Understanding Lateral Lispsby Jacky G.
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Some types of lisps (frontal and dentalized) can arise during normal development. This is not the case with lateral or palatal lisps. When vocalizing the “s” and “z” sounds, a child with a lateral lisp directs air flow over the sides of the tongue, rather than straight down the middle of the tongue. This is often a result of incorrect tongue placement. Speech-language pathologist (SLP) Caroline Bowen notes that children with a lateral lisp often use a tongue placement for the “s” and “z” sounds that is quite similar to the tongue placement for an “l” sound.
Identifying a Lateral Lisp
A lateral lisp is fairly easy for parents to identify because it results in the classic “slushy” sound. Listen closely to your child as he vocalizes sounds or words with the “s” and “z” sounds. If your child appears to have articulation difficulties, bring him to an SLP for an assessment. Treating a lateral lisp early can help your child learn proper speech patterns. Because a lateral lisp is not developmental it is critical to avoid waiting for the child to “grow out of it.”
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Treating a Lateral Lisp
Your child’s speech therapist will likely begin treating a lateral lisp with auditory discrimination training. The speech therapist will help your child learn to discriminate between the proper and improper pronunciations of the “s” and “z” sounds. She will likely have your child work on articulating these phonemes by themselves. Your child will progress to articulating these sounds at the beginning, middle, and end of target words.
Your child’s SLP may also use tactile feedback to help your child with proper tongue positioning. Seal Speech Buddies provide a target in your child’s mouth so that he knows when his tongue is in the right place for proper articulation. You can also use Speech Buddies at home.
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Activities at Home
In addition to the Seal Speech Buddy, you can do other activities at home to help encourage your child’s progress. Hold a feather in front of your child’s mouth and instruct him to blow air through the front of his mouth to move the feather. You can also play pretend games with your child to encourage proper air flow. Have him to pretend to pull a piece of string straight out of his mouth along the front teeth. Instruct your child to hiss like a snake while he does so. Every time you get your child a drink, give him a straw. Before giving him the drink, have him place the straw directly into the front of his mouth, underneath the front teeth. Encourage him to direct air flow into or along the straw.Speech Disorders
- Created: Monday, 14 November 2011 21:29
- Updated on Tuesday, 24 November 2015 13:46
Sheila Drummond 1915-2006
Butterfly? Aspiration trick?
I first heard the term "butterfly position" as a speech therapy student in 1967 from an inspirational Melbourne speech pathologist, Sheila Drummond AO (1915-2006). Mrs Drummond was one of three foundation members of Speech Pathology Australia. She did not claim to have "invented" the term or the procedure for working on lateral fricatives and affricates, and she may have heard it from someone else. I came up with up with the name "aspiration trick" in a therapy session some time in the the 1980s but the technique itself had been around for much longer. Once again, I heard about it first from Mrs Drummond, in the 1960s - she called it h-insertion.
In intervention for speech sound disorders, imagery is often used to help the client visualise or conceptualise what they need to do, and where they need to put their articulators in order to achieve standard sound production. In the therapy technique described here the 'mental image' of a butterfly is used to make it easier for the client to visualise the position they need their tongue to assume while they are in the early stages of learning to replace their lateral or palatal s and z sounds with their new /s/ and /z/ sounds.
The butterfly technique has also been successfully applied in working on the elimination of lateral and palatal "sh" and "zh", and remediating lateral and palatal affricates.
Part of the skill and experience of the speech and language clinician is to know when to phase out this imagery, because of course you cannot speak naturally if you force yourself into the butterfly position every time you need to produce an ess or zed.
The butterfly position
The "butterfly position" is essentially the position the tongue is in when you sustain the "i" sound in bin, fin, win, or the "ee" sound in me, knee, sea. The client is encouraged to think of the tongue simulating the shape of a butterfly.
When you say "i" as in "bin", or "ee" as in "been", the sides of the tongue are raised slightly, like the raised wings of a butterfly, and are in light but definite contact with the teeth. Meanwhile, a central groove is formed along the middle of the tongue where the body of a butterfly would be.
The butterfly position is the position to aim for in producing a correct /s/, /z/ etc. Holding this position, the client learns to direct the air-flow "along" the central groove, and not (laterally) over the sides of the tongue.
Before you start
- Do not attempt the butterfly procedure unless the alveolar stops /t/ and /d/ are correct.
- Demonstrate the correct tongue position for /s/, model the sound, and see if the child can imitate. You might get lucky!
- "Discuss" what you do when you make /s/ and compare it with what the child is doing.
- Make sure the child knows, in simple terms, what you are working together to achieve.
- Do not attempt to use the butterfly procedure with children below four years of age unless you are certain they can follow the instructions.
The butterfly procedure
The butterfly procedure is firmly rooted in the principles of Traditional Articulation Therapy. It is suitable to use with children with children 4 years and over, and adults. It may be possible to use the technique with children below four years of age who understand what to do in terms of tongue placement.
Early in therapy children must be taught the ability to hear the error-sound, in this case the lateral /s/, when the therapist produces it. Later in therapy they need to be able to recognise the lateral-s when they produce it themselves. In other words, they must be able to listen critically, first to the speech of another person, and subsequently, to their own speech. Such self-monitoring can be learned at a very early age.
Focused Auditory Input
"Auditory training", or auditory input / listening techniques can be a powerful adjunct to direct work on eliciting the target sound and then producing it in increasingly challenging speech contexts.
Oral Motor Therapy and Oral Motor Tools and Toys
There is no need for Oral Motor Exercises (e.g., sucking and blowing exercises, drinking thick-shakes through straws, etc), oral motor tools (e.g., horns, straws, etc) or oral motor toys (e.g., toy whistles, trumpets, etc) in treating speech sound disorders.
- ee as in peep or i as in pip
Talk about the "butterfly position" for the tongue, or the position the tongue is in when you prolong the "i" in "pip" or the "ee" in "peep". Point out to the child that the lateral margins of the tongue are in contact with the teeth: like a butterfly with its wings up.
- on the edge
Draw the client's attention to the way the tongue edges (wings) press quite firmly on their teeth. You might mention that "floppy edges" or "floppy wings" let the air out sideways, while "strong edges" or "strong wings" do not.
Help the child to imagine the midline of the tongue as the butterfly's body, visualising the groove that forms along its centre.
- straight shooting
Tell them the groove is there for them to "shoot" the air down, straight out in front! It is there especially to guide the air in the right direction for a super sounding ess. Use your hands to convey the idea of "wings up", "wings firmly tucked in against the teeth", and language such as, "a nice little groove where the butterfly's body sits", and a "straight shot" of air. Employ imagery to talk about "shooting straight" and "shooting sideways".
Ten easy (we hope!) steps
- Typically, therapy proceeds in a series of steps.
- Allow the child not to feel rushed, and give him or her time to master each step before proceeding to the next. Slow and steady (usually) wins the race! There is no "correct speed" that any of this should happen.
- Every child is individual, and of course, that is why very rigid home programs that prescribe activities for week 1, week 2, week 3 and so forth, can be so unrealistic, and worrying for those who attempt to administer them without the professional supervision of a speech-language pathologist.
/s/, /z/, sh zh ch dg
In the following example the focus is on /s/, but the same procedure is adopted for /z/, sh, zh and the affricates, ch and dg.
Model /t/ and have the child imitate your production. Do the same with /t-t/, then /t-t-t/ and then /t-t-t-t/. If the child is producing a schwa or other vowel between the consonants, eliminate it if possible. Aim for a "pure" sounding sequence of consonants.
If the child "needs" a vowel to get from one /t/ to the next use "i" as in "pip" (ti- ti- ti- ...) ) or "ee" as in "peep" (tee- tee- tee- ...). Some SLPs/SLTs prefer "ee" because it creates a firmer "seal" between the tongue margins and the teeth, and, potentially anyway, this discourages lateral air-flow.
Increase the rate at which the child repeats /t-t-t-t/. Notice the subtle /s/ that starts occurring between the t's. Point this out to the child in your speech and in his/her speech. The sequence is now starting to sound like /ts-ts-ts-ts/.
The child will probably be unaware at this stage that the little "under-articulated" /s/ is there. In this step, tell the child to produce the /t/ and to let a little air come out at the end of the sound. Demonstrate what you mean, without actually instructing the child to produce "t and then s". Just emphasise that you want to have "air happening" after the /t/. Gradually "sharpen" the /ts/ thus produced, so that it becomes obvious that there are two sounds, /t/ and /s/, being articulated clearly. Once it's perfect, have the child practice saying /ts/ until they can do it very easily. It is a good idea to stay on this level for several days.
Now it is time to put the /ts/ combination into real words. Again using the vowels "ee" as in "feet" or "i" as in "fit" to facilitate correct placement, present the child with a practice list. For example, "He eats meat, She eats candy, It eats grain, etc.; or, It's a boy, it's a man, it's a cow, etc. or, It's good, it's bad, it's tall, etc. In making up the phrases or sentences, do not include other words containing /s/ or /z/. This means don't have items such as "He eats pasta" or "It's a zoo" or "It's silly".
Being careful not to rush, give the child other /ts/ words, IN SIMPLE SENTENCES, WITHOUT OTHER S-WORDS, to practice saying (in the speech clinic and at home) in short practice sessions of 5 to 7 minutes, once, twice or three times daily.
The practice periods can be separated by as little as five minutes. When it comes to homework some families find it easier to do a sequence such as this: practice-1 - read a story - practice-2 - read another story - practice-3 - read a story.
sits eats cuts squirts knits floats skates gets pots mats boats cats hats coats bats nets roots pants nuts shorts fort-forts hat-hats nut-nuts suit-suits mat-mats seat-seats cat-cats kite-kites goat-goats coat-coats
Try to put the /ts/ word at the end of the phrases or sentences, to make it easier for the child. For example, many lights, many kites, many fights, many jets, many mitts, etc; or, the men are in the boats, the sheep are in the boats, the fish are in the boats, the deer are in the boats, etc.
By now the /s/ the child is producing should sound clear and "adult-like", and ready to separate from the /t/. Without mentioning the tongue too often, instruct the child to "say ts without moving the tongue, and then add an ess, like this: /ts-s/. This may be difficult for the child at first, so take it slowly and quietly and give plenty of support and encouragement.
Determine whether producing /s/ SFWF (after a vowel) is easier for the child, or whether producing /s/ as the first sound in a consonant cluster is easier.
Children vary with regard to this, with some children finding /s/ before a consonant, in a consonant cluster such as /sp/, easier to say. If the child can ONLY manage /s/ in clusters, start with /st/, thereby building directly on what has already been achieved.
spy speech spit spot spin spill space spear spine
clasp asp gasp crisp grasp rasp
stool stop steam stork stake stack star stick steel store sty stamp
Provide practice with all two element s-clusters SIWI. Do not include three-consonant combinations such as /str/ and /spr/ unless the child achieves quick success with them.In the same step, introduce st- and ts- clusters SIWW, with production practice words such as master, Betsy, instant, etc.
Producing /s/ in the SIWI position may be the hardest step for the child (depending on the particular child, of course), but it should happen smoothly if the preceding steps have been mastered.
/s/ Syllable Initial Word Initial
seat sun C sign sack seal soap seed salt six saw sock sums suit sink seven sauce sieve sea sand soup six sails safe
Move on to /s/ SIWW and SFWW, and /s/ SFWF.
/s/ Syllable Initial Within Word
messy parcel dinosaur casserole blossom pussy pencil taxi rhinoceros croissant lasso icing bassoon insect fossil bison glasses jig-saw basin unicycle bicycle tricycle vaccination synthesizer consultation juicer
/s/ Syllable Final Within Word
basket toaster ice-cream pasta listen cassette Australia restaurant saucepan crossword insect houseboat Christmas tree hospital baseball Easter bunny escalator investigator
/s/ Syllable Final Word Final
bus purse mouse nurse gas horse case goose juice house yes rice kiss ice dice S sauce dress
Individualizing the program and tailoring it to the particular child's needs, follow a traditional therapy hierarchy of activities in order to complete the process of eliminating lateral /s/ (or palatal /s/) and establishing standard production. Additional work on the voiced cognate /z/ may or may not be required, depending on the child.
Cite this article as:
Bowen, C. (2011). Butterfly Procedure. Retrieved from http://www.speech-language-therapy.com/ on [insert the date that you retrieved the file here].