What is a lisp?

A lisp is considered a “functional speech disorder” which means that a child has difficulty learning to make certain speech sounds but the cause of the disorder is not known. Common signs of a lisp include having problems saying /s/, /z/, /r/, /l/ and /th/ due to trouble achieving the correct tongue position for pronouncing the /s/ and /z/ sounds. This usually occurs as if the child is replacing the /s/ or /z/ sound with a /th/ sound.

Although having a lisp may not reduce the intelligibility of, or the ability to understand, what the child is saying, it may impact the way others see them or the way they see themselves.

Types of Lisps

There are four types of lisps: Interdental (frontal), Dentalised, Lateral, and Palatal lisps.

Interdental (frontal) lisps refer to when the tongue sticks out between the front teeth and air-flow is directed forward. This results in /s/ and /z/ sounding like /th/.

• Interdental /s/ – “sad” → “thad”, “missing” → “mithing”, “saw” → “thaw”, “grass” → “grath”
• Interdental /z/ – “zip” → “thip”, “easy” → “eathee”, “buzz” → “buth”, “ways” → “wathe”

Dentalised lisps refer to when the tongue rests on/pushes against the front teeth and the air-flow is directed forward. This creates a slightly muffled sound.

Lateral lisps refer to when the tongue position is similar to a typical /l/ sound position and the air-flow is directed over the sides of the tongue. This makes the sounds sound “wet”, “spitty” or “slushy”.

Palatal lisps refer to when the mid-section of the tongue comes in contact with the soft palate in the far back of the mouth.

Some children and adults who lisp may have other tongue placement problems that results in trouble pronouncing the /sh/, /ch/, /zh/, and /dg/ sounds.

What to do if your child has a lisp?

Functional speech disorders, such as a lisp, can be treated successfully in both children and adults by a Speech Language Pathologist (SLP). Although treatment is usually short-term at a young age, it can be longer and more difficult if left untreated for too long. Typically developing children may produce interdental or dentalised lisps during their developmental phase and tend to grow out of it as they get older. If the lisp continues until they are about 4 ½ years old it is recommended that they see an SLP to be assessed. If a child is producing a lateral or palatal lisp they should be assessed without delay as these are not typical during the developmental phase and could be harder to treat if it becomes habitual.

Typical assessment involves the SLP evaluating your child’s communication skills in different ways. This includes the quality and fluency of their voice, and their semantic and pragmatic skills. The SLP will also assess your child’s mouth, mouth movements, tongue placement, palate structure and the function of these structures. After taking speech and language samples to assess, the SLP can determine what needs to be worked on.

What happens in therapy?

Intervention for lisps typically focuses on re-training the tongue to assume the correct position when producing certain sounds in order for the sounds to be as precise and clear as possible. For instance, the clinician would work on re-training the tongue to assume a more back position instead of a frontal position for an interdental (frontal) lisp.

Intervention for an interdental (frontal) lisp working on the /s/ sound may follow these steps:

• The first step in intervention is determining if the child can accurately tell the difference between the /s/, /z/ and /th/ sounds. This means finding out if the child can correctly identify which of the following is the right way to say a word, such as “soup” vs. “thoop”.
• The next step is to teach the child how to correctly make the new sound. This usually starts by isolating the sound in broken syllables (/s/: s-ay, s-oh, s-ee), followed by syllables (/s/: say, soh, see), and then words with the targeted sound at the beginning, middle, and end (/s/: song, messy, glass).
• After working on words, the clinician will move onto sentences using the words they have been working on, controlled conversations by the clinician, and then in regular conversation while phasing out modelling and reinforcement until the sounds are produced automatically and the child can self-correct when needed.

Is your child entering Kindergarten this Fall? 

Wondering if your child is ready? Worry no more! The below checklist will help you understand and monitor your child’s speech, language and literacy milestones.

If you child receives 3 checks in a category on the Kindergarten Checklist, you may wish to consider looking into a consulting a local Speech-Language Pathologist.

TAKE ME TO THE KINDERGARTEN CHECKLIST! 

 

 

 

Most children make some mistakes as they learn to say new words. When these mistakes continue past a certain age, that is when a speech-sound disorder may be occurring. Every sound has a different range of ages when the child should make the sound correctly. See the chart below for typical speech sound development. Speech-sound disorders include problems with articulation, which is making sounds, and problems with phonological processes, which involves sound patterns.

An Articulation disorder involves problems making sounds. Sounds can be substituted, left off, added or changed; these errors may make it hard for people to understand what someone is saying. For example, many children make a “w” sound for an “r” sound such as “wabbit” for “rabbit” or may leave sounds out of words such as “nana” for “banana.” Treatment involves demonstrating how to produce the sound correctly, learning to recognize which sounds are correct and incorrect, and practicing sounds in different words.

A phonological process disorder involves patterns of sound errors. For example, substituting all sounds make it the back of the mouth like “k” and “g” for those in the front of the mouth like “t” and “d,” saying “tup” for “cup” or “das” for “gas.” Another pattern of sound errors is when children don’t follow the rule of speech that some words start with two consonants, such as broken or spoon. Instead, these children say only one of the sounds such as “boken” or “poon,” which makes it difficult for the listener to understand the child. Treatment involves teaching the rules of speech to children to help them say words correctly.

Many speech sound disorders occur without a known cause. A child may not learn how to produce sounds correctly or may not learn the rules of speech sounds on his or her own. Speech-language pathologists provide treatment to improve articulation of individual sounds, or to reduce errors in the production of sound patterns.

Communication breakdowns are one of the top reasons for negative toddler behaviors.

Often times when a child is unable to send a clear message to request an item, action or event, they become overwhelmed with frustration; leading to frequent whining, crying and meltdowns.

Empowering your toddler with the expressive language they need to improve the effectiveness of their overall communication abilities will dramatically ease frustration, while fostering your child’s independence.

As your child learns their thoughts, wants and needs can be shared, they will learn that their communication has a direct effect on altering their environment. This new found independence is thrilling for toddlers! 

We’ll discuss to how to grow your child’s language from single words to phrases, as well as language based tips and strategies to foster improved communication your little one!

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This Free Parent Workshop will be Facilitated by Megan Rozantes, M.S., CCC-SLP of Chatterboxes Pediatric Speech-Language & Feeding of Newton & Lexington.

 

Workshop Information: 

The Loved Child: www.thelovedchild.net

The Loved Child is located at 173 Belmont Street Belmont, MA

Event Date & Time: March 17th 7-9pm

Come enjoy Wine and Appetizers and mingle with the TLC Community.

 

 

1. Use one language at a time, for short periods of time. Daily routines can be an optimal time for using the second language. For example, speak the second language only during the bath time routine (without language-mixing.) Your child will become familiar with all of the vocabulary associated with bath (soap, water, towel, bubbles, etc). Once you feel your child is comfortable with these vocabulary words, you might add a second daily routine, such as breakfast.

2. Make a picture dictionary. To make a picture dictionary, staple sheets of construction paper together and cut pictures out of magazines. Use categories which complement your child’s experiences. Label pictures in both languages.

3. Use repetition. By singing songs or rhymes and repeating them each week, your child will be able to remember the ways words are used and apply them in their day-to-day lives. Make learning games that involve silly phrases or actions so they can enjoy the learning process.

The American Speech Language Association notes:

• Most bilingual children speak their first words by the time they are 1 year old (e.g., “mama” or “dada”).

• By age 2, most bilingual children can use two-word phrases (e.g., “my ball” or “no juice”). These are the same language developmental milestones seen in children who learn only one language.

• From time to time, children may mix grammar rules, or they might use words from both languages in the same sentence. This is a normal part of bilingual language development.

• When a second language is introduced, some children may not talk much for a while. This “silent period” can sometimes last several months. Again, this is normal and will go away.

Welcome, Alexandra!

Alexandra’s flexible, creative and passionate personality creates an engaging therapy environment for children and their families.

Her previous work with clients in their home environments via Early Intervention has helped her develop active listening, empathy and experience identifying shared goals.

This results in progress, ongoing involvement and eventual positive therapy outcomes.

Alexandra is an advocate of the co-treatment therapy model and working with other professionals and disciplines involved in each child’s ecosystem.

Alexandra holds a Master of Science in Speech-Language Pathology from Worcester State University where she was elected President of the National Student Speech-Language Hearing Association (NSSLHA) chapter of WSU.

Alexandra’s professional experience includes a Speech-Language Pathologist position with Family Services of Rhode Island, where she led a community-based “Mother Goose” and center-based speech and occupational therapy group with Family Service of Rhode Island. Additional previous experience includes The Wolf School of Providence, RI, a private school dedicated to complex learners.

Alexandra has had the opportunity to work with children ranging in age from 3-20 years old diagnosed with pragmatic language disorder, expressive/receptive language delay, fluency disorder, autism spectrum disorders, articulation and feeding disorders. She is specialized in conducting assessments and evaluations, and provides parent education and coaching for families and caregivers

Alexandra is based out of our Lexington location at 35 Bedford Street, Unit 6, Lexington MA and is available to her current and prospective clients at alexandra@teamchatterboxes.com

Early Intervention (EI) is a service that is available for children between birth and 3 years, who present with developmental difficulties or who are at risk for developmental disabilities or delays due to birth or environmental conditions.

EI services are provided by a multidisciplinary team of professionals including; Developmental Specialists, Speech Language Pathologists, Physical Therapists, Occupational Therapists, Psychologists, Social Workers, and more. EI services can be provided through government-based programs (see your state’s guidelines for more information) or privately.

The Chatterboxes Way

Chatterboxes is a private practice that offers EI services, targeting speech and language delays or disorders. Our family focused model allows our clinicians to spend ample amounts of time preparing for sessions and creating individualized materials for each child. Chatterboxes offers both individual and group EI sessions. Our approach is play-based, and directly involves parents, caregivers, and any other  Aesthetically, we have created our space to be very inviting to children, providing them with the feel of a vibrant play-space, as opposed to feeling like a doctor’s office.  We find that children are ready to play and are very much at ease even upon their first visit.

Please see the chart below, for an outline of the differences between EI services provided through the state funded EI companies and EI services provided through Chatterboxes Private Practice.

Early Intervention

Chatterboxes Private Speech & Language Therapy

A child must qualify for services, based on results of evaluation conducted by EI team (OT, SLP, Psychologist & Developmental Specialist) A child may only receive services until the age of 3 Parents may experience Under the IDEA, evaluations and the creation and review of the IFSP must be free Most health insurance companies will pay for some or all of the cost Team of professionals for all services: OT, SLP, PT Psychologists Developmental Specialists

No qualifications to receive services Evaluations and therapy available every week- No wait-list No age requirements to receive services. Early Intervention goals target increasing expressive and receptive language skills, and social skills and continue targeting all goals after a child turns 3. Referrals or prescriptions are not required to receive services Chatterboxes, is considered an ‘out-of-network’ provider for insurance companies and do not bill insurance directly Claim forms are generated for families to submit to their insurance companies for potential reimbursement Clinicians are all ASHA licensed Speech Language Pathologists

For more information on our Early Intervention Program, please contact Heather at 617-969-8255 or via email at Heather@teamchatterboxes.com

Signs are considered to be words that are produced with the hands instead of the speech mechanism. They are easier for children to use that orally produced words and have been evidenced to facilitate speech production and oral word use, especially when paired with spoken words. Signs can help children express themselves, reducing communicative frustration.

When introducing signs, start with just one or two signs for the purpose of requesting, e.g., sings for more and please. (Image below demonstrates ‘more’)

Use hand-over-hand modeling to teach the signs, e.g., taking your child’s hands and performing the sign for him or her. Over time, fade the level of support you provide your child to facilitate their use of the signs. After your child becomes proficient with a requesting sign, introduce early vocabulary items, e.g., ball, car, train, music, open, eat, drink, milk, cookie, cracker, all done, help and thank you.

When practicing signs, especially when introducing a new sign, it’s ideal to have two adults available to work with your child. This way, one person can hold the toy/object that your child is requesting and the other person does hand-over- hand modeling of the sign.

The person holding the toy/object sits across from your child, at eye level with him/her, and the other person sits behind him/her, taking his/her hands to help him/her physically produce the sign!

Meal times are an excellent time to work on signs, as your baby is seated eye level to you, and is most likely motivated to ask for favorite foods! Check Out This Video of a Baby in Action!

 

Color Me Fluent is a fluency program for children who stutter, and one of the Fluency Tools implemented at Chatterboxes. Various speech patterns are designated by color: red, orange, and green. Red speech represents stuttering, orange speech represents adaptive stuttering, and green speech represents fluent speech. The goal is for the child to progress from red speech through orange speech to green speech.

Therapy focuses on orange speech, which is the practice speech. The speech-language pathologist (SLP) works with the child to implement specific strategies to improve fluency of speech.

There are several strategies under the umbrella of orange speech that help the child stay on track and use their best speech habits. These targeted strategies under the umbrella of orange speech include:

• Full Breath
• Breath and Speech Together
• Pause Often
• Regulated Rate
• Continuous Vocal Phonation
• Talking in Short Sentences
• Minimizing Consonants and Maximizing Vowels

SLPs engage fluency shaping by introducing over-learning and exaggeration of correct speech patterns as they assist the child progress from red speech through orange speech to green speech.

Using the Color Me Fluent program, SLPs are utilizing learning theory, behavior modification, and family education to facilitate an increase in awareness, self-esteem, and fluency for the child.