Lisps

As young children develop their speech and language skills, imperfections should be expected. Errors are often a part of typical development, and they're extremely common. 

Lisps are one of the most noticeable speech disorders that can happen during this period of development. People with a lisp often struggle to pronounce certain consonants, with the “s” and “z” sounds being some of the most common and challenging.

In many cases, lisps are just temporary bumps in the road on the path to language development, and over time they’re corrected naturally on their own. However, while a lisp might seem “cute” or “adorable” during a child’s toddler years, it can be concerning if the lisp persists as they get older. The number one question parents typically ask is “Will my child grow out of a lisp?” Many caregivers worry that their child’s lisp will continue into school-age and eventually adulthood, affecting their child’s confidence and self-esteem. 

Fortunately, there are effective treatments available. Plus, there are many ways caregivers can reinforce good communication habits at home to prevent a lisp from becoming more pronounced.

As with all speech and language challenges, educating yourself is the best way to make informed treatment decisions. For that reason, we’ve put together this informational guide to answer common questions about lisps, identify signs and symptoms, and explain how a lisp is typically evaluated, diagnosed, and treated. 

1What is a lisp?

2What causes lisps?

3Is there a difference between a tongue thrust and a lisp?

4How can a lisp affect a person's life?

5How are lisps recognized and diagnosed?

6How are lisps treated?

7How do lisps affect adults?

8How does Expressable assess and treat lisps?

9How can parents help their child overcome a lisp?

What is a lisp?

Many of us know what a lisp sounds like. The most common form occurs when someone makes a “th” sound when trying to say an “s” or “z” sound. Lisps are caused because of the incorrect placement of a person’s tongue inside their mouth during speech. When a person lisps, their tongue usually touches, pushes against, or protrudes between their teeth.

There are actually four distinct types of lisps, with certain characteristics and tongue placement. While the differences may seem small, correct diagnosis is important when considering treatment. Here are the four types of lisps:

• Palatal lisp: As the name suggests, this lisp is associated with a person’s soft palate, more commonly referred to as the roof of the mouth. When a person’s tongue rolls back and touches the roof of their mouth during speech, they often have difficulty making “s” and “z” sounds.

• Lateral lisp: This happens when a person’s tongue remains in a close-to-normal position, but airflow manages to escape from one or both sides of their mouth. This is sometimes referred to as a “slushy lisp” because it can make the speaker’s words sound “wet” or “spitty.” What you’re hearing is a mix of air and saliva.

• Dentalized lisp: With a dentalized lisp, a person’s tongue pushes against their front teeth, directing airflow forward. This commonly produces a “muffled” sound.

• Interdental lisp: These are commonly referred to as frontal lisps. They happen when the tongue pushes forward or protrudes between the front teeth.

Lisps often become noticeable after the age of 2, when children begin developing their language abilities.

Both dentalized and interdental lisps are common and perfectly normal during a child's language development phase. Many children experience them until around 4½ years of age. While it’s always a good idea to talk with a qualified speech-language pathologist if you suspect your child has a lisp (more on that below), it’s especially important once your child is approaching age 5.

Conversely, lateral and palatal lisps do not happen as part of a child’s natural development. A child with this type of lisp should receive a professional evaluation from a speech-language pathologist as soon as possible. 

What causes lisps?

Lisps are caused by the incorrect placement of the tongue in the mouth. This can, in turn, obstruct air flow when speaking, and cause the distortion of how a person pronounces words and syllables. Lisps can be caused by a variety of factors, including: 

• Learning to pronounce sounds and syllables incorrectly

• Problems with a person’s jaw alignment

• A tongue tie, which occurs when the tongue is attached to the bottom of the mouth and its movement is limited

• A tongue thrust, where the tongue protrudes between a person’s teeth

Is there a difference between a tongue thrust and lisp?

Yes, there is a difference between a tongue thrust and lisp. However, the distinction can be hard to identify with an untrained eye and is best left to the clinical assessment of a speech-language pathologist, also known as a speech therapist.

A tongue thrust is technically referred to as an orofacial myofunctional disorder (OMD). It occurs when the tongue moves forward in a pronounced way when a person is either speaking or swallowing. The tongue may sit too far forward in the mouth, or push between a person’s teeth during speech and swallowing. Articulation errors can result from both tongue thrusts and lisps, affecting how the person produces sounds.

A person’s lisp can be a result of a tongue thrust. This is especially important to know because a tongue thrust can eventually cause significant dental issues if left untreated.

How can a lisp affect a person’s life?

Lisping often doesn’t have a severe impact on a person’s ability to be understood. However, a lisp can still have effects on a person’s social and emotional wellbeing. 

Some caregivers fear their child could be teased by their peers. Children may also feel anxious or uncomfortable when speaking with other people, which can affect their confidence, self-esteem, and ability to socialize with others. 

For adults, these effects can be worse. They may feel frustration or embarrassment in the workplace, and try to avoid certain social situations altogether. 

While lisps affect everyone differently, there are things that caregivers and adults can do to minimize the impact of lisps and regain normal speech. 

How are lisps recognized and diagnosed?

In most cases, your pediatrician, school nurse, or teacher may refer you to a speech therapist. Speech therapists are communication experts and are the most qualified professionals to assess, evaluate, and treat children and adults with lisps.

As mentioned, there are different types of lisps of varying severities that can impact your child’s speech. That’s why if you suspect your child has a lisp, it’s a good idea to be proactive and seek an evaluation from a speech therapist. To assess your child’s speech patterns, your speech therapist may: 

• Review your child’s medical history

• Examine the anatomy of their mouth and tongue placement

• Check for issues like a tongue tie or tongue thrust

• Observe your child’s speech fluency, their vocal quality, and their social communication skills

• Determine whether your child has a lisp or a different type of speech sound disorder

• Provide a professional opinion of when to start intervention; for example, the speech therapist may recommend delaying treatment and closely monitoring your child to see if the lisp naturally disappears over time

How are lisps treated?

Habits become harder to break over time. Therefore, the earlier treatment is provided, the more quickly a lisp can be corrected and your child’s overall communication will improve. 

Once your speech therapist assesses your child’s speech, identifies the type of lisp they have, and recognizes which sounds they’re mispronouncing, they’ll develop a tailored treatment plan to help your child reach their communication goals. This plan will often include helping your child:

• Increase their awareness of where they’re placing their tongue when speaking

• Hear and recognize the difference between correct and incorrect pronunciation of sounds and syllables

• Correctly make the target sounds they’re struggling to pronounce

• Correctly pronounce more complex language, such as consonant and vowel combinations, structured and spontaneous sentences, and more

• Practice using these correct pronunciations in real-life settings outside of therapy sessions

Every child is different, and the frequency and intensity of treatment will shift depending on their needs. While some children can see considerable improvement in a month or two, others will need intervention for a year or more. Factors that can affect the length of treatment include your child’s age, type of lisp, awareness of mispronunciations and ability to self-correct, how well they follow directions, and how often they practice at home. 

How do lisps affect adults?

First things first: It’s never too late to correct a lisp. 

Many adults have a lisp that was never properly treated in their younger years. They may have feelings of frustration, embarrassment, or low self-esteem, and want to improve their communication to feel more confident when speaking in their daily lives and workplace. 

However, it’s also important to note that not all adults want to "fix" or get rid of their lisp--and that’s perfectly OK! Often, these adults have accepted their speech the way it is. It's become part of their unique image and persona.

Assessing and treating lisps is largely similar in both children and adults, beginning with seeking professional help from a speech therapist. The only added challenge with adults is finding someone you can practice with on your own time. Whether this is a spouse, family member, or friend, it’s important to have someone you trust provide honest feedback and encouragement so you can continue to improve on your own time, outside of therapy sessions.

How does Expressable assess and treat lisps?

Expressable matches families with a certified speech therapist trained to evaluate and treat speech impediments like lisps. All therapy is delivered online via face-to-face video conferencing.

The client’s age and development will influence how the speech therapist interacts with them through these video sessions:

Ages 0-3: Caregivers attend sessions and work directly with their child's speech therapist to learn cues and at-home strategies. This way they can confidently practice with their child outside the sessions and help improve their child's communication. 

Ages 3-6: Caregivers attend video sessions alongside their child so they both learn valuable skills from their speech therapist. Reinforcing these lessons outside the session will continue to promote at-home skill building.

Ages 7 and up: Most children attend video sessions independently, but parents are kept in the loop with updates and tips during each session.

Adults: Adults attend sessions by themselves, but they are welcome to bring loved ones or family members as well.

Your Expressable speech therapist will introduce a variety of techniques to improve a lisp. Different types of cues and techniques will work for different people. 

As the client learns to make the target sounds and becomes more independent in their sound productions, the speech therapist will decrease the amount of help provided. This increases the client’s independence in their speech sound productions, which is the whole goal of speech therapy. 

As your independence grows, your speech therapist will also increase the complexity of tasks you’re working on. For example, at the beginning of therapy you may work on the /s/ sound by itself, not in words. Over time, you will likely move on to practicing /s/ in sentences and conversation. 

Your speech therapist will work closely with you every step of the way. In addition, all Expressable clients have access to our client portal, which features educational Learning Paths covering the strategies taught in therapy sessions. You can access examples, tips, demo videos, quizzes, and more. Plus, through the portal, you'll receive weekly home practice activities tailored to your needs. The more you practice speech therapy techniques at home, between sessions, the faster you'll make progress!

How can parents help their child overcome a lisp?

As with all speech impediments, having your child practice once or twice a week with a speech therapist simply isn’t enough. Overcoming old habits takes constant reinforcement outside of these sessions. When caregivers are actively involved in their child’s speech development, and they reinforce at home what their child is learning in speech therapy, children make more progress. 

While your speech therapist will provide personalized recommendations for at-home practice, here are a few tips and techniques you can start using immediately to help prevent a lisp from becoming more pronounced. 

• Model correct speech: Children are sponges. They pick up speech habits by watching and interacting with people they love--namely, their family. So it’s important to “model” correct speech every day when speaking with your child. Make sure that you speak slowly, clearly, and with correct pronunciation. In addition, maintain eye contact with your child, even if you have to kneel down to get on their level, so they can see how your mouth moves and how you form sounds.

• Use a mirror: Position your child in front of a mirror so each of you can practice pronouncing the “s” and “z” sounds. Watch how your teeth and mouth move when properly pronouncing these sounds, and encourage your child to imitate these correct mouth movements. This is helpful for all children, but in particular for those who are more visual learners.

• Try the butterfly technique: This is a common technique used in speech therapy that can be easily practiced at home. To do this, prolong the letter “i” when you say words like “chin” or “win.” Take notice of how the sides of your tongue slightly raise upward like a butterfly’s wings. When pronouncing the “s” and “z” sounds, our tongue should ideally be in the same position. The goal of this exercise is to help prevent the tip of your child’s tongue from protruding past their teeth.

• Drink from a straw: For children with dentalized and interdental lisps in particular, it can be especially helpful to use a straw when drinking. Straws naturally force the tongue to pull back into our mouths, which can help increase oral-motor strength. If you’re not a big fan of wasting so much plastic, spend a few dollars on a reusable, eco-friendly metal straw that can be easily washed.

• Try to stop thumb-sucking: While thumb-sucking is a natural instinct, it can actually lead to lisping or make it worse. This is because thumb-sucking can cause the teeth to shift and create space for the tongue to protrude forward. Instead, try to find a comforting replacement that your child loves, such as a toy or blanket.