Help! My child has a lisp. What can we do about it?

ByLondon Speech and Feeding

What is a LISP?

There are different types of LISPS. Let me explain:

A lisp is the difficulty making a clear ‘S’ and ‘Z’. Other sounds can also be affected by the tongue protruding too far forward and touching the upper teeth or the upper lip even. ‘T’ and ‘D’ can be produced with ‘too much tongue at the front’ and this can also have an impact on ‘CH’ and often also ‘SH’.

  1. Interdental lisp

Protruding the tongue between the front teeth while attempting ‘S’ or ‘Z’ is referred to as interdental lisp; it can make the speech sound ‘muffled’ or ‘hissy’. Often, we associate a lisp with the person sounding a bit immature. The good news is that this type of lisp is the easiest to correct and, in my practice. I have a 100% success rate with this type of lisp.

  1. Lateral lisp

In a lateral lisp the person produces the ‘S’ and ‘Z’ sounds with the air escaping over the sides of the tongue. This renders the ‘S’ as sounding ‘slushy’ or ‘wet’. This type of lisp is a bit harder to correct than the interdental lisp. In my experience this can be fixed but it might need a bit longer, more intensive therapy than the interdental lisp.

  1. Palatal lisp

With a palatal lisp the ‘S’ sound is attempted with the tongue touching the palate, much further back than it should be. The ‘S’ sounds ‘windy’ and ‘hissy’. This is a quite rare lisp production but it is also not difficult to correct.

These types of speech difficulties come under the category of ‘speech delay of unknown origin’ and may persist into adolescence and adulthood as ‘residual errors‘.

Some thoughts on Treatment in general:

Lisps can be treated successfully by a Speech and Language Therapist. However, for the treatment to work well, a student needs to be able to cooperate and want to improve his or her speech. Lisp remediation entails a fair amount of repetitive work and very young children or unmotivated older children don’t make the best candidates for treatment for this reason. Often students present with other speech, language or social communication difficulties and here the lisp might not be the priority for treating. For example, it might be that due to a student’s Attention Deficit Disorder they are simply not able to focus on speech practice in their daily life.

When should treatment of lisp begin?

Waiting well past 4½ years is not advisable as the longer we wait and do nothing the stronger engrained the erroneous tongue/speech habit will become. The ‘right’ age for therapy for one child may be different from the ‘right’ age for another child even within the same family. So do make an appointment with a speech and language therapist to assess and see whether your child might be ready to start therapy.

Do lots of children lisp—is it normal?

Until the age of about 4–4.5 years old it can be a perfectly normal developmental phase for some children to have the interdental lisp. But when we see and hear a lateral or palatal lisp we ought to act and see a speech and language therapist for sure.

After the age of 4.5 or 5 years old most speech therapists would agree on at least having a look to see if treatment could be started. The longer we wait the harder it is to retrain the brain pathways to adopt new speech habits.

What happens during the first Speech and Language Consultation?

The first consultation takes about an hour and involves screening relevant areas of communicative function. We take a detailed history, examine the anatomy of the child’s mouth and tongue movements. We check for tongue tie, teeth formation, palate structure and function, as well as swallowing patterns.

Then we begin straight away to try and see if any of the alveolar sounds (T/D/L/N) can be produced correctly with the right tongue placement as that would be the starting point from where to shape a good, clear ‘S’ sound.

The first consultation usually ends with home practice being given, explained to parents and another appointment being made for follow up.

Therapy – what does a session look like?

Each therapy session consists of:

  1. Listening to sounds, discriminating sounds, identifying sounds, listening to rhyming sounds, sound awareness. We call this Auditory discrimination of single sounds: can the student hear the difference between two words that are the same apart from the first sound: ‘sing’ and ‘thing’ or ‘sigh’ and ‘thigh’?
  2. Sound production: using a variety of different prompts and cues we will teach how to physically make the new sound. Often, we work on making a NEW sound, instead of correcting the OLD one. We work on imitation of single sounds then gradually we try and make new sounds in short words, then longer words and then phrases and sentences.
  3. Games! We play games and try and have fun in between listening and producing our new sounds to help students stay motivated and even enjoy the therapy session and process.

How long does it take to ‘fix up’ a lisp?

It tends to take about one term with weekly sessions to help a student make good ‘S’ sounds in phrases and sentences. If the student can do the home practice every day in between the weekly sessions, then in most cases I am able to pronounce the lisp as ‘fixed’ after about one term.

After that the student needs to practise, practise, practise, at home and in daily life to keep reminding themselves of their new skills and their new sound production.

It is a matter of reminding and wanting to get it right. Occasionally a student returns to me for another term of simply practising their skills together with me as they are finding it hard for any number of reasons to practise at home. But generally, 8/10 students will be fine after some 12–13 sessions and their speech will be perceived as perfectly typical by family and friends.

If your child has a lisp or any other speech error, 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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    ByLondon Speech and Feeding
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    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.

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    How do we know our Gestalt Learner is moving to Stage 2?

    ByLondon Speech and Feeding
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    Is our student ready to move to NLA 2 (Natural Language Acquisition stage 2)?

    We know that the GLP (Gestalt Language Processor) will move into the next stage when they are ready. But are they now ready you might think? When are they ready? How do I know? If you are not sure whether your child is ready to move forward then go and see your GLP trained Speech Therapist. Together you can work out what the next steps are and how to help your child settle into NLA 2. It’s very exciting!!

    Tip

    The first useful tip: keep a language sample of phrases your child says. This is very helpful!

    You might want to check with your Speech Therapist and offer some language sampling you have taken so they can help you figure out where your child is currently. Always keep an Utterance Journal that you can share with your Speech Therapist and with others who look after your child.

    Basically, we want to listen out for phrases our child says that you or nursery don’t say routinely; that way you can presume that this is not an echo but a mixing together of two chunks of gestalts. Watch out for those coco melon phrases though: double check it really isn’t an NLA 1 gestalt that is copied verbatim from a favourite you tube video.

    You can best support your child best by listening, and thus figuring out what your child is TRYING TO SAY. Often your child might skip over the parts of gestalts they don’t want to say. This is common in older kids who have long gestalts, sometimes even whole episodes or whole stories!

    Try and tease out their shorter mitigations and then focus on practicing and modelling those as they are so much more useful!

    So back to our question: are they ready?

    Are their gestalts covering a variety of situations and contexts?

    Make a note in your journal to see what the backgrounds are to each phrase you ear, so for example:

    • Transitioning: ‘it’s time for the park’ ‘what’s next’ ‘shoes on’
    • Bed Time: ‘we need to wash’ ‘let’s get in (bath/bed)’ ‘ready for our book’
    • Toilet/nappy: ‘we need the potty’ ‘where’s the potty’ ‘let’s wash hands’
    • Mealtime: ‘time to eat’ ‘go get a spoon’ ‘yummy num num’
    • Park/going out: ‘look at the squirrel’ ‘funny doggy’ ‘I wanna swing’
    • At the shops: ‘let’s get the trolley’ ‘lots of veggies’ ‘no tomatoes’ ‘ooh long queue’ ‘back to the car’

    And… does the child use the phrases for a variety of functions?

    • labelling
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    • calling out
    • affirming
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    We need to offer lots of similar language models so that in their own time our children can extract/mitigate useful phrases for what they want to express. The more similar utterances a child hears around him the more he/she can discover the communalities. Once the child has a small range of phrases, he/she can mix them up and create semi-original own phrases.

    If the answer is YES!! our child has perhaps not all but a range of functions and a range of situations where they use a variety of easily mitigable gestalts then yes they are ready for moving to stage 2 of NLA!

    Hurrah!

    Keeping a journal of what your child is saying and in what circumstance is crucial to help with our ongoing detective work!

    Next time I will be looking at how we can help our NLA 2 GLP produce even more of their own mix and match phrases.

    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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  • Why imitation is a powerful strategy to support social communication

    ByLondon Speech and Feeding

    Before reading this blog, it’s important to understand what we mean by ‘social communication’ and ‘imitation’. Social communication is more complex than it first appears. It refers to many aspects of communication such as body language, voice, conversational skills, social ‘rules’ (such as being polite and using manners), interpersonal skills (such as developing friendships), and emotional literacy (such as appropriacy and developing self-awareness). Imitation refers to the simple act of copying.

    You may have noticed that your child has difficulties in some of the areas mentioned above. They might be less responsive to you and appear to be quite happy in their own world. Whilst we do not want to change their unique characteristics, we do need to prepare them for future experiences, and what is socially acceptable.

    How will copying my child develop their social communication?

    1. If your child is already engaged with a certain activity, they are already interested and motivated. You’re not competing for their attention.
    2. Both yours and your child’s attention is on the same activity which makes imitating for you (as the parent) easier.
    3. Studies have demonstrated that when a parent imitates a child, they are more likely to look at the adult.
    4. Imitation not only supports eye contact but supports facial expressions (such as smiling), may increase vocalisations, and encourages your child to sit closer to you.
    5. Children learn through trial and error. They may start to try to perform new actions to gain their parents attention. Let your child lead the play!!

    How do I start imitating my child?

    1. Start with observing them. Take the time just to watch. You don’t need to make notes. Sit back and observe their actions, movements, and sounds they make.
    2. Wait for your child’s reaction when they realise you are copying their actions. Remember they may not notice, you don’t need to remind them, simply copy them again.
    3. Having the same set up as your child allows them to feel in control. So, you may have two sets of the same activity rather than copying using their set of toys.

    This may sound daunting, but it doesn’t have to be. Start with a ten-minute time frame where you choose to copy your child. This is where you can practise your imitation strategy. Ten minutes a day is far more effective than an hour every two weeks. You may feel self-conscious but trust the process. Build your confidence, whilst exposing your child’s to increased language and communication, enabling them to develop vital social communication skills.

    Look at the video above to watch the strategy in action!

    Support is only a click away. I’m here to help.

    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 role of spinning and swinging in speech and language therapy

    ByLondon Speech and Feeding
    Sonja with a child on a swinging with a stuffed monkey

    Spinning and swinging are often observed behaviours in autistic children. While these actions might seem repetitive or unusual to some, they serve crucial functions for these children. Understanding the underlying reasons for spinning and swinging can provide valuable insights into how to support autistic children and incorporate these activities into therapeutic settings.

    Why do children spin?

    Spinning is a common sensory-seeking activity in autistic children. Sensory seeking means that the child actively looks for sensory input to regulate their nervous system. Here’s why spinning can be beneficial:

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    • Calming effect: For some children, spinning can be a self-regulating strategy. The rhythmic motion can help to calm the nervous system and reduce anxiety.
    • Sensory exploration: Spinning allows children to explore their sensory experiences. It can help them understand their bodies and how they move in space.

    The allure of swinging

    The rhythmic back-and-forth motion of a swing offers several benefits:

    • Vestibular input: Like spinning, swinging stimulates the vestibular system, helping to improve balance and coordination.
    • Proprioceptive input: Swinging provides proprioceptive input, which is the sense of where your body is in space. This information is crucial for motor planning and coordination.
    • Calming and organising: The rhythmic motion of swinging can have a calming effect on the nervous system, helping to regulate emotions and improve focus.
    • Social interaction: Swinging can be a shared experience, fostering social interaction and communication.
    • Facilitating communication: While swinging, children are so much more relaxed and open to communication. The rhythmic motion can also help facilitate singing, humming, listening to my singing, non-verbal communication for sure but also more verbal and mouth words can be heard from children on my swing. If nothing else, it is so fun and helps build trust and rapport between my child and me.

    Therapeutic Activities Combining Spinning, Swinging, and Speech and Language Therapy

    Here are some therapeutic techniques that I use at London Speech and Feeding to combine movement with speech and language development:

    • Swinging with verbal prompts: While the child is swinging, I provide simple verbal prompts such as ‘up’, ‘down’, ‘fast’, and ‘slow.’ This helps to develop receptive language skills and improve auditory processing.
    • Sensory-motor play: I like to combine swinging with tactile activities like playing with textured balls or bean bags. This can facilitate language development through descriptive language, words and scripts like: ‘that’s so soft’, ‘oooh tickle tickle tickle!’
    • Storytelling on the swing: Often I manage to create a story while the child is swinging. This can improve narrative skills, vocabulary, and imagination. Recently I did the ‘Tiger who came to tea’ story and each time the swing stopped the tiger came and ‘ate some more cakes’ and ‘tickled their tummy’ whilst eating. It may make not much sense but my child loved it and we had ‘more tiger eat more’.
    • Song and rhyme time: Often I sing the ‘rumble in the jungle’ song while swinging my child to enhance phonological awareness, rhythm, and timing.
    • Visual supports always help: I use LAMP Words for Life AAC support during swinging and show core words such as: ‘go’ / ‘stop’/ ‘more’ / ‘tickle tickle’ etc. #lampwordsforlife #aac
    • Movement-based activities: We can incorporate activities that require sequencing, such as imitating animal movements or following simple commands while swinging. This can improve motor planning and language comprehension.

    For more information follow me on Instagram, Facebook or LinkedIn.

    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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  • ·

    Four struggles parents face when out and about with children with speech, language, and communication difficulties

    ByLondon Speech and Feeding
    A man and a woman hug a young girl at a table
    Hug

    You (as parents) often describe yourselves as being under constant pressure and stress when looking after your children and young people with Special Educational Needs and Disabilities (SEND). You may find going out to do the simplest of tasks a challenge. And you will try to avoid social situations out of fear and anxiety. One of the most important factors to you is having like-minded people who understand your position as a parent with a young person with additional needs. Let’s look at some of the challenges you face and how I can support you and your family.

    1. Challenging behaviour and going out to the shops

    When your child displays challenging behaviour and won’t go into a shop without buying a toy that they insist on having, it can be tough on your family. You see people around you staring as you try to manage the situation. They do not understand the pressures you face, or that the simplest of tasks are a huge challenge.

    I can support you by giving strategies to use when out and about. I know that using visuals is important for your child. They may not understand or take in language when they are in a heightened state of anxiety or feeling overwhelmed. You could print pictures of the places you’re going to and put them on an easily accessible chain. Then you could use that chain when out and about at the shops. You may want to introduce a visual timetable at home. That way your child or young person understands where they are going. This may lessen their anxiety and subsequent behaviour.

    2. Your child is not able to communicate their needs to an unfamiliar communication partner

    When your child has difficulty communicating to an unfamiliar person it can be hard to manage. You feel yourself explaining your situation repeatedly. I can provide your child with individualised strategies or communication aids which support your child to communicate with both familiar and unfamiliar communication partners. We’ll work together to find which communication methods work in different situations and how your child will use these to help their independence.

    3. Being overwhelmed

    Your child or young person may easily be overwhelmed which may contribute to behaviour changes. I’ll work with your family to understand what the behaviour means, looking at what happened before and what happened afterwards. We’ll not only look at the behaviour but at the environment as well. This can inform how you can support your child or young person in the future, to reduce sensory stimuli (if needed) and for them to feel emotionally regulated.

    4. People avoid engaging with you

    One of the hardest things as a parent is for others to avoid you. You see them crossing the street because they don’t know what to say to you. All you want is them to accept you, to maintain your identity as a person and not as a SEND parent. I can support you emotionally. I can give you advice on local support networks where you can find other parents in a similar situation.

    We know the stresses that being a parent with a child with SEND comes with. Please know I am always here to support you, to find solutions so that when you’re next out and about. Your experience will be a little easier and you’ll feel less isolated.

    Improve your child’s communication, confidence, reduce overwhelm and feel supported here.

    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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    Autism – Benefits of Early Assessment and Intervention

    ByLondon Speech and Feeding
    I think my child might be autistic – how can we help?
    Image by macrovector on Freepik

    Consulting a Specialist Speech and Language Therapist can help you in several ways: assessment, informal and formal observation, discussion and advice, onward referrals, direct intervention, parent coaching, educational support and much more, all geared towards supporting you the parents, and helping your child to flourish and thrive.

    First up, we can help you with assessment and advice: with a wealth of expertise in observing childrens’ play and communication, as well as knowledge of the latest research we can see a child’s strengths and areas of struggle very quickly indeed.

    Within a short space of time, we can identify the areas we need to focus on and start guiding you towards helping your child to connect, respond, react and feel better.

    Early detection is key

    If autism is detected in infancy, then therapy can take full advantage of the brain’s plasticity. It is hard to diagnose Autism before 18 months but there are early signs we know to look out for. Let’s have a brief look at the sorts of things we look at.

    The earliest signs of Autism involve more of an absence of typical behaviours and not the presence of atypical ones.

    • Often the earliest signs are that a baby is very quiet and undemanding. Some babies don’t respond to being cuddled or spoken to. Baby is being described as a ‘good baby, so quiet, no trouble at all’.
    • Baby is very object focused: he/she may look for long periods of time at a red spot/twinkly item further away, at the corner of the room for example.
    • Baby does not make eye contact: we can often see that a baby looks at your glasses for example instead of ‘connecting’ with your eyes.
    • At around 4 months we should see a baby copying adults’ facial expressions and some body movements, gestures and then increasingly cooing sounds we make; babies who were later diagnosed with autism were not seen to be doing this.
    • Baby does not respond with smiles by about 6 months.
    • By about 9 months, baby does not share sounds in a back-and-forth fashion.
    • By about 12 months baby does not respond/turn their heads when their name is called.
    • By around 16 months we have no spoken words; perhaps we hear sounds that sound like ‘speech’ but we cannot make out what the sounds are.
    • By about 24 months we see no meaningful two-word combinations that are self-generated by the toddler. We might see some copying of single words.

    24 months plus:

    • Our child is not interested in other children or people and seems unaware of others in the same room/play area.
    • Our child prefers to play alone, and dislikes being touched, held or cuddled.
    • He/she does not share an interest or draw attention to their own achievements e.g., ‘daddy look I got a dog’.
    • We can see our child not being aware that others are talking to them.
    • We see very little creative pretend play.
    • In the nursery our child might be rough with other children, pushing, pinching or scratching, biting sometimes; or our child might simply not interact with others and be unable to sit in a circle when asked to.

    What sort of speech and language difficulties might we see?

    Our child might do any of the following:

    • have no speech at all, but uses body movements to request things, takes adults by the hand
    • repeat the same word or phrase over and over; sometimes straight away after we have said it or sometimes hours later
    • repeat phrases and songs from adverts or videos, nursery rhymes or what dad says every day when he gets back from work etc.
    • copy our way of intonation
    • not understand questions – and respond by repeating the question just asked:
      • adult: Do you want apple? child: do you want apple?
    • not understand directions or only high frequency directions in daily life
    • avoid eye contact or sometimes ‘stares’
    • lack of pointing or other gestures

    Common behaviours:

    • Hand flapping
    • Rocking back-and-forth
    • Finger flicking or wriggling/moving
    • Lining up items/toys
    • Wheel spinning, spinning around self
    • Flicking lights on and off, or other switches
    • Running back-and-forth in the room, needing to touch each wall/door
    • Loud screaming when excited
    • Bashing ears when frustrated or excited
    • Atypical postures or walking, tip toeing, can be falling over easily, uncoordinated
    • Can be hyper sensitive to noises, smells, textures, foods, clothing, hair cutting, washing etc.
    • Being rigid and inflexible, needing to stick to routines, unable to transition into new environments
    • Food sensitivity, food avoidance, food phobias

    I mentioned this to be a ‘brief’ look at the areas and it is: each topic is looked at very deeply and each area is multi-facetted therefore a diagnosis is rarely arrived at very quickly. We want to make sure we have covered all aspects and have got to know your child very well before coming to conclusions.

    Early detection is key, because we want to start helping your child to make progress as quickly as is possible. If you feel /know that your child is delayed in their speech and language development and you would like a professional opinion then please do contact me, I look forward to supporting you. It is important to know at this point, that if your child only has one or two of the above aspects it may mean that your child is simply delayed for reasons other than Autism and if that is the case, we will be able to help you iron out a few areas of need so that your child can go on thriving.

    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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