Lisps and other childhood articulation errors

All children who are able to learn to speak orally, all over the world, learn to say their sounds over time. No child is able to produce all the sounds of the language that they are learning perfectly from day one.

It's all about learning the sound system of the language that you hear around you - what we call, "the ambient language".

 

We know - certainly from the studies on the acquisition of English - that the first words that very young children say contain the sounds that they babbled. You will never hear a "s" in babble, nor will you hear a "th", and you do not hear these sounds in early speech.  In their first words, you'll hear children say things like 'mama', 'dada', 'botti' (bottle), 'gone', 'more', and 'uppie'. As children mature, they learn to pronounce the full range of consonants and vowels.

What is typical speech development?

We have lists of 'norms' of sound acquisition, but I really do not like to refer to them too much (especially in South Africa) because there is tremendous cultural and developmental variability. The information here is based on international English norms but also on my clinical experience of South African English children - please use the information as guidelines only!

  • Children learn to say almost all of the sounds by the time they are 3 years old.

  • In their 4th year, they learn to say "l", "sh", "ch" "j" "s" and "z" well.

  • In their 5th year, they learn to say the "r".

  • In their 6th year, they learn to say "v" and "th".

Not only do children learn to say the sounds (what we refer to as 'phonetics'), but they learn the sound patterns of language (which we call 'phonology'). We distinguish between sound patterns that are MUDDLED and actual sounds that are produced incorrectly i.e. distorted.

 

When sounds are muddled or when sounds are distorted:

The "muddles" are patterns (what we speech therapists refer to as "phonological processes') that we can identify such as:

  • "bet" for "bed: the final consonant is produced without voicing

  • "sho" for "shop": the final consonant is left off

  • "sape" for "shape": the "sh" is made in the front of the mouth instead of the middle of the mouth

  • "tefone"or "telephone" and "lieve" for "believe": the syllable that is usually unstressed is left off

  • "wun" for "run", "yeg for "leg" and "wie" for "lie": the sound 'glides'

  • "top" for "shop" and "doo" for "zoo", "top" for "chop", 'tum" for "thumb", "doze" for "those" and "dump" for "jump": the 'fricative' sound is turned into a 'stop' sound (fricative and affricate sounds are learned last - we never hear them in babbling!). We expect children to learn to say these fricative and affricate sounds well by the time they are 4 to5 years old.

Distortions are attempts to produce the speech sounds but they sound "wrong" - they are produced in ways that one would never that one would never hear in  a typical adult's speech in any position of any word. It is  unusual for children to produce distortions of a sound, but if they do, we like to correct them before they become a habit.

By which age should a child speak intelligibly?

By the time a child is 4 years of age, his or her speech should be mostly intelligible to strangers who have never met them. Children of this age should be able to say most of the speech sounds except for a few muddles such as "f" for "th", "w" for "r" and may also muddle up sounds when words are unfamiliar to them, or when words are multi-syllablic such as   "epscalator" for 'escalator" and "pisghetti" for "spaghetti".

By the age of 4 years, none of the speech sounds should be distorted - they should sound like speech sounds but some of these sounds may be in the wrong places.

When do we learn to say "thumb" and not "fumb?"


South African English-speaking children learn to say "th" between the ages of 4 and 6 years, but some learn it only in their 7th year (often in grade 1), and some only get it by their 8th year!

Many children continue to substitute a "d" or a "t" for a "th" (e.g. "doze:" for "those" OR "ting" for "thing") until they are 5 years old.

By which age should a child have learned to say the "r" sound?

South African English-speaking children learn to say "r" between the ages of 3 years and 6 years, and we expect 5 year olds to have mastered it. By the time they enter school at age 6 years, we expect them to  differentiate clearly between "rings" and "wings".

By what age should a child learn to say the "l" sound?

We expect the /l/ sound to be learned by the 4th year of age, but some children continue to muddle up "y" and "l" (e.g. "yeg" for "leg") , and "w and "l" (e.g. weg" for "leg") until they are 5 years old.

Lisps

Not all lisps are cute!

Lisps can take different forms.

 

  • Some of the the time, children substitute sounds for an "s"

  • Some children substitute "sh" for "s" as in  "shake" for sake" or "shun" for "sun".

  • Some children say "thun" for "sun" and "thower" for "shower".

  • Some children say can say and "s" but cannot say a "sh"

  • Sometimes, sounds like "t" and "d" as well as "s" are made with the tongue between the teeth.

 

                        See this videohttps://www.youtube.com/watch?v=xDTTKlgVm7A

  • And sometimes, the "s" sounds like it is distorted.

  • Sometimes the "s" is produced with what we call a "jaw slide", where the jaw shifts to one side.

So when should a child be referred to a speech therapist?


Any one of these markers calls for a referral to a speech therapist, at any age.

Marker 1:  Atypical look: Does your child's speech LOOK typical? Is your child producing his or her sounds with a crooked mouth? with a tongue that sticks out too much? with spit in the mouth? with pursed lips?

Marker 2: Groping for sounds: Does your child have difficulty imitating you? With putting his or her tongue, lips, jaw in the right place? Does the child look like he or she is struggling to find the right place to make the sound?

Marker 3: A tongue that thrusts: If your child speaks with all sounds being produced with the tongue in a forward position in the mouth, like all "d"and "t" sounds being produced with the tongue between the teeth and the "s"and "sh"

Marker 4: Intelligibility: A child under the age of 4  whose speech is unintelligible to familiar partners more than 40% of the time, and any child over the age of 4 years who is unintelligible to familiar partners and who is unintelligible to strangers more than 40% of the time.

Marker 5:  When a child does not reach these milestones:

  • Children learn to say almost all of the sounds by the time they are 3 years old.

  • In their 4th year, they learn to say "l", "sh", "ch" "j" "s" and "z" well.

  • In their 5th year, they learn to say the "r".

  • In their 6th year, they learn to say "v" and "th"

Marker 6: Distortions: If the child produces sounds that a typical speaker would not say, when the sound sounds "wrong".

Marker 7: Sounds substitutions or "patterns" that are used for too long:

Most patterns are resolved by age 3 to 3,6 years

Some children continue to leave off unstressed syllables (like "ephant" for "elephant"); and substitute "d" for "j" (dump/jump) and "t" for "ch"  (tin/chin) but these should be resolved by 4,6 years.

By age 5, children should stop to use a "w" or a "r" and a "w" or a "y" for "l".

Marker 8: When an 8-year old does not produce all speech sounds accurately and is not intelligible all of the time to strangers. (But remember that the earlier we see a child for therapy, the better the outcomes).

Marker 9: If you are at all concerned. Don't wait, and don't let anyone other than a speech therapist that you should wait.