Q: My child has a lisp and he is really bothered by it as his classmates are making fun of his speech. He has been in speech therapy for years, but it doesn’t seem to help. Someone said that it could mean that my child has incorrect swallow patterns. Could that be why speech therapy doesn’t seem to help?
A: A lisp is difficulty saying certain letter sounds, most commonly /s,z/, but it can also affect the way /ch, sh/ are produced. The “wet or slushy” sound during production of these speech sounds comes from incorrect placement of the tongue. The tongue may stick out between the front teeth or on the sides. Children who have difficulty producing these sounds correctly often produce incorrect swallow patterns.
Because traditional speech therapy did not seem to work for your son, correcting the lisp is dependent on correcting the swallow patterns. Because you swallow between 500 and 1000 times per day and swallowing involves muscle memory, your child could be practicing “incorrect” tongue patterns every time he swallows. Therapy for correcting a lisp must include teaching your child what part of the mouth is used for correct swallowing as well as for correct production of speech sounds.
The first thing you should do (especially given the fact that he is being teased by his peers) is contact a speech pathologist who also specializes in feeding/swallowing difficulties. An evaluation should include a detailed history, examination of your child’s anatomy and function during speech and swallowing and ruling out possible contributing factors such as allergies, sinus issues, tongue tie, tongue thrust, and reflux. A plan of action will be based on your child’s individual needs.
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Other things to do:
- Discontinue any pacifier, finger- or thumb-sucking habits.
- Discontinue using a bottle or sippy cup.
- Use an open cup or a straw with correct placement (straw placed between lips and teeth). Straw drinking promotes good oral motor strength that is important for speech development.
Seeking the help of a speech pathologist with expertise in pediatric feeding/dysphagia will start the process to clearer, more understandable speech and should reduce the attention that your son is getting for producing incorrect speech sounds. For your child, addressing the swallow patterns and speech patterns together will hopefully ensure faster progress. Using correct tongue patterns for swallowing may also reduce the need for expensive dental work or braces.
Joan Dietrich Comrie of Carolina Pediatric Dysphagia (feeding.com, 919-877-9800) has dedicated her entire career to studying, teaching and practicing in the area of dysphagia, specifically pediatric dysphagia.