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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A Day In The Life Of An Independent Speech And Language Therapist

A Day In The Life Of An Independent Speech And Language Therapist

ByLondon Speech and Feeding
A Day In The Life Of An Independent Speech And Language Therapist

A Day In The Life Of An Independent Speech And Language Therapist

I often get asked how many clients/children I see per working day or what my working day/life looks like. I always reply that every day is different, which is true, but there is a sort of average working day which looks a bit like this:

I usually start preparing for my first client of the day at around 9.30 am: I clean the room, wipe down all the toys and materials (that’s if they are coming to my clinic room) and then it takes me about 30 minutes to select and sometimes make suitable materials, games and activities for the child’s therapy programme. Client arrives at 10.30 am and the fun begins. They leave around 11.30am, and the cleaning and wiping down starts again – yes it’s the pandemic but to be fair I would do this anyway. I quickly write up my notes and send home work to the client via email. Now it’s 12 noon and I start preparing for the next client at 12.30 pm. This might be online parent-child interaction coaching and so I need different materials and activities that are suitable for teletherapy. We finish around 1.30 pm and I will write up my notes before having some lunch.

Lunch tends to not be around 30 minutes. Around 2.00 pm I start prepping again for the next client: selecting activities, going over their last session, making sure I have everything I need to start at 2.45pm – we finish at 3.45pm, I write up my notes and then have a cuppa. The next client might be more on-line coaching or a child coming to see me: room cleaned and tidy, materials and activities prepared: client arrives at 4.30 pm and we finish at 5.30 pm. I clean the toys again, write up my notes and it is 6.00 pm ready for dinner. So that was four clients between 9 am and 6pm allowing for preparation, aftercare, cleaning and coffee and lunch.

Other days I might see three clients and do more admin like ordering toys or books or teletherapy activities, or making materials (we therapist make tons of materials, we’d put Blue Peter to shame!) Sometimes I do two home visits, one in the morning and one in the afternoon – the travelling/parking in London is so time consuming that it really reduces the number of clients I can see which is why I don’t do many of those.

I hand pick my clients to make sure that we are a good fit, and my service is bespoke: no one client gets the same treatment as another; each client is unique, usually very well-known and always highly valued. That takes time and means that in reality each client gets about 2 hours of my time, that is the actual session plus all the preparation and aftercare.

I love this way of working and would not ever want to return to seeing tons of clients each day, not knowing any of them really well, due to high caseload numbers, staff shortages and an overload of administration.

My way of working affords all my lovely clients the help they need to be able to feel empowered and to then support their children to make progress; when working with children they make the best progress they can make, fulfilling their potential. My lovely reviews and testimonials tell me that my clients appreciate the extra attention.

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.

Four reasons to continue Speech and Language Therapy during the summer
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Four reasons to continue Speech and Language Therapy during the summer

ByLondon Speech and Feeding

The summer holidays can be tricky for parents as there is so much to do: organising childcare, the actual holiday, and trying to have some all-important ‘me time’. Speech therapy for your little one might be the last thing on your mind. But …. If we can prioritise only a small amount of time every day then we are maximising time and finances spent thus far and can continue your child’s Speech and Language Therapy sessions throughout the summer, no problem. Have a look at this blog. We’ll take you through good reasons why you shouldn’t ignore Speech and Language Therapy sessions this summer.

1. Building communication skills takes time

You’ve worked so hard throughout the year to support your child’s speech, language and communication. Now is the time to continue, not to stop! You will watch your child’s communication and confidence grow and flourish over the next couple of months. All the different experiences your child will have on holiday or just even pootling about in your local park with you, or granny/nanny will help expand their capacity for learning and using language and words to communicate with you. If you have time during the summer, you can embed the skills your child has learnt into everyday life which is vital . If in doubt ask how you can use the strategies you have learned in any new environment. Together we can workshop all eventualities and make them fun and doable. There is no end of fun and opportunities with a bucket, spade and a bit of sand!

2. Getting to know your child’s Speech and Language Therapist is vital

Here’s a plug for regular therapy sessions: building a rapport with your child’s Speech and Language Therapist is key. If our sessions together are consistent and regular, then it will be so easy for us to develop a good rapport with your little one. Trust is key. So if sessions are infrequent and irregular it is hard for your child to build up trust with their therapist and it is hard for the therapist also to get you know your child and tailor the sessions so that they really work very well. We need to know what your child loves and what activities or toys work well; so, if sessions are missed and irregular then the process just takes longer.

3. Goals are set and measured

Sometimes a break is needed and that’s fine. We measure goals within a certain time frame and whilst a few weeks holiday are great for everyone, we don’t want to lose any progress your child has made. If a child does not attend sessions, progress will often diminish as consistency in therapy is key!

4. You’ll be able to embed skills over the summer at home

Did you know you can access Speech and Language Therapy wherever you are with our remote service? Teletherapy allows flexibility which means your child’s sessions can be wherever you are. Whilst this isn’t for everyone, it does allow regular sessions to continue. If that does not work for you then let’s talk about how we can help you transfer all the therapy goals into your holiday. You will be surprised how easy it is: lots of goals can be worked into snack times for example or bath times. You will have those wherever you are so this won’t take away your holiday fun, promise!

Find out more about teletherapy.

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?
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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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Teletherapy: A fun and convenient way to help your child master those sounds!

Teletherapy: A fun and convenient way to help your child master those sounds!

ByLondon Speech and Feeding

It can be hard to get your child to come to the clinic on a weekly basis to work on those tricky sounds. Perhaps the car isn’t working, you have had a lot on, or our student has a bit of a cold but is still able to do a little bit of sound practice?

The good news is that Teletherapy can be a fantastic option to continue your child’s speech journey from the comfort of your own home!

Even when your wifi is not working and your laptop is broken, as you can see on this clip I was able to stretch into running the session on WhatsApp video, but that is less then ideal I will say.

What is Teletherapy?

Teletherapy is speech therapy delivered virtually, through a secure video platform. I use Zoom for example, but I have also used WhatsApp Video Call on occasions where parents’ zoom was not working.

When is Teletherapy perfect?

Here’s why teletherapy can be a great fit for helping your child solidify those learned sounds:

  • Basic sound patterns have been established in clinic: Your child is now able to say those tricky sounds BUT they are not saying them in daily life yet; they are not ‘generalising’ those new sounds into the normal speech.
  • You just can’t make it today: No more fighting traffic or fitting appointments into busy schedules. Teletherapy sessions happen at home, on your time. Sometimes even in the attic or the garden shed as in my video clip here ????
  • Your child is about 7 years old or older and is motivated to work on their sounds: I use fun and interactive online tools and games to keep your child engaged during practice sessions. Due to having done teletherapy over the Covid period I have amassed lots of great games and know-how in this area. Our student needs to be mature enough to be able to sit in front of the laptop camera and participate with a minimum of adult help.
  • Your child loves gaming and is best motivated through online games: Sometimes children are best motivated when playing online games in between speech sound/language activities; in this case teletherapy is totally perfect.
  • Focus on Carryover: The familiar environment of your home can actually be an advantage! I can guide my student on practising sounds in everyday situations, like reading a book together or playing with toys, sometimes even talking to their sibling or a.n.other in the room.
  • Parental Involvement: Teletherapy allows you to be directly involved in the sessions just in same way as when I see your child in my clinic. You can learn strategies and techniques from me to continue practising with your child throughout the day. You can also make a note of the online games I have and then use them in your home sessions.

What to Expect During a Teletherapy Session

  • Initial Consultation: We start with a brief chat on how the week has gone, what gains have been made with the home exercises and we settle the student into a good learning mode; sometimes I start off with a very quick game just to set the scene.
  • Working on generalising: When asking my student about how their week has been I will remind them to remember their new sounds and to try and produce them whilst talking to me. This is already the start of therapy.
  • Practising target sounds: We practice our target sounds in different contexts, using games, visuals, and activities.
  • The teletherapy session lasts the same amount of time as do 1:1 sessions, unless I see that a child becomes very fidgety and we are not able to hold out much longer, I will cut short the session and focus on increased home practice.
  • Home Practice: Just like in 1:1 clinic sessions, I will provide you with easy-to-follow tips and activities to continue practising sounds throughout the week.

Getting Started with Teletherapy

  • Technology Check: Ensure you have a reliable internet connection and a device with a camera and microphone.
  • What device is best: Ideally the student needs to be on a laptop or PC because that way the student can actively engage with their mouse, moving game pieces, or participating in online activities using their mouse. Tablets are ok but do not allow active participation of the student as described above. However once in a while we can make it work and I do have some games and activities that do not rely on student participation.

Finally, I would say that Teletherapy is a safe, fun and effective way to continue your child’s speech therapy journey. It’s convenient, engaging, and it is perfect on a rainy day when you don’t want to or can’t come out to bring your child to clinic.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

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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Succeed with lisps at London Speech and Feeding
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Succeed with lisps at London Speech and Feeding

ByLondon Speech and Feeding
A child is on the right-hand side, touching their lips and holding a mirror. They're facing an adult on the left hand side, also holding their hand to their lisps.
Mirror game

You may notice that your child or young person finds certain sounds difficult to produce. With a lisp, the sounds /s/ and /z/ are more problematic. You may notice that your child’s speech is affecting their confidence. They are quiet, and the teacher reports they don’t engage in classroom conversations. You feel it’s impacting on their social and emotional wellbeing. The good news is that with the support of a Speech and Language Therapist and the determination and motivation of your child, we can treat a lisp can.

You feel you have so many questions and you don’t know where to begin. Let’s start by answering some of the most frequently asked questions.

1. Is it normal for my child to have a lisp?

It’s important to remember that we can expect a lisp in a child up until four and a half years of age.

2. Can I do anything for my child’s lisp?

The best approach you can take is to provide a good model. You can show the correct sound and you can talk about where in the mouth your tongue or lips are. Your Speech and Language Therapist can recommend you on what you can say.

3. Should I wait to see if my child’s lisp resolves on its own?

As always, early intervention is advised as producing sounds as a lisp can be more ingrained the longer your child waits for therapy. It is true that some children’s lisps resolve on their own.

Therapy depends on many factors, one of which is deciding on whether your child is ready for therapy. It’s best to seek advice from a qualified Speech and Language Therapist about whether your child is ready for therapy. It takes motivation, determination, and practice.

4. What should I expect from a Speech and Language Therapist when they see my child?

Your Speech and Language Therapist will ask you as parents and carers about your child’s history. This is because they’ll want to confirm it is a lisp and no other areas of communication are affected. They may ask your child about the impact of their lisp on them (if your child is aware of their speech difficulty).

They will then assess your child using a speech assessment. Your Speech and Language Therapist will confirm their findings and will put a plan in place with you.

5. How will my child’s therapist fix my child’s lisp?

  • The start to fixing any sound is looking at discrimination between the sound your child is making vs the correct sound. Can your child hear the sound they should be making?
  • Your therapist may still get your child to discriminate two sounds. They will begin to work on the sound in isolation, so saying the child’s tricky sound by itself (e.g., /s/)
  • Then they will ask your child to say their tricky sound with a vowel, with a breath between the consonant and the vowel (e.g., s-oo, s-ow, s-ee, s-aa, s-ai)
  • Your child will then remove the gap between (e.g., soo, sow, see, saa, sai)
  • Your child will then be ready to move onto consonant-vowel-consonant words (e.g., sat, sit, seen, sown)
  • Your child’s therapist will tell that the next step is to produce sentences using your child’s tricky sound, /s/ in this example (e.g., Simon says silly sausages)
  • Your child is working towards generalising their ability but there are a few steps before this happens
  • Choose a context where your child can practise their talking, focusing on one sound (e.g., during 10 minutes of special time). This is an ideal environment as you can create opportunities for your child.
  • The next stage is saying the sounds correctly in general conversation
  • You’ll want your child to be less reliant on you for modelling the sound, so you’ll want to start to phase this out
  • It’s important for your child to self-correct and self-monitor. Encouraging this is the final stage to correcting your child’s lisp.

You and your child will need to be motivated, as it’s true: practice makes perfect!

For support on speech sound difficulties, feel free 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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Help! My child has a lisp. What can we do about it?

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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