Cleft Palette Repair on Hold? How to Help Promote Speech

Lateral lisps can be so persistent and frustrating to correct. These “slushy” sounding /s/ errors are caused by incomplete elevation of the sides of the tongue, causing the airflow to be released over the side rather than straight down the middle. The resulting “lateralized” airflow is what creates that slushy sound.

My favorite go-to for lateral /s/ errors is to start with sending air through a rolled tongue. Getting kids to roll their tongue creates an overly exaggerated central groove, which will prevent the air from leaking over the sides.

What you need: a mirror, tongue depressor or lollipop

Tell the child to watch your mouth while you demonstrate rolling your tongue. If they’re unable to do this on their own, use a tongue depressor or lollipop to tap the sides of the tongue and give them a bit more feedback about which part of the tongue to try to use. Cue them to curl the sides of their tongue up towards their upper teeth.

After they can make a tongue roll (typically within a few minutes of trying in the mirror), tell them to blow air through the roll. They’re probably sticking out their tongue at this point, which can be reinforced. Then, tell them to slide their tongue back into their mouth until the tip of their tongue touches their lower front teeth. In the transition, they’ll end up making an /s/ with central airflow release! Praise them for these great central air /s/ sounds and repeat, repeat, repeat.

After they can slide their tongue to the correct position and keep the central airflow going, see if they can now imitate an /s/ in isolation without going through the tongue roll process. Typically, these /s/ productions have rounded lips, because you started with a rolled tongue, and so transitioning to syllables and words with round vowels like “oo” and “oh” can help to stabilize before introducing high front vowels that spread the lips.

This trick tends to work even for kids with cross bite, missing teeth, or even a protrusive premaxillary segment. The focus is entirely on the tongue’s movement to achieve a central groove, which is something that is not necessarily affected by dental differences. It should be noted that reduced stridency is sometimes inevitable if dental differences are present. This is an error that’s related to the airflow constriction and release being more diffuse, rather than precise, resulting in productions that are sometimes challenging to differentiate from lateralized airflow release. However, they are fundamentally different in the underlying cause and decision to treat or not treat. Lateralized airflow errors are caused by mislearning correct position of the tongue, and therefore worth treating in therapy. Reduced stridency due to dental differences will be very challenging, if not impossible, to correct in speech therapy services. When these dental differences are present, if an /s/ is lateralized, we can still try to correct the tongue positioning, but know that there may be limits to carry over and some reduced stridency may still persist.

Check out our free downloads page to get free /s/ flashcards!