| Lisp | |
|---|---|
| Classification and external resources | |
| ICD-10 | F80.8 |
| ICD-9 | 307.9 |
A lisp is a speech impediment, historically also known as sigmatism.[1] Stereotypically, people with a lisp are unable to pronounce sibilants (like the sound [s]), and replace them with interdentals (like the sound [θ]), though there are actually several kinds of lisp. The result is that the speech is unclear.
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The cause of a lisp can vary. In some instances, the cause is physiological, and the patient has some sort of deformity or medical condition which causes a lisp. For example, a child with swollen adenoids may tend to lisp, as will people who have recurring stuffy noses. Also, a lisp can be formed when the tongue is bruised or swollen. People with underbites and/or large tongues or tongue piercings may also lisp.
Treating lisps in children usually involves speech therapy treatments and are generally successful. Speech therapy sessions include a wide variety of activities and speech drills, though what specifically happens in any given session will depend upon many variables. The content of these sessions will be affected by the length of each therapy session (usually between a half hour and one hour), its location (whether at home, school or a private facility), the age of the child involved, whether the therapy session is private or involves a group, and the type of lisp that is being treated.
One popular method of correcting articulation or lisp disorders is to isolate sounds and work on correcting the sound in isolation. The basic sound, or phoneme, is selected as a target for treatment. Typically the position of the sound within a word is considered and targeted. The sound appears in the beginning of the word, middle, or end of the word (initial, medial, or final).
Take for example, correction of an “S” sound (lisp). Most likely, a speech-language pathologist (SLP) would employ exercises to work on “Sssssss.” Starting practice words would most likely consist of “S-initial” words such as “say, sun, soap, sip, sick, said, sail.” According to this protocol, the SLP slowly increases the complexity of tasks (context of pronunciations) as the production of the sound improves. Examples of increased complexity could include saying words in phrases and sentences, saying longer multi-syllabic words, or increasing the tempo of pronunciation.
Using this methodology, the SLP achieves success with his/her student by targeting a sound in a phonetically consistent manner. Phonetic consistency means that a target sound is isolated at the smallest possible level (phoneme, phone, or allophone) and that the context of production must be consistent. Consistency is critical, because factors such as the position within the word, grouping with other sounds (vowels or consonants), and the complexity all may affect production.
Another popular method for treating a lisp is using specially designed devices that go in the mouth to provide a tactile cue of exactly where the tongue should be positioned when saying the "S" sound. This tactile feedback has been shown to correct lisp errors twice as fast as traditional therapy.
Using either or both methods, the repetition of consistent contexts allows the student to align all the necessary processes required to properly produce language; language skills (ability to formulate correct sounds in the brain: What sounds do I need to make?), motor planning (voicing and jaw and tongue movements: How do I produce the sound?), and auditory processing (receptive feedback: Was the sound produced correctly? Do I need to correct?). A student with an articulation or lisp disorder has a deficiency in one or more of these areas. To correct the deficiency, adjustments have to be made in one or more of these processes. The process to correct it is more often than not, trial and error. With so many factors, however, isolating the variables (the sound) is imperative to getting to the end result faster.
A phonetically consistent treatment strategy means practicing the same thing over and over. What is practiced is consistent and does not change. The words might change, but the phoneme and its positioning is the same (say, sip, sill, soap, …). Thus, successful correction of the disorder is found in manipulating or changing the other factors involved with speech production (tongue positioning, cerebral processing, etc.). Once a successful result (speech) is achieved, then consistent practice becomes essential to reinforcing correct productions.
When the difficult sound is mastered, the child will then learn to say the sound in syllables, then words, then phrases and then sentences. When a child is able to speak a whole sentence without lisping, attention is then focused on making correct sounds throughout natural conversation. Towards the end of the course of therapy, the child will be taught how to monitor his or her own speech, and how to correct as necessary.
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