When a tongue thrust in a child is recognized by a Pediatrician, Orthodontist or Dentist, a Speech Therapist should be included in the assessment and treatment. A Speech Language Therapist can assess the root cause and assist in altering the behavior causing the problem.
As Maria Del Duca states in her guest post on Smart Speech Therapy “A tongue thrust occurs when one’s tongue is pushed against or between the front teeth during a swallow. This should not be confused with a frontal lisp.”
A frontal lisp occurs when the tongue protrudes between the front teeth and the air-flow is directed forwards. A tongue thrust occurs during the swallowing process. So, the objective when treating a tongue thrust is to develop appropriate behavior for tongue placement during the swallowing process; and also when eating or even at rest. However, a lisp can develop if the tongue thrust is not corrected because the teeth structure can be altered by this unnatural swallowing behavior.
There are different types of swallowing dysfunctions, also referred to as Dysphagia. This comes from the fact that there are different phases of the swallowing process. One is the oral phase which is the part of the process that occurs in the mouth, called the Buccal phase. Another phase is in the throat called the pharyngeal phase. And then the esophagus, called the esophageal phase. A child with tongue thrust will have difficulty during the oral phase (Buccal phase) of the swallowing process.
There is a difference between a language disorder and a speech disorder. A child with a language disorder may have difficulty understanding what another person is saying or is not understood by others because they have difficulty expressing their thoughts. Apraxia of Speech is an example of a speech disorder.
Developmental apraxia of speech (DAS), also known as childhood apraxia of speech (CAS), occurs in children and is present from birth. It is usually detected around 2 years of age when speech development appears to be delayed. A child’s speech may be unintelligible and sound like ‘babbling’ or jargon. The child may show symptoms by having difficulty saying what he or she wants to say correctly and consistently. However, DAS is not due to simply weakness or a paralysis of the speech muscles. The child will generally not have trouble chewing or biting down on objects.
A lisp in a child can be developmental or from incorrect placement of the tongue on the roof of the mouth, such as a lateral lisp. A lateral lisp is caused by the child directing air flow down the sides of the tongue rather than directly down the middle of the tongue. This causes the pronunciation of the letters ‘S’ and ‘Z’ to be muffled or slushy.
What may not be obvious to the parent is that the child with a lisp does not perceive themselves as speaking differently from the children or adults around them. Therefore, waiting for the child to “grow out of it” is not advisable, because children very rarely outgrow a ‘lateral’ lisp. The longer a child continues to pronounce words incorrectly, the more difficult it can be to correct the problem as the child grows older.
The result of waiting too long can be especially problematic as the child enters school. The child has the probability of being teased by peers and will not understand why. The child will perceive themselves as speaking flawlessly.
Beth Fine, of Fine Communication in Manhattan, New York, New York, had a young patient that, as an 8th grade student, had her dreams of having leading roles in school plays shattered because of her lateral lisp. She did not perceive her speech to be any different from her peers. With speech therapy, the student became aware of correct tongue placement and corrected her lisp in a relatively short period of time. Now a college student, she speaks in front of large groups of people and has chosen to be a mentor to other girls.