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Sunday, April 3, 2011

ELICITING SOUNDS- /s/-Lateral Lisp

Good Morning! Today’s post is brought to you by Kleenex. Not really, but with spring allergies invading my head, tissues are close at hand. With itchy, watery eyes and a grand swipe of my nose I bring you tips and tricks for correcting the Lateral Lisp. (It’s ok if you feel the overwhelming need to spray your computer screen with Lysol about now.)

Most of you seasoned therapists know and use the techniques that I am going to share, so I apologize if you are disappointed that there’s nothing new for you. However, those who have less experience under their belts and feel frustrated with the lateral lisp will appreciate these “pearls of wisdom.”

What is a Lateral Lisp?

According to Carolyn Bowen, “Lateral lisps are not found in typical speech development. The tongue position for a lateral lisp is very close to the normal position for /l/ and the sound is made with the air-flow directed over the sides of the tongue. Because of the way it sounds, this sort of lisp is sometimes referred to as a 'slushy ess' or a 'slushy lisp.’ A lateral lisp often sounds 'wet' or 'spitty.'

Unlike interdental and dentalized lisps, lateral lisps are not characteristic of normal development. An SLP assessment is indicated for anyone with a lateral lisp.” (direct quote from her website) Since a lateral lisp is not developmental, you do not delay therapy until the child is older. You would address it as soon as it is identified according to Dr. Lonnie Harris.

Treatment Techniques

As the old adage goes, there is more than one way to skin a cat and I’m going to share some proven strategies and even some unorthodox methods that have worked for me. Yeah, I’ve always been a rebel of a therapist.

The number 1 best tip I can give you is to go to Carolyn Bowen’s website and wander through her personal gold mine for lots of great information. Heck, I’ll even make it simple for you and put the link here that will take you straight to her techniques for Lisps :) http://members.tripod.com/caroline_bowen/lisping.htm I do, however, want to summarize what you will find there. Besides defining the four different types of lisps, she also reviews the Traditional Approach to Articulation Therapy clearly defining each step in the process. Just below the steps for traditional therapy you will find links to the Butterfly Procedure and Imagery and the Butterfly Position.

It is this Butterfly Procedure to which I want to draw your attention. Basically, you can achieve correct tongue positioning for /s/ by approaching it from /ts/. She provides very detailed directions for using this technique in 10 easy steps. She will direct you from beginning to the final, end product of having that good /s/ in words, at which time she transfers you to traditional articulation therapy.

Years ago Jane Folk published a book called Straight Speech: a lisp treatment program (1992) which taught /s/ from the “ts.” It was a wonderful book that provided all the word lists and practice materials for using this treatment approach. Unfortunately, it is out of print, but I did find that it is still in the libraries of Walter W. Gerboth Music Library, Brooklyn College Brooklyn NYC 11210 and the James C. Kirkpatrick Library, University of Central Missouri Library, Warrensburg, MO 64093 I dare say it is still on some of the shelves of your fellow colleagues. I’d ask around, as you might just stumble upon a copy.

An unorthodox approach we have used successfully is to convert that lateral lisp into a frontal lisp and then correct the frontal lisp. Crazy? Definitely, but it works! You aren’t really going to do a complete conversion from lateral to frontal because the idea is to teach /s/ from voiceless /th/. If you do try this strategy, I caution you to not tell the child that you are working on /s/, as just the thought causes the tongue to go to the lateral position. Tell them you are going to work on /th/. In session one, practice /th/ in isolation. For session two, practice /th/ with the teeth closed. DO NOT say anything about /s/ at this point! This is crucial. For the third session, the child should be saying /th/ with closed teeth (which in reality should be the perfect /s/). If the child is doing the /s/ correctly at this point, then at the end of this 3rd session you tell them that they have been doing the /s/ sound correctly!! They will look at you in total disbelief and you will say, that is how you say /s/. If they revert back to a lateral at this point remind them to think /th/ to get the tongue back into position. After that, you should be able to follow the normal therapy sequence.

Another great tip is Pam Marshalla’s book, Frontal Lisp, Lateral lisp . She wrote an entire book on the lateral and frontal lisps, which includes how to diagnose direction of airflow, treatment techniques, how to combine articulation and oral motor therapy, and much more. Here’s a link to the book http://www.pammarshalla.com/catalogue/alph/flll.html This would make a great resource for your personal library.

The final tip is to check out Talk Tools and this book in particular Oral Placement Therapy for /s/ and /z/ http://www.talktools.com/s.nl/it.A/id.1702/.f It provides instruction for doing an evaluation specifically for interdental and lateral lisps, and 20 lesson plans with Homework sheets and speech practice sheets. It also includes a DVD of Sara Rosenfeld-Johnson performing a couple of assessments; reports generated and therapy video clips.

We hope this has provided you with an assortment of ideas and resources to try with your clients and that you will no longer dread working with the Lateral Lisp!

Until next Monday have fun in therapy!

Leah and Dean

www.2galsspeechproducts.com

13 comments:

  1. this post came at a perfect time because i just finished writing an ax report for a child with a lateral lisp...thank you for this informative post, and even when it is a review of info it is awesome to have it all in one place

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  2. Thank you. Always nice to review procedures you have used in the past or need to "refresh" yourself with. Good to know about the Marshalla book also for my own library as well as my niece's who is studying to be an Slp! :)

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  3. Thank you for your help, as I was searching the web and creating my own 'ts' pictures I came across your very informative aricle! It is wonderful to have all approaches addressed in 1 location.
    Perth WA Australia

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  4. thank you for this post. i am a mother with a 7 year old son with a severe lateral lisp, as well as "backing." i have no speech training, but i've always known his speech defects weren't developmental. he was tested at age 3 and age 4, and refused therapy each time because his "inability to produce the 'S' and 'Z' sounds is developmentally appropriate." But, having other children, I *knew* it wasn't true, and he needed therapy. Finally, at age 6, he started getting services, but his speech teacher only works on the backing sounds, (much easier to correct) and is stymied by the LL. Just today on the phone she told me, "I won't start worrying about him not saying 'S' right until he's 8" (next year, when she won't be working with him any longer.) When I politely told her I'd feel the same way if he substituted "th," for "s," but not with the LL, she quickly backpedaled when she realized I "had done my homework." But she obviously wanted to pawn him off yet again. EVERY SLP that we've had through the county has tried to say, "Oh, he's FINE talking like that this year. If he's doing it next year, his teacher should be worried." One of his SLP's hadn't even heard of a lateral defect. I think it's very unknown/misunderstood, and I appreciate you bringing it to the fore. Thank you. I will follow ALL your links and try to implement some of this at home, since I don't have money for private therapy. Even at school, he's in a group of 5 or more kids, working on tons of speech issues, most of them NOT artic.

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    1. I highly doubt that the SLP had never heard of a Lateral lisp. I'm sorry, but this post reeks of exaggeration. I understand your frustration, but sometimes these things are developmental, and SLPs are not trying to just 'pawn him off'. Try talking to your SLP about this frustration - ask if they don't mind seeing you child 1-on-1. I do a lot of my private practice clients 1-on-1, as they are getting group therapy in school. However, I also run small groups as well. I really try to work with what the child/family is looking for.

      I'd contact some local SLPs in private practice and ask if any take on pro-bono cases. I do about 20-30% of my caseload pro-bono. I know I am not alone - there are many of my colleagues who also take on frustrated families and clients. You are not alone. I just highly doubt that your SLP has never heard of a lateral lisp and that everyone of the SLPs in your county has tried to pawn your child off.

      Contrary to popular belief, we love when families "do their homework" - research shows the largest therapy gains are made with active families. It is a huge benefit that you've been 'doing your homework' and don't believe your therapist 'backpeddled' when you presented the frontal-lisp approach. Your post reeks of hyperbole and falsities. Try some of the advice I've given you - you should be able to easily find a local SLP willing to take you own pro-bono, or to just give you some basic tips and tricks. I'd offer you my email, but to be honest, you've burned your bridge with me already. Good luck!

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  5. Straight Speech by Jane Folk is still sold. Go to www.speechbincom. They sell it in their catalogue for 10.99

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    1. YAY! Thank You Birthday girl for sharing this with us! I thought I had seen it sold somewhere but couldn't find where I had seen it! I'll do an update to this post to make sure people see this!

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  6. Thank you for this blog post!
    I'm a speech path student clinician on my first placement, and I'm looking for a therapy approach to my client's lateral /s/. I think I'll use the Butterfly Technique.
    Thanks again! :)

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  7. I have a lateral emission lisp, and I am in 8th grade. I've been going to speech for two years and nothing has changed. My teacher has taught me several techniques, but they all feel unnatural and sound even worse than before to me. I can't get used to any of them or transfer them into everyday speech, and it takes forever to get my mouth into position! I can't even hear my own lisp, and neither can my mother anymore, but my teacher says it's really bad. I've been trying to correct it myself, but all the posts seem to be for teachers and there are none for self-correction. My tongue isn't that flexible, and as hard as I try, I can't do the Butterfly Technique. I don't know what you mean by "closed teeth". The link doesn't work, by the way...thanks for posting anyway...

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    1. Your ear has been used to the lisped sound for years at this point, so any new way of producing it is going to sound weord. Don't worry - that's normal! Find someone who can show you how to produce a normal sound, and then practice it so it feels normal in your mouth and in your ear. Don't worry about trying to add it to your speech right away, just take some time to get used to producing the non-lisp, and letting your ear hear the difference. I even have some of my patients spend some time producing the lisp sound and then producing the non-lisped sound. Think of it as working out for your tongue, just like how a sports person works out in the gym.

      After a while, when your mouth and ear feel normal doing the non-lisped sound, try to add it to words and sentences. You're going to need to remind yourself A LOT to do the normal sound. I am surprised your Speech-Language Pathologist hasn't told you this. This is not like some other disorders, where we can treat it without your participation. A lisp takes A LOT of work on your part to change it. Remember, your muscles and ears have had YEARS of producing it wrong, so it's going to take you some time to produce it correctly.

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  8. Anonymous, closed teeth means to keep your top and bottom front teeth together when you say your /s/. Try it while producing "th".

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  9. Great material! I have a child with a lateral lisp AND a tongue thrust. He also had weak contacts for /t, d/. I had been focusing on the /t,d/ and trying the /ts/, without success. At least now, I have a couple of great strategies to try!

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  10. what about lateral /S/ not lateral /s/ . have a 4:3 year old
    thanks!

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