Difficulties with the "S" sound need evaluation if they persist until school age.

Speech Issues with the Letter "S" in a Child

by Sharon Perkins

When your toddler happens to be missing a few letter sounds when he speaks, everyone thinks it's cute. But when your first-grader still struggles with the "S" sound, it goes from being cute to being a reason for a referral to speech therapy. Speech therapists sometimes don't use the word "lisp" -- because of its negative connotation -- to describe difficulty with "S" sounds, but other people might. Around 5 percent of first graders still have functional speech disorders, meaning that they have no identifiable cause, according to the Encyclopedia of Children's Health.

1. Common Causes

Making the "S" sounds requires your child to place her tongue in a certain position in relation to her teeth. If you think about it, it's amazing any child ever learns to talk; the dynamics of speech are amazingly complex. Common types of functional lisps -- including interdental, frontal or dentalized lisps -- often occur as part of normal speech development and generally disappear on their own. Placement of the tongue between or touching the front teeth, rather than just behind them or the lower front teeth, causes these types of lisps.

2. Speech Evaluation

Some types of lisps don't occur as part of normal speech development. A lateral lisp occurs when your child makes the "S" sound with the tongue in a position similar to that required to make the "L" sound. This type of lisp might be called "slushy," "messy" or "spitty." A palatal lisp occurs when making the "S" sound if your child places her tongue against the soft palate. Since neither of these types of lisps occurs as part of normal speech development, both need evaluation by a speech therapist, suggests pediatric speech language pathologist Katie of PlayingWithWords365.com.

3. Speech Therapy

If your child's lisp shows no signs of disappearing by age 4 1/2, it's a good time to have a speech evaluation, speech-language pathologist Dr. Caroline Bowen recommends. Treatment depends on whether your child's difficulty is due to a functional speech disorder or if there's another cause. In some cases, low motor tone, habitual mouth breathing, atypical facial structure formation or cognitive delays can cause difficulties with "S" pronunciation. Tongue thrusting can also cause lisping; prolonged thumb sucking, bottle or pacifier use can lead to tongue thrusting, according to the Encyclopedia of Children's Health.

4. How to Address the Issue

As a parent, the best thing to do with a frontal lisp is not to bring constant attention to it. Rather than telling your child she's saying it "wrong," use recasting as a correction technique. Repeat what she said, in slightly different form, with a slight emphasis on the correct pronunciation. Follow your child's speech therapist's suggestions on how to work specifically with your child to correct her pronunciation, but at other times, don't draw attention to it.

About the Author

A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.

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