S & Z

How do you train the correct production of /s/ and /z/ to a child with a lisp?

When training a child with an interdental lisp to say the /s/ and /z/ sounds I have followed what might be considered a traditional approach by simply teaching the child to keep his teeth closed when producing the /s/ and /z/ sound. After multiple successful repetitions of the /s/ with the teeth closed I introduce them to a list of 20 words ending with /s/ since the /s/ is generally mastered at the end of words first. After the child masters the list of 20 words I have them put those words into sentences and practice reading the sentences aloud. When the sentences are mastered I have the child read a story with multiple pictures or words ending with /s/. I continue to follow this outline as we practice /s/ and /z/ as it occurs in the initial and medial positions of words as well. Finally I have the client read aloud for 10-20 minutes working toward 80% accuracy or better. I conclude therapy once a client has mastered the correct production of /s/ and /z/ in all positions in conversation.

I often pair the articulation therapy for /s/ and /z/ with a straw drinking program to pull the tongue back since a forward tongue posture often contributes to interdental and dentalized lisps. Straw drinking also helps reinforce centralized airflow for clients with a lateral lisp. Some speech therapists don’t believe straw drinking is necessary but it has always been very successful technique for me and my clients.

When teaching the /s/ and /z/ sound to a child with a lateral lisp I have used a short straw placed at midline so the client could hear when the airflow was centralized. I have not found this approach to be very effective! It seems to take a long time for my clients to produce their first true /s/ sound. That is why I am so excited about the Butterfly Procedure by Dr. Caroline Bowen PhD, CPSP I read about on speech-language-therapy.com. With this approach, it just seems that teaching the /s/ to a client with a lateral lisp would be so much easier because they are able to visualize exactly what you want them to do with their tongue.

The gist of the “Butterfly Procedure” is that the tongue imitates the position of a butterfly, with the sides of the tongue up slightly like butterfly wings, and the groove of the tongue the body. The sides of the tongue touch the teeth lightly while the airflow goes down the groove of the tongue or body of the butterfly instead of out the sides as it does with a lateral lisp. You achieve this position by having the child say the “ee” as in key, or the “i” as in him. Then try for an /s/ holding the butterfly position. I have a couple of clients I am so excited to try this with!

The other new exciting tip I picked up from Dr. Caroline Bowen PhD, CPSP is to train the /s/ from the /t/ sound. She outlines 10 easy steps to teach this procedure. To give you a quick idea she begins by having the child say the /t/ sound, and then the /t/ sound repetitively, for example /t-t-t-t-t-t-t/. When you do this exercise quickly you can feel a slight /s/ coming out. Cool, huh! Check out the other steps, they just make sense.

Heidi Hanks, M.S.CCC-SLP

HOW TO TEACH THE S SOUND BY CHICAGO SPEECH THERAPY

The /s/ sound is made by placing the tip of your tongue just behind the front teeth, very close to the roof of the mouth but not touching it. The sides of the tongue are raised to touch the roof of the mouth, leaving a passage for air down the middle of the tongue. The sides of the tongue should also rest against the side of your teeth, which should be together. Finally, the lips should be parted slightly with the corners drawn up, like a smile. The /s/ sound is unvoiced, so the sound comes purely from the air travelling through the passageway created in your mouth and through your teeth.

This is a trickier sound for kids to make and it is common for children replace it with the /th/ sound. Your child should begin getting the sound by around three years and should have it mastered by age seven or eight. The /s/ sound has a little more leeway in the age by which it needs to be developed, but if your child has trouble pronouncing it, the longer you wait to seek help, the more difficult it will be to remediate the sound. If your child is over eight years old and still has a lisp or other difficulty with the sound, it is highly recommended that you consult with a licensed speech-language pathologist as soon as possible.

At any stage in your child’s language development, practicing articulation at home can be a wonderful activity for you and your child. Schedule specific time to spend working on articulation with your child and take advantage of smaller moments like making dinner or walking to the park to reinforce your practice.

Here are a few speech therapist recommended activities for you and your little one:

• Verbal cues

When you practice a specific sound with your child, begin by pronouncing the sound slowly and clearly for your little one. With a sound like /s/ that does not have an inherent end point, say it one a time, for a few seconds each: “/s/”. This helps your child understand the single sound you will be focusing on, and provides a correct example for her to imitate. As your child masters the individual sound, move on to simple syllables by adding vowels to the /s/: “so, so, so,” “see, see, see,” “sa, sa, sa.” With time and practice, your little one will be able to move on to words and, eventually, sentences and conversation.

• Visual Cues

Often accompanying a sound with a visual cue helps to ground the idea for a child and provides an association for them to remember the sound in the future. When you pronounce the /s/ sound for your child, place your index fingers at the corner of your mouth and pull them back towards your ears as your mouth stretches to make the sound. Encourage your child to do the same each time he pronounces the sound. Practice with a mirror for even more visual feedback.

• Tactile Cues

Speech therapists often use tools similar in size and shape to a tongue depressor or a toothbrush that are specifically designed to help children with the placement of their mouth for certain sounds. Ask a speech-language pathologist about tools like the Speech Buddies for tactile help in improving articulation. These tools are effective, but should only be used with the help of a trained therapist.

• Awesome /s/ Activities

The /s/ sound is particularly fun because it is the “snake sound”. Put your hands together with the palms flat and facing each other, then move your arms side to side as though you are a snake. Encourage your child to do the same and slither around the house together making the /s/ sound. Create games and challenges for your little snake; he must name and then eat every object he finds that begins with /s/, or he must introduce himself to all the family members as “I am Sam, the slimy, slithering snake!” Kids love these activities and they are a great way to reinforce the /s/ sound!

LINKS TO PRACTICE AT HOME

/s/ Word List

Initial /s/ Board Game

Medial /s/ Board Game

Final /s/ Board Game

/s/ Board Game Directions

Silly Tongue Twisters