Parent Question: My four year old has a lisp. Help!

Parents have a lot of questions when it comes to speech and language development and don't always have a reliable place to get an answer. On this blog, I'll post some of the most common questions I get and ideas on what to do. Send me your questions to mlachman.speech@gmail.com.

Q: I have a four year old boy who's name is Sam. When he says his name or any other word with an 's' in it, he makes the 's' sound as a 'th' sound. So if people ask him his name he says "Tham." I think my son has a lisp. Help!

A: I know lots of parents who have brought up this very concern. In fact, both of my kids did the same thing. My son even stopped at age 5 and then started back up again about six months later.

The type of lisp this parent is describing is called a "frontal lisp" (or interdental lisp). That's when a person has difficulty producing the 's' or 'z' sound because of their tongue placement. The tongue may stick out between the teeth a bit which results in a sound distortion.

In children Sam's age a frontal lisp is considered developmental and speech language therapists may not suggest therapy. Developmental norm data suggests that a frontal lisp may even occur until age 7 or 8. What is important to remember is that a young child with a frontal lisp will not have any difficulty communicating and should not become frustrated. In Sam's case, his parent may not choose to wait until 7 or 8 if the lisp does not eliminate on its own. But only because Sam's name is "Sam" and the sound distortion might eventually become noticeable (and not as cute) to adults and peers.

If Sam still does not outgrow his lisp around age 5 or 6 therapy may be recommended. Here is what I might suggest:

- Therapy once a week (for 1 month) to teach proper placement and train parents in beneficial activities at home for carryover
- 1 therapy session per month for the next 2-3 months to make sure proper placement has carried over and the child is able to make the proper sound independently
- Teach the child to bite down, and blow air through his teeth with a gentle smile
- Teach the child to keep their snake (tongue) in its house (mouth)
- Encourage parents to make activities targeting the sound fun
- Suggest books that focus on the 's' sound like Sid and Sam by Nola Buck and Silly Sally by Audry Wood
- Encourage confident communication

Of note: A lateral lisp may sound similar but occurs when air escapes over the sides of the tongue (not the front of the tongue like a "frontal" lisp). A lateral lisp can sound "wet" and "slushy" due to saliva. This type of lisp is not developmental. Parents should consult with a speech language therapist if their child sound like they have a lateral lisp. Therapy could begin as early as 4 years of age.

Michelle Lachman
Schedule your free consultation today: 1.408.365.4423 / mlachman.speech@gmail.com