September 1, 2017 by Kids Chatter Speech Pathology

Help! Nobody Understands My Child’s Speech!

How Clear Should a Child’s Speech Be?

My daughter was 3 years old when I found her upset and crying in her room. I asked her what was wrong, expecting her to tell me that she had hurt herself or her twin sister had done something to annoy her, but she said through her streaming tears “I tan’t bind my tow” and she was absolutely distraught. What she was trying to tell me, was that she couldn’t find her cow, her beloved soft toy that she sleeps with every night.

How many times have you heard your child mispronounce a word? I’m sure every parent will put their hand up and will probably be able to tell you a list of some of the funny things their kids have said. There are tons of videos floating around the internet with kids mispronouncing words like the classic “truck” being mispronounced as a certain swear word. We all find them funny and can usually have a good laugh, but at what point, do you worry that your child’s speech errors are not just funny anymore and actually a sign that there might be a problem with their speech development?

If your child is still mispronouncing words, it doesn’t necessarily mean that it’s a problem as speech errors are a normal part of speech development while kids are learning to talk. But let me help you work out when those speech errors are considered part of normal development and at what point they may not be anymore. Below, you will find a list of ages and stages when it comes to specific speech sound development and when certain errors are expected to resolve on their own, including a free download that you can keep for your own reference.

What is speech?

Before we get into the specific speech errors and their development, I want to ensure that we are all talking about the same topic as there can sometimes be a bit of confusion. When I’m referring to SPEECH development, I mean the speech SOUNDS that children say that has to do with their overall clarity of speech – how well you can understand what they’re saying. LANGUAGE development has to do with a child’s ability to understand and use words (how many words they are saying i.e. vocabulary), follow instructions, put grammatically correct words together to form sentences etc. Many parents think that speech and language are one and the same thing, but they are in fact two very different things (which I’ll talk about in a future blog). So in this blog, we’re talking about the speech sounds, the overall clarity of a child’s speech when they’re talking.

Why do children have speech errors?

The act of using spoken words to communicate is actually quite a difficult skill for children to learn. When babies are born, their main form of communication is by crying. This eventually turns into making noises and babbling and ultimately they start to say words that match what we as adults use every day. We probably take for granted as to how hard this process can actually be. The precise tongue, lip, teeth and jaw movements that we have to use to make certain speech sounds, is a fine art that most of us have perfected, but young toddlers and children are just starting out to learn this skill when they first start to talk. So it is perfectly normal for children to have speech errors when they’re young as they’re working out how to make the sounds. Some speech sounds like /m/, /b/ and /d/ are much easier for children to learn, hence why they tend to develop first, but other sounds like /s/, /r/ and /th/ are much harder and typically develop much later. This is normal! Not every speech sound will be correct from the time children start to talk, because some sounds are simply more difficult to produce and will take more time to learn. It’s when speech errors are still happening after certain ages and/or multiple errors are occurring, that it may become a cause for concern.

What causes speech errors?

In most cases, we don’t know what causes a child’s speech errors. Unless there’s a known disability such as Cerebral Palsy where the muscle movement and strength is affected or children who are born with an anatomical problem such as a Cleft Palate, we don’t always have a clear answer for why some children have speech errors that don’t resolve on their own whereas other children go on to develop clear speech without intervention. In this blog, I’m referring to those kids who do not have a known diagnosis/disability that would be contributing to their ability to learn speech sounds.

What is normal in a child’s speech sound development?

If you often find yourself having to translate your child’s speech for another person, or perhaps even an older sibling is translating for them, then that’s probably a good indicator that your child’s speech is unclear. Parents, particularly us mums more so than dads (sorry dads, I’m not having a go at you), but more often than not, mums hear their child’s speech all day, every day, so we are much more familiar with our child’s speech than strangers, or family members and friends who don’t see your child every single day. So we don’t always realise how unclear our child’s speech may be to others because we don’t notice it as much. So, if you’re always translating for your kids, take that as a sign that this may need some further investigating by a Speech Pathologist.

As I mentioned before, it is very normal for young children to make speech errors while they’re learning to talk, but let’s look at the overall clarity, or what is also known as speech intelligibility, that we expect at certain ages. Below shows the percentages of how much a stranger i.e. someone who is not familiar with your child’s speech, should be able to understand.

By 1 year of age, an unfamiliar person should be able to understand 25% of a child’s speech
By 2 years of age, an unfamiliar person should be able to understand 50% of a child’s speech
By 3 years of age, an unfamiliar person should be able to understand 75% of a child’s speech
By 4 years of age, an unfamiliar person should be able to understand 100% of a child’s speech

Flipsen, P., Jr. (2006). Measuring the intelligibility of conversational speech in children. Clinical Linguistics & Phonetics. 20(4), 202-312.

Now, that does NOT mean that your child doesn’t have speech errors, all it means is that those errors, aren’t impacting too much on us being able to understand what they’re trying to say. For example, if a child said “tan I pwease have some duice?” you know that they’re saying “can I please have some juice?”. There are 3 speech errors in that sentence, but you can still quite easily make out what he/she was trying to say.

The overall intelligibility of a child’s speech can be affected by their age as younger children typically make more speech errors than older children, but the number of errors a child makes as well as the type of errors can also affect this. There are typical errors that we expect to see in speech development that follows common patterns, but when children make unusual or atypical errors, or they are using multiple errors, that’s when their overall clarity will be decreased even further. There are also different types of speech disorders that children may have. They can have an Articulation Disorder, a Phonological Disorder or some children may have a diagnosis of Childhood Apraxia of Speech (CAS), which is a motor based speech disorder. CAS is quite rare so we will discuss this in more detail in a future blog and for now, we’ll focus on the two most common speech disorders that we see in our Indooroopilly clinic on a daily basis.

What is an Articulation Disorder?

An articulation disorder is where children have difficulties saying a speech sound in isolation. It’s usually due to the incorrect placement of their articulators (tongue, lips, teeth, jaw) which results in a distorted production of the sound. Articulation errors are NOT considered part of typical speech development and may not always resolve on their own. An interdental lisp is an example of an articulation disorder as the tongue sticks out between the teeth when saying the /s/ or /z/ sounds when it should stay behind closed teeth.

The table below shows the ages by which specific speech sounds should have developed. If your child is not yet saying certain sounds by the listed ages or is not producing them correctly, please seek advice from a Speech Pathologist as these children usually require speech therapy intervention to help in correctly saying their sounds.

What is a Phonological Disorder?

The other common speech disorder we see in our clinic is a phonological disorder. This is where children often CAN say the individual speech sounds, but when they are saying words and sentences, they are swapping some of their sounds to another sound, or they are deleting sounds in their words. Common ones that you have probably heard children say is “wabbit” instead of “rabbit” or when they’re counting, young kids will often say “one, two, fwee, bour, bibe”. What about “nake” instead of “snake” and “boon” instead of “spoon”.

Sound familiar?

These are all very common and normal errors that we see in kids, up until a certain age. When children continue to use these errors beyond the expected ages, that’s when it would be considered a phonological delay and more often than not, children will need to see a Speech Pathologist to help correct these errors as they do not always grow out of this on their own.

When children produce atypical/unusual phonological processes, that’s when it is a phonological disorder as they are using errors that we do NOT typically expect to see in speech development. For example, children using a process called backing, which is where they produce a sound like /t/ and /d/ and swap it to a /k/ and /g/, so “turtle” become “kurkle” or “dinner” becomes “ginner”, it is a much bigger concern because is it not part of normal speech development. Another pattern that some children will use is called initial consonant deletion, which means that they are deleting the first consonant sounds in all of their words. So for example, “dog” becomes “og” and “car” becomes “ar”. If you hear a child using these errors, it is highly recommended to see a Speech Pathologist as those errors should not occur at any age and they will also significantly affect a child’s overall clarity of speech.

For a full list of phonological speech errors that children make, download our free speech chart here. This chart lists the ages of when we expect those errors to disappear. So if you hear your child making any of the errors and they are older than the age listed and/or they are using multiple phonological errors, please seek advice from a Speech Pathologist.

Do children grow out of speech errors on their own or do all children need speech therapy?

A lot of children will figure out a lot of the speech sounds over time and may correct their errors without any intervention, however, this is not the case for all children. As mentioned above, it all depends on a child’s age, the type of errors and how many errors they make as to whether or not speech therapy is warranted. And if you have any concerns yourself, the best thing you can do is ask a Speech Pathologist for advice as speech development is a very complex process.

The most important piece of advice I can give you though, is not to ignore speech errors and just assume that children will grow out of it, because not all children do. If left untreated, speech sound errors can affect a child’s phonological awareness, reading, spelling and writing skills and can also have a huge impact on their confidence, social skills in the playground with their friends, withdrawal from educational tasks such as not wanting to speak in front of their peers or asking/answering questions, or having difficulties making new friends in fear of being ridiculed or bullied.

Thankfully, there are lots of things a Speech Pathologist can do to help your child to prevent ongoing speech difficulties, but it starts with listening to your child’s speech and taking action on seeking advice from a Speech Pathologist when their errors are not resolving on their own. Remember to download your free copy of our speech chart and contact us if you have questions or concerns about your child’s speech.

Monique Speakman
BA, MSpPathSt, CPSP, MSPA
Speech Language Pathologist

Monique Speakman is a Paediatric Speech Pathologist in Brisbane with over 14 years experience, mother of a son and twin daughters, business owner and blogger. She aims to educate parents about child development and communication through the Kids Chatter Speech Pathology Blog and Facebook Page and to provide information and tips on anything to do with Speech Pathology.

September 8, 2016 by Kids Chatter Speech Pathology

Will my child grow out of a lisp?

I hear this question all the time from parents whose child has a lisp. Unfortunately, it’s not quite as simple to answer without explaining a few things first.

Have you ever noticed that your child is poking their tongue out when they’re speaking or that they sound “slushy”? Do you or other people find it difficult to understand their speech clearly? This could be a sign that your child has a lisp.

Some parents already know their child is lisping, but you’d be surprised to hear how many parents never realised their child has a lisp. This is usually because they are so used to hearing their child’s speech every day (and they can usually still understand them), that this speech error goes unnoticed, or they don’t know what a lisp is. We successfully treat lisps on a daily basis in our clinic, plus we have a trained ear, so we can show you what to look and listen for.

What is a lisp?

There are in fact four different types of lisps, and this is why it isn’t always as straight-forward as people may assume.

Interdental lisp or also known as a frontal lisp
This lisp is probably the most common one children have and usually the one most people are familiar with. This is where the tongue sticks out between the front teeth on all /s/ and /z/ sounds, and essentially makes a sound like a /th/. So instead of “snake”, kids will say “thnake” or “bus” will sounds like “buth”. Children can also have an interdental production (i.e. putting the tongue between the teeth) for other sounds like /t/, /d/, /l/ and /n/. Check out the video below for an example.

Dentalised lisp
With this lips, the front of the tongue pushes against the inside of the front teeth and makes the /s/ and /z/ sounds quite muffled.

Lateral lisp
This lisp is usually described as a “slushy” or a “wet” lisp. This is because the airflow that’s produced for the /s/ and /z/ sounds, is coming out the sides of the mouth into the cheeks, rather than out the front/centre of the mouth where the airflow should be going. The lateral lisp can sometimes affect the /sh/, /ch/ and /j/ sounds as well.

Palatal lisp
This lisp occurs when the middle of the tongue touches the soft palate of the mouth. It’s really difficult to comprehend what that would sound like, but if you tried to say the /h/ sound closely followed by the /y/ sound, you would have a pretty good production of a palatal lisp.

Here is a video of my daughter Scarlett showing you what an interdental lisp looks and sounds like. She is currently attending speech therapy sessions to correct her lisp and I will begin a blog series to cover her progress over the coming weeks with hints and tips for you to try at home.

Other people tell me my child has a lisp, but I don’t hear it

Have you ever had to translate your child’s speech to another person because they had trouble understanding what they said? As a parent, you hear your child speak everyday, so you are familiar with how they sound, so you get pretty good at knowing what they’re saying. So it can come as a surprise sometimes that others find it difficult to understand your child or that you yourself don’t always realise your child actually has any speech errors until someone else points it out.

It depends on the severity of the lisp and how many sounds it’s affecting in a child’s speech, as to whether or not people have trouble understanding them. With children who only have a mild lisp on just the /s/ and /z/ sounds, you’ll probably find that despite this error, their overall clarity of speech isn’t affected too much. On the other hand, children with a significant lisp that’s affecting multiple sounds, can be much harder to understand, particularly for people who are not familiar with that child.

I will aim to answer the questions that you will mostly likely have, so hopefully by the end of this post, you’ll have a much better understanding of how to recognise if your child has a lisp, whether or not you should be worried, and more importantly, how we can fix this. If you have a question that I haven’t covered below, please comment on this post or get in contact with us and we will answer your questions.

Your lisp questions answered

What causes a lisp?
Lisping is NOT seen in typical speech development in children. It is a speech error that can happen for no reason sometimes and it’s just one of those things that some children have from the time they started to talk. Other times though, there may be an underlying cause such as a tongue thrust swallow. Prolonged dummy use or thumb sucking can also contribute to lisps as the continuous forward sucking motion of the tongue (as described in our tongue thrust post), can affect speech as well due to the muscle memory which can be very strong. It can happen to any child, for example my own daughter has an interdental lisp, and she has never sucked her thumb or a dummy, doesn’t have a tongue thrust swallow, and her mum is a speech pathologist!

Will my child grow out of a lisp?
In most cases, children will NOT grow out of a lisp! There are plenty of websites and other speech pathologists out there who say that children can grow out of a lisp, however I question how often that really happens, and here is why I think that… Because a lisp is a tongue placement issue and muscle memory is often our biggest enemy in treating it, unless someone has taught the child how to correctly say the /s/ and /z/ sounds, I wonder how we can expect children to correct this entirely on their own without any form of intervention? And out of all speech errors that people can have, one of the few that are carried through into adulthood, is a lisp (think Jamie Oliver). You don’t often hear an adult say “dod” for “dog” because they haven’t learned the /g/ sound… Both personally and professionally, I have never seen a lisp resolve on its own yet in the 17 years I’ve been working as a speech pathologist. Now that doesn’t mean it hasn’t happened, but those children who supposedly have grown out of it (I’d love to hear about them), did someone along the way show them how to make the sound correctly, or did they truly figure it out on their own? It’s often such an ingrained habit, it doesn’t just fix itself from one day to the next.

Why should my child need therapy to fix a lisp?
Ultimately, no one can force you or your child to do therapy, and having a lisp is probably not a big deal for some people in the big scheme of things. Having said that though, while some people will say it’s “cute” while they’re little, once children grow up into teenagers and adults, they are often teased or made fun of because they sound different. Sometimes there can also be the thought that someone with a lisp is not as intelligent as someone without a lisp (by the way, a lisp has no influence on intelligence at all!), but the reality is, that’s what some people assume if they don’t know anything about lisps. So think of the potential future consequences in adulthood if your child did not get their lisp corrected.

What is the best age to start therapy for a lisp?
This can vary depending on your child. Typically speaking, early intervention is the key, as the continuous movement of the tongue sticking out (interdental lisp) only reinforces this habit. The longer this habit remains (as with almost any habit), the more difficult it becomes to treat. Usually from 3.5 years of age onwards is a good time to start, bearing in mind the child’s maturity, personality, ability to follow instructions and attending to the task. If a child has a lateral lisp, which is definitely not considered as part of typical speech development, therapy is definitely recommended as soon as possible. At Kids Chatter, we see children as young as 3 years old for a lisp and have successfully fixed many children’s lisps.

Does a lisp affect a child's education? Kids Chatter Speech Pathology

Does a lisp affect my child’s education?
This can depend on the type and severity of the lisp. Having a lisp does not affect a person’s intelligence, so their ability to learn at school should not be affected. However, when a child is difficult to be understood by others, or the child is ashamed to speak up in class or if they are being bullied because of it, this can lead to them not wanting to participate in class, especially with things that require talking (oral presentations, reading aloud, answering questions etc.). So it’s usually the negative attention from the people around them that can result in a child struggling at school because they don’t want to talk. The social pressure can be huge for some children and we all know how mean some kids can be to others.

My child can say a proper /s/ sound on its own, so why aren’t they using it in their everyday talking? Are they just being lazy?
I can assure you, they are not being lazy! It takes quite a bit of effort and practise to change a long term habit into a new one. Especially in this case, where muscle memory is our biggest enemy, it’s not going to happen overnight unfortunately. As I often explain to the parents in our clinic, imagine if you, who can (presumably) say the /s/ sounds clearly, were suddenly expected to say all your words with a lisp on all /s/ and /z/ sounds (remember, they occur at the beginning, middle and end of words), could you do it? Chances are you probably can’t! We are essentially expecting our kids to do the same, but in reverse. This is why in speech therapy, we teach the child and their parents the systematic steps to get from that single sound all the way up through to conversational level. At Kids Chatter, we follow our Articulation Tracker that we have designed to show you exactly where your child is up to and what steps we still have to get through to work towards the ultimate goal of everyday conversation.

How do I know if it’s truly a lisp and not something else?
Hopefully, this post has given you some information about what a lisp is and how to recognise it. If you still find it difficult to identify what your child’s speech errors really are though, because it may not be an exact match of any of the descriptions above, then the best thing you can do is see a speech pathologist. We will be able to check exactly what type of lisp your child has, or identify if there’s another problem. If the errors are considered age appropriate, then we can monitor it over time, or if they are not age appropriate, we can discuss how we can treat it.

Can a lisp be fixed?
Yes! With the right speech therapy, motivation, practise and a bit of time, lisps can usually be successfully treated. You want to ensure though that if there’s an underlying cause for the lisp such as a tongue thrust swallow, that this problem is also addressed as in this case, the lisp is more of a symptom of tongue thrust, rather than the lisp being a problem on its own. So make sure your speech pathologist is qualified and experienced in checking for a tongue thrust swallow (very few speech pathologists actually have experience with this area) to rule it out or identify and treat accordingly. Thankfully at Kids Chatter, we deal with lots of children who have tongue thrust swallows, which can also be treated successfully.

If you’d like to purchase your own /s/ and /z/ articulation cards, you can find them on the Teachers Pay Teachers website. In order to buy from Teachers Pay Teachers, you will need to create a free account.

My child’s front teeth are missing, will that cause them to lisp?
If a child does not already have an existing lisp and then they lose their front baby teeth, then theoretically there should be no reason why they should start lisping. Because the /s/ and /z/ sounds are TONGUE sounds, and not specifically teeth sounds, it is the tongue position that is important, whether or not there are teeth present. Now, it is quite likely that the quality of /s/ and /z/ sounds will change a little because the teeth do help in making it sound “hissy”, but most children adjust quite well and continue to use their tongue in their correct spot despite the gap.

My child’s front teeth are missing, does that mean they can’t do therapy?
As per the question above, the /s/ and /z/ sounds are based on tongue position, so it can be possible to do speech therapy to treat a lisp. However, if your child is new the speech therapy when they have a gap, sometimes we may recommend to wait until the teeth do grow back, because it will make it a little easier, especially when trying to achieve that “hissy” sound, but if they are already receiving therapy when their baby teeth fall out, they can usually continue. The speech pathologist can usually give you more specific advice based on your child’s circumstances.

Why do some adults still have a lisp?
Without intervention, lisps can persist into adulthood, especially for those children who have never been to speech therapy or didn’t complete all their therapy. Some adults have accepted their speech the way it is and have no desire to fix it, while others are really bothered by it and want to be able to fix it. Adults can attend speech therapy to treat a lisp and it works much the same as how we would treat it in children, probably minus the kid’s games though!

So, a lisp can sometimes be a very straight forward problem, while at other times it can be a little more complicated if we’re dealing with a lateral lisp or an underlying problem like a tongue thrust swallow. If you think/know that your child has a lisp, contact us for an assessment to determine what type of lisp your child has and we can explain how we can fix it as the longer a lisp is left untreated, the harder it can be to correct. If there is no lisp or other speech errors, we can reassure you that your child’s speech development is doing just fine and there is nothing to worry about. Should speech therapy be recommended and your child is ready, motivated and you can are able to commit to doing the follow-up homework practise, I believe the earlier therapy is started, the better the outcome will be and it will save you time and money in the long run.

If you found this post useful or you know someone with a child who has a lisp, please share this post so we can help other families.