation: Help the child produce the /s/ or /z/ sound in isolation without lisping. You can use any facilitating contexts that you found in the last step or use some elicitation techniques.
  3. Sound in Syllables: Pair the newly discovered /s/ or /z/ sound with vowels to make nonsense syllables
  4. Sound in Words: Moving on up!  Time to try that sound in some single words
  5. Sound in Sentences: Practice the sound in words in sentences.  Make sure you’re practicing the sound in a variety of word positions.
  6. Work on the Other Sound: Now that the child has mastered one of those sounds in sentences, go back and work on the other one from the start.  If the child was able to do /s/ to begin with, go back and work on /z/ now in isolation and move through the steps again.
  7. Sounds in Conversation: Once the child can say both sounds in sentences, time to start working on it in conversation.  Start with structured conversation and then move up to unstructured conversation.

Activities:

Now for some practical strategies and activities that you can do in therapy for each of these steps.  Click on the task analysis level to drop down the list of activities:

Here’s a quick list of /s/ and /z/ words (and some others for lateral lisps) so you can run the child through a bunch of words.  Maybe one will be easy enough that you’ll have a good non-lisped /s/ or /z/ to start from!

Word Lists for /s/ and /z/

Try to find a word or context that the child can use the /s/ or /z/ sound in correctly and build from there.  However, if the child does not already have a natural /s/ or /z/, try some elicitation techniques:

Elicitation Techniques for /s/ and /z/

Tackling the Frontal /s/

Full hour-long webinar recording from Laura Powell where she shows her tips for correcting the frontal /s/

Elicitation Techniques for “sh”

What if /t/, /d/, and /n/ are forward as well?

Try these great resources for helping your clients pair the target sound with vowels to make nonsense syllables.

Sound Syllable Spiders
These cute little spiders will help your clients practice pairing consonants with different vowels

What to Do When a Child Can’t Move Past Isolation

Ok, let’s move on to single words!  Here are some worksheets to get you going.

/s/ Articulation Worksheet

/z/ Articulation Worksheet

Use the sound worksheets from the last step to have the child use the sound in sentences.  Or, have the child read sentences from these reading passages:

Reading Paragraph for /s/

Reading Passage for /ts/

(Great for getting forward air flow!)

Now I don’t know of any research that specifies when you must do this step, but this is the timing that has worked for me in the past.  I’ve helped the child get to the sentence level with one sound before going back to the other.  You can always do them simultaneously or just see how your client is doing.  If you seem to get stuck at a step earlier than this, go back and try the other sound a little sooner.  Individualize this to what your client needs.

Let’s try some of these simple structured conversation prompts to practice the sound in a more complex environment:

Sounds in Structured Conversation Pack

Now comes the hard part, getting them to do it the rest of the time in every-day conversation!  

Tips for Encouraging Speech Sounds in Conversation

Speech Sound Carry-Over Challenge

 

Troubleshooting:

What do you do if these things don’t work the way they’re supposed to?  Well, nothing’s ever easy, is it?  Try these great troubleshooting tips that some of our other members have found helpful.  Click the problem to drop down the link to the solution.

If a child lacks awareness of his articulators, it will be difficult to encourage him to move his tongue to the different locations to work on a lisp.  Try these tips:

 

If a child is producing /t/, /d/ or /n/ with an incorrect tongue position, it may be affecting his/her ability to produce the /s/, /z/, and other sounds correctly.  Learn how to establish proper position for /t/, /d/, and /n/ so you can have a strong foundation upon which to target more difficult sounds: 

Resources, Tools, and Training for Speech-Language Professionals

*** The SLP Solution is for informational and educational purposes only and does not provide medical or psychological advice.  We provide general resources but cannot tell you exactly what should be done for a specific client.  Every client is different and your clinical judgement should be used when making decisions about specific individuals.

 

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