What to do if your child has a lisp?

When children have a lisp, it sounds cute to some adults. However, most parents worry when their child doesn't pronounce the s sounds correctly - especially if this severely disrupts communication or the lisp doesn't disappear even after a long time.

It is typical of a lisp that a child does not pronounce sibilants such as «s» and «z» correctly (sigmatism). The tongue normally lies a little behind the teeth when the «s» is formed. When lisping, it hits the front teeth so that the «s» sounds like «f» or similar to the English «th». This also affects the sound combinations «ts» and «ks», which occur in German in the letters «z», «x» or «chs».

Around 40 per cent of all children develop a lisp with the sibilants «s», «z» and «x» in the course of their speech development.

However, lisping can also affect the «ch» and the «sch» (chitism or schetism): The «ch» is then pronounced like «sch» or «s», the «sch» like «s», «ch» or «t». First of all, to reassure many parents: lisping is relatively common in toddlers and at nursery school age: around 40 per cent of all children lisp with the sibilant sounds «s», «z» and «x» during the course of their speech development.

And: Lisping is one of the less severe speech disorders. However, it can have an impact on the position of teeth later on. But when is lisping harmless and does it disappear by itself with age? And when does it make sense to specifically train pronunciation with speech therapy?

Recognising abnormalities at an early stage

In order for lisping to be treated successfully, the causes must first be identified. This is primarily the responsibility of speech therapists, who in many cantons are firmly integrated into the kindergarten or school. «At the age of five to six, the level of language development is assessed in most kindergartens during language assessment,» says Vanessa Braun Shakeshaft, head of the speech therapy service in Andelfingen ZH. «It serves to recognise possible abnormalities in speech at an early stage.»

Parents are then informed of the results of the test. Important to know: «s», «sch» and «r» are the most motorically demanding sounds in the German language. This is why children are often only able to pronounce them correctly towards the end of their language development, at around the age of five. «Lisping at this age is also linked to the growth of teeth and tongue,» explains Braun. «The tongue is now growing relatively strongly, while the milk teeth are still small in comparison. That's why sibilants are often pronounced incorrectly.»

Another cause of lisping can be unfavourable sucking habits, for example if a child sucks a pacifier or thumb a lot. «This creates an incorrect swallowing pattern. In addition, the tongue is pressed between the teeth or lips, which can lead to misaligned teeth and thus favour lisping,» explains the speech therapist.

Disorders of the mouth muscles - such as the tongue or lips - or misaligned teeth or jaws can also lead to lisping. «Such misalignments are often noticed by the dentist or orthodontist treating the child,» reports Braun. «They often pass the information on to the kindergarten or school after the school dental check-ups so that appropriate measures can be taken there.»

Lisp to stand out

Sometimes a hearing disorder can also be behind the lisp, says Andrea Haid, Rector of the Swiss School of Speech Therapy in Rorschach. «If there is a suspicion of hearing problems, this should definitely be clarified by an ear, nose and throat specialist,» emphasises the expert. «This is usually arranged by the paediatrician. However, speech therapists or nursery school teachers can make the recommendation.»

In rare cases, it is paralysis of the muscles, tumours or malformations of the tongue or palate that lead to the child's impaired pronunciation. «In addition to speech therapy treatment, it is important to treat the underlying physical causes,» says Haid.

Finally, there is the rather special case of a child suddenly developing a lisp, even though it has already mastered the sound «s». «This can happen, for example, when a sibling is born,» reports Haid. «The child then lisps in order to appear younger and receive more attention and care.» As a result, a number of different components need to be taken into account in the diagnosis, says the speech therapist.

The crucial question that concerns many parents is: when can you simply wait for the lisp to disappear on its own and when should you take action? Most experts agree that lisping at the age of three to four is still age-appropriate and that you can wait and see.

In most young children, lisping can be treated with speech therapy.

Some experts advocate treating lisping from the age of six or seven - others from the age of five. «At the age of five to six, the change of teeth and the associated gaps between teeth often lead to a lisp, which then often disappears on its own,» says Vanessa Braun. "However, if a child still has a lisp in first grade or at the age of seven, speech therapy should be started.

By the time they start school , children should be able to form all sounds correctly so that they can also write them correctly." However, starting therapy at the age of five can also be useful. «If the lisp is caused by an incorrect swallowing pattern with a strong tongue thrust or if the change of teeth occurs at an early age, it makes sense to start therapy at the age of five in order to avoid misaligned teeth,» says Braun. Andrea Haid advocates starting speech therapy at the age of five if a child consistently mispronounces the s sound but is already able to form the «s» correctly. «This prevents the incorrect pronunciation from becoming more entrenched,» says the speech therapist.

Practising early makes sense

Early practice also makes sense because lisping is no longer perceived as cute in older children, but rather as a flaw. «If older children or teenagers still have a lisp, this leaves different impressions on the people they talk to,» emphasises Haid.

No matter which approach is chosen: The prognosis for young children is generally very good - in most cases, lisping can be successfully treated with speech therapy. Children attend speech therapy once a week for this. If the lisp is particularly pronounced, therapy takes place individually or in a group of two. The speech therapists also form an «s group» in kindergarten or later at school, in which the pronunciation and correct hearing of the s sounds are trained.

«As the progress of the therapy depends on the intensity of the exercises, we also give the parents exercises to do at home with their children on a regular basis,» reports Braun. The exercises should be individually tailored to the children. «Some find it difficult to hear and recognise the s-sounds correctly, for some the lip and tongue muscles are slack, for others the correct position of the tongue or jaw does not yet work well,» explains Haid. «The exercises are therefore selected to train precisely these aspects.» At the very beginning, the children still have to consciously form the s sound, which requires a lot of concentration. «However, the aim is for them to be able to pronounce the «s» correctly spontaneously and without difficulty,» says the speech therapist.

Some children have a lisp - and they don't mind it at all. Others, however, are ashamed of their mispronunciation and their self-confidence suffers. This is often exacerbated when schoolmates tease them about their lisp or their parents frequently criticise or correct their incorrect pronunciation. How common is this kind of psychological stress? And how can they be avoided?

In Vanessa Braun's experience, older children in particular suffer from lisping. «In kindergarten, children's awareness of the disorder is still low,» says the speech therapist. «Lisping is also much less problematic than other speech disorders. In most cases, the children are still well understood and parents and teachers are relatively relaxed about it.»

Lisping can be more stressful from the 3rd grade onwards. «Here it is no longer perceived as age-appropriate. In addition, the children now often have to give small presentations alone or in a group, where the lisp is particularly noticeable,» says Braun. Girls often suffer more from a lisp than boys - however, awareness of the disorder and psychological stress vary greatly from person to person. «In any case, it is important to take away the children's shame and maintain their joy of speaking,» emphasises Braun. «You can tell them that lisping is common and that it often disappears with appropriate exercises.» Teachers and parents should also boost the child's self-confidence - for example, by praising them for things they can already do well.

And finally, it depends on the attitude of classmates, parents and teachers, emphasises Andrea Haid. «Teachers and other carers should create an atmosphere in which tolerance for differences is a matter of course,» says the speech therapist. «This is important for all types of abnormalities - many of which are more serious than lisping.»