Living life with a lisp

ByLondon Speech and Feeding
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You may be questioning ‘will my child grow out of having a lisp?’ There are so many myths out there that it’s sometimes difficult to find your way out of a complex maze of information.

The good news: lisps can be successfully treated by a Speech and Language Therapist and the earlier it’s resolved, the better. We know from the evidence base that some children’s lisps will resolve and, as always, it is completely age appropriate to have this speech pattern up until aged 4 ½.

As with any speech and language targets your child will need to be motivated to practise their newly acquired techniques, at home and in other settings. They will eventually be able to generalise this skill, but it takes lots of practice. So, think carefully about if your child is ready and motivated before commencing Speech and Language Therapy.

There are essentially two ways in which your child has acquired a lisp. It’s key here to mention that parents have no blame in this.

  1. They’ve mis-learned it and now incorrect production has become a habit
  2. Children have difficulties organising the sounds to make a clear production

You may be surprised to realise that there are different types of lisps. But all the techniques will be the same.

  1. Interdental lisp

When your child pushes their tongue too far forward, they will make a /th/ sound instead of /s/ and /z/

  1. Dental lisp

This is where your child’s tongue pushes against their teeth

  1. Lateral lisp

Air comes over the top of the tongue and down the sides

  1. Palatal lisp

Your palate is the roof of your child’s mouth. Sometimes they will touch their palate when making certain sounds (e.g., /s/ and /z/)

It’s useful for you to know what type of lisp your child has because you can then support them to make the correct production. You’ll be able to talk about where in the mouth their tongue is and where it needs to be to produce a clear sound. Your Speech and Language Therapist will be able to help you with this.

Top therapy tips for lisps

  1. Awareness is key. Does your child know where their tongue and teeth are (i.e., are they behind their teeth)? Do they notice the air escaping? Use a mirror so that your child can see not only themselves but also you in the mirror.
  2. Repetition! As with most therapeutic intervention, practice makes perfect. So little and often is key!
  3. Make sessions fun, perhaps around your child’s interests or allow them to drink from a straw
  4. Comment on how the sound is produced (e.g., /z/ is like a bee, /s/ is like a snake)
  5. Use tactile cues. Your child’s vocal folds vibrate when they produce a sound like /z/ but not with /s/. You could use the words ‘loud’ and ‘quiet’ to describe this.
  6. Start with a /t/ sound and gradually elongate the sound to an /s/

Having a lisp may not be problematic for some, but for other children, it can have a significant impact on their emotional wellbeing. Intervening at an early age can prevent this from happening. We always advocate for early intervention!

Contact Sonja for support on resolving your child’s lisp.

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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    How can I incorporate AAC into my speech therapy sessions?

    ByLondon Speech and Feeding

    Many parents are surprised when I bring AAC into a session, especially if they’ve come to see me primarily for speech sound work.

    They might wonder: ‘If we’re working on pronunciation, why are we using a communication device?’

    The simple answer is this: speech therapy is about communication first, and speech sounds second. Supporting a child’s ability to express themselves clearly and confidently is always the priority, and AAC can be a powerful tool alongside spoken speech.

    What do we mean by AAC?

    AAC stands for Augmentative and Alternative Communication.

    This can include:

    • A speech-generating device (such as LAMP Words for Life or GRID as I used in the photo below)
    • A communication app on a tablet
    • A symbol board or communication book
    • Gestures, signs, or visual supports

    AAC does not replace speech. Instead, it supports language development, reduces frustration, and builds communication success while speech skills are developing.

    Pretend Play using Speech and AAC in my clinic room

    But I mainly work on speech sounds… So how does AAC fit?

    Most of the children I see are working on:

    • Articulation difficulties
    • Phonological delay
    • Motor planning challenges (including apraxia/dyspraxia)
    • Unclear speech affecting confidence

    For these children, AAC isn’t a separate therapy. It’s simply woven naturally into what we are already doing.

    If a child brings their device to sessions, I actively include it. If they don’t yet use AAC but could benefit from visual or symbolic support, I may introduce simple options within activities.

    Using AAC to support speech practice

    Let’s say we are working on early speech targets like: ‘GO’.

    We might practise:

    • Saying the word verbally
    • Listening for the target sound
    • Using play (TOY TRAIN GOING ROUND A TRACK)

    Now we can extend this using AAC.

    On the device or communication board, we might model: ‘LET’S GO’ or ‘IT’s GOING up the hill’.

    This allows the child to:

    • Practise their speech sound target
    • Build a simple sentence
    • Experience successful communication even if speech is not fully clear yet

    All responses are valid and supported.

    AAC helps children communicate more than they can say

    Many children can understand and think in longer phrases than they can physically say.

    For example:

    • A child who verbally says single words may build longer phrases on AAC.
    • A child who struggles to plan speech movements may use AAC to communicate smoothly while still practising verbal attempts.
    • A child who becomes frustrated when misunderstood gains a reliable backup system.

    Rather than slowing speech progress, AAC often:

    • Reduces communication pressure
    • Increases participation in therapy
    • Encourages more attempts at speech
    • Supports language growth

    When children feel understood, they usually become more motivated to try speaking.

    There are no ‘prerequisites’ for AAC

    One of the biggest myths I hear is: ‘My child isn’t ready for AAC yet.’

    In reality, children do not need to:

    • Reach a certain speech level
    • Use pictures first
    • Prove they understand everything
    • Show immediate interest

    Instead, we presume competence and introduce AAC in meaningful, playful ways.

    That means:

    • Modelling words while blowing bubbles
    • Commenting during playdough activities
    • Choosing words during games
    • Building simple phrases in shared reading

    AAC should never feel like extra ‘work’. It’s simply another way to join in communication.

    My goal is always the same: to help each child communicate as clearly, confidently, and successfully as possible, using every helpful tool available.

    If your child uses AAC (or might benefit from it)

     Please feel free to:

    • Bring the device to sessions
    • Show me how your child currently uses it
    • Share advice from school or other therapists

    I am very happy to incorporate AAC into our work together so that speech practice, language development, and real communication all move forward hand-in-hand. Because ultimately, therapy isn’t just about producing perfect sounds. It’s about helping your child be heard and understood.

    If you’d like support or advice, please contact me and I can help guide the next steps.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

      Health Professions Council registered
      Royal College of Speech & Language Therapists Member
      Member of ASLTIP

      Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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    • Explore the relationship between poor speech, language and communication and literacy skills

      ByLondon Speech and Feeding

      Communication skills are critical in all areas of communication throughout childhood and into adulthood. They are needed for understanding, narrating, making predictions and to develop social skills, for example in understanding everyday language or talking in the classroom or socialising with peers. Children with communication needs can experience low self-esteem, potential behavioural difficulties, lower school attendance and attainment.

      Communication skills have a strong impact on literacy. Let’s look at some of the facts:

      • 50% of children with language delays also have challenges with literacy (Burns et al, 1999).
      • 73% of poor readers in year three had a history of difficulties with phonemic awareness (the ability to hear, identify and manipulate sounds) or spoken language in pre-school (Catts et al, 1999).
      Speech Therpaist in London

      The effect of expressive language on spelling and reading

      The ability to read is very much dependent on competent language skills. Furthermore, a limited vocabulary will also have an impact on literacy skills. The more we know about a word, the easier it is to retrieve, recall, understand and use. So, if a young person has a poorer vocabulary, it’s likely that they will not have the same decoding skills as a peer with a richer set of vocabulary. By decoding we mean the ability to apply knowledge of letter-sound relationships including pronunciation of words. Decoding is a vital skill used in literacy.

      Whilst learning to read is a key skill, it’s important to remember that a solid foundation is needed for success. We need to ensure that no steps are missed, otherwise there will be gaps in knowledge.

      As your child moves further through the education system, they will be “reading to learn”. This is where young people with poorer language skills may show literacy difficulties (for example, reading comprehensions become more challenging, and their expressive language skills impact on their written abilities).

      When should I seek advice or support?

      Always seek the advice from a qualified professional such as a Speech and Language Therapist. You need appropriate advice for the age and stage of your child’s development and early intervention is of course key to success. It is never too late to ask for advice. The earlier you seek support, the better the outcome for your child in all areas (language, literacy, and emotional well-being).

      Have you still got unanswered questions? Contact me here and we can have a look at your child’s phonemic awareness, auditory processing skills, verbal understanding and assess his/her ability and likelihood of reading and literacy struggles. If we find that your child has dyslexia I can refer on to a specialist colleague who can help you further.


      Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    • Speech sound disorders

      ByLondon Speech and Feeding
      Kids Speech Therapist London
      Speech Sound Disorders

      Treatment Approaches – A Typical Session

      There are various great ways to treat speech sound disorders and I use all the approaches available selectively; I decide what works with each individual child and I also vary the approach depending on the child’s frame of mind at any given time during my session.

      Some of the approaches are more “drill-based” and require a child to be able to pay attention and really participate actively in the therapy, and this is what I am showing you today with this video clip.

      My little student here has been working with me for some time and from only saying a handful of words which were not very easy to understand he has come a long way. He does have some features of Verbal Dyspraxia which I shall briefly outline here:

      • Making sounds in general is a struggle, especially when asked to copy certain sounds, example: ‘can you say: a ee ou oo?”
      • Repeating sound sequences or words sequences is hard, for example: “say p-t-k in sequence” or “say fish chips fish chips fish chips
      • When saying the same word again and again, different mistakes can be heard
      • Intonation difficulties: speech sounds monotonous
      • Vocabulary is very limited

      Some therapy approaches are more play based, for example the Core Word method: here we pick a few words at a time which are very significant to the child and therefore highly motivating to try and say. These could be characters of Pokemon or Minecraft for example, or simple words like “GO!”

      When you watch the video you will see that I use a lot of visual prompting, such as showing him where the tongue is moving to or from. I do this with my index finger and this approach is called Tactile Cueing or “Cued Articulation”. Part of the approach is to give a visual prompt and then reduce the prompt as the learner is more able to produce the correct sounds. Once he can produce the sound on its own, we quickly move to the sound within a word.

      I do mix and match my approaches and in fact here I am drilling but I also use the Core Word which for him (YELLOW) — it’s his favourite colour and I happen to have quite a few good games where a YELLOW something or other can be asked for….. WHO KNEW!? 🙂

      Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    • · ·

      Feeding therapy: A guide for parents and caregivers

      ByLondon Speech and Feeding
      Image by gpointstudio on Freepik

      Feeding therapy is a specialised form of therapy and support that helps children develop healthy eating habits and overcome challenges related to food. It’s often used for children with picky eating, feeding disorders, or sensory processing issues.

      What is feeding therapy?

      Feeding therapy involves a series of techniques designed to improve a child’s eating skills and attitudes towards food. In the UK it’s typically provided by speech and language therapists and dietitians. These professionals work closely with parents and caregivers to create a personalised treatment plan tailored to each child’s unique needs.

      How does feeding therapy work?

      Feeding therapy sessions are typically 30–60 minutes long and involve a variety of techniques, including:

      • Family counselling: Providing support and guidance to parents and caregivers. This can help address any practical, behavioural and emotional issues that may be impacting the child’s eating.
      • Play-based activities: Engaging children in fun activities while introducing new foods or textures. This can help alleviate anxiety and make mealtimes more enjoyable.
      • Sensory exploration: Helping children become more comfortable with different tastes, smells, and textures. This can be achieved through activities like touching, smelling, and tasting various foods.
      • Oral motor exercises: Improving chewing, swallowing, and lip coordination. These exercises can help children develop the necessary skills for eating independently.
      • Behavioural techniques: Using positive reinforcement to encourage healthy eating habits. This can involve rewarding children for trying new foods or eating a variety of meals.

      When is feeding therapy needed?

      Feeding therapy may be beneficial for children who:

      • Are picky eaters: Refuse to eat a variety of foods or have strong preferences.
      • Have feeding disorders: Experience difficulties with eating, such as swallowing or chewing.
      • Have sensory processing issues: Are sensitive to certain textures, smells, or tastes.
      • Have medical conditions: Such as autism, cerebral palsy, or gastrointestinal disorders.

      Feeding therapy strategies you can try at home

      While professional feeding therapy can be invaluable, there are several techniques you can try at home to support your child’s eating development:

      • Create a positive mealtime environment: Make mealtimes enjoyable and stress-free by avoiding distractions, limiting screen time, and creating a calm atmosphere.
      • Create regular mealtimes and mealtime routines: Introduce set ways of announcing meal times, including songs or short nursery rhymes, try and involve your child with table setting, even just carrying their spoon to the table and putting the beaker next to the plate and ensure that meal time finishes after about 30 minutes, again with a set routine so that the child always knows: this is how we do it in our home, now I am finished and meal time is over.
      • Introduce new foods gradually: Start with small amounts and gradually increase exposure. This can help reduce anxiety and make new foods less overwhelming.
      • Model healthy eating: Show your child how to enjoy a variety of foods by eating a balanced diet yourself.
      • Avoid forcing food: Allow your child to choose and explore foods at their own pace. Forcing them to eat can create negative associations with food.

      Seek professional help

      If you’re concerned about your child’s eating habits, consult with a feeding therapist. We can provide guidance and support.

      Remember, feeding therapy is a collaborative process between parents, caregivers, and professionals. With patience, understanding, and the right strategies, you can help your child develop healthy eating habits and enjoy meals.

      Would you like to know more about specific techniques or have any other questions about feeding therapy?

      Please feel free to contact me.

      Sonja McGeachie

      Early Intervention Speech and Language Therapist

      Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

      The London Speech and Feeding Practice

      Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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    • · ·

      Are the Gestalts I model easy to mix and match later on?

      ByLondon Speech and Feeding
      Image by bearfotos on Freepik

      Here are some examples of great phrases and Gestalts that we could use:

      • Let’s get a banana / Let’s go out / Let’s play lego / Let’s go see daddy
      • That’s nice! / That’s really good! / That’s a green one / That’s a submarine
      • Need more help / Need a wee wee / Need that / Need to run
      • How about a biscuit / How about a cuddle / How about watching tv
      • We love bananas / We love a monkey / We love a cuddle

      Why or how could these examples be mixed and matched?

      You can see I have given several examples for each, that is how later a child can take one chunk (let’s) and add another (go out) or (need) + (go out).

      What about our own grammar? Should we be using grammatical phrases?

      In general for NLA 1 (Natural Language Acquisition stage 1) we want to use short phrases and keep them quite generic, something like:

      ‘Let’s go’ or ‘let’s play’ and pick 2-3 phrases per communicative function (see next point below).

      And if we are going to say longer sentences, for example: ‘let’s go and feed the ducks now’, then we should do so with good grammar and really varied intonation. It sometimes helps me to make up a little song/jingle on the spot that has a lot of intonation, more than I would perhaps use just by speaking.

      How many varied communicative functions do we cover with our modelling?

      We want to model a variety of Gestalts other than just requesting for example. In general, we are looking at our child having one or two Gestalts in the following areas before they are ready to move on into stage 2.

      These are the most common ones I see in my practice:

      • Requesting ‘want a banana/biscuit’ ‘Wanna play ball’
      • Transitioning: ‘what now?’ ‘what next?’
      • Ask for help: ‘need help’ ‘help me’ ‘mummy help’
      • Commenting: ‘it’s big’ ‘it’s red’ ‘it’s fast’ ‘too loud’
      • Speak up for self: ‘not that one’ ‘go now’ ‘stop it’

      Is the Gestalt I am modelling meaningful to my child?

      We don’t use all available Gestalts for every child. It has to be meaningful to the individual and has to match their interests. If our child is a big fan of feeding the ducks in the park then we can think about Gestalts like:

      • I see ducks!
      • They’re over there
      • Let’s feed them?
      • Let’s get some seeds
      • They’re coming!
      • They want food / They wanna eat!
      • That’s a big one
      • It’s so hungry
      • It loves the seeds!
      • No more! All done! Finished! Let’s go home

      What is my child actually trying to tell me?

      We have to be become word/phrase detectives! Is the phrase/script/Gestalt they are using right now actually meaning what they said or does it mean something else, and if so, what?

      Here is an example from my own personal experience in my practice:

      The little boy I was working/playing with was building a tall tower with blocks. When it finally fell with a great big bang he said in a sing-song voice ‘ring-a-ring-a roses’ … then he began to collect the blocks again to make a fresh tower. I sat there and thought: why ‘ring-a-ring-a roses’? What does that mean in this context? I then sang the song (silently) to myself with my detective hat on and realised as I came to the end that it finishes with ‘we all fall down’! it was a real AHA!!! moment for me as I saw right there what the meaning of his Gestalt was. He sang the first line of the song to say ‘all fall down!’

      So realising this I waited for the next tower to fall, and there it was again, he sang the first line of the song. I replied thus, copying him at first:

      ‘RING-A-RING-A ROSES – WE ALL FALL DOWN!…

      FALL DOWN

      WE LOVE IT FALLING DOWN.’

      The process to find what we should say is not always straight forward or easy at all, and often we don’t quite know in the moment what our child is trying to say. But we can try and get to know their interests and then gradually we do know more and more what the meaning behind the Gestalt is or could be.

      What pronouns should we use?

      This can be a tricky one.

      We don’t want to use language that uses the pronouns ‘you’ or ‘you’re’. The reason is that our child will likely copy us exactly as we have said it. Therefore, using pronouns ‘you’ and ‘you’re’ will then sound wrong.

      Always try to model language that is from the child’s perspective or in other words how they would say it if they could.

      Alternatively, you can model using WE or US. For example, if the child is tired, rather than saying ‘you are so tired’ model language from his or her point of view: ‘I’m tired’ or ‘let’s go have a lie down’.

      There is so much more to talk about. Stay tuned for a blog on NLA stage 2 coming soon.

      If you need help with your child, please do not hesitate to contact me.

      Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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    • The tricky /R/: Mastering tongue placement for clear speech

      ByLondon Speech and Feeding

      The /R/ sound is notoriously challenging for many children (and even some adults!). It’s one of the most complex sounds in the English language, with various pronunciations depending on its position in a word. If your child is struggling with their /R/s, you’re not alone. As Speech and Language Therapists (SLTs), we frequently work on this sound, and a key component of our therapy is focusing on proper tongue placement.

      Why is the /R/ so difficult?

      The /R/ sound requires precise coordination of the tongue, jaw, and lips. Unlike sounds like /P/ or /B/ that involve simple lip movements, the /R/ involves intricate tongue movements and tension. There are also different ways to produce the /R/ sound, which adds to the complexity:

      • Retroflex /R/: The tongue tip curls up and back towards the roof of the mouth.
      • Bunched /R/: The body of the tongue bunches up towards the roof of the mouth, while the tongue tip remains down.

      The importance of tongue placement

      Regardless of which /R/ variation is being targeted, accurate tongue placement is crucial. Even a slight deviation can result in a distorted or inaccurate sound. That’s why SLTs dedicate significant time to teaching and practising tongue positioning.

      Speech therapy techniques: Focusing on the tongue

      Here’s a glimpse into how I address /R/ sound difficulties, with a focus on tongue placement:

      • Visual aids:
        • Mirrors: I use a mirror to help children see their tongue movements and make adjustments.
        • Tongue diagrams and models: These visual tools provide a clear representation of where the tongue should be positioned.
      • Tactile cues:
        • Tongue depressors: These can be used to gently guide the tongue into the correct position.
        • Food-grade tools: Sometimes, I use flavoured tongue depressors or other tools to provide tactile feedback and increase awareness of tongue placement.
      • Auditory discrimination:
        • I help children distinguish between correct and incorrect /R/ sounds.
        • I use auditory cues and verbal feedback to reinforce proper pronunciation.
      • Exercises and drills:
        • Tongue strengthening exercises: Strengthening the tongue muscles can improve control and coordination.
        • Tongue placement drills: We practise positioning the tongue in the desired location and holding it there.
        • Sound approximation techniques: Sometimes we use other sounds to help approximate the /R/ sound. For example, I use the /L/ sound, to help achieve the correct tongue placement. Once my child has found the /L/ sound it is then a matter of pulling back just slightly to get a good /R/.
      • Contextual practice:
        • Once the child can produce the /R/ sound in isolation, we gradually introduce it into syllables, words, phrases, and sentences.
        • We also practise the /R/ sound in different contexts, such as at the beginning, middle, and end of words.

      Tips for Parents:

      • Be patient and supportive: Learning the /R/ sound takes time and practice.
      • Practise regularly: Short, frequent practice sessions are more effective than long, infrequent ones.
      • Make it fun! Use games, stories, and other engaging activities to keep your child motivated.
      • Work with an SLT: A qualified SLT can provide personalised guidance and support.

      In conclusion:

      The /R/ sound can be challenging, but with targeted speech therapy and a focus on tongue placement, most children can achieve clear and accurate pronunciation.

      I hope this blog post is helpful!

      Get in touch with me via my contact form if you need support

      Sonja McGeachie

      Early Intervention Speech and Language Therapist

      Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

      The London Speech and Feeding Practice

      Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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