Tongue Thrust – It’s a Speech Disorder


You are probably wondering why we have a picture of a dancer on the cover of our newsletter.  It’s because this particular dancer was my client a few years ago.  And she has an inspirational story that is worth sharing.

Her pediatrician, Richard Walls, referred Lauren to us.  She was 7½, and her “r” sounds were not emerging.  Our evaluation revealed the usual reason for delayed speech development in a 7 year old; Lauren had a tongue thrust.

She had a history of allergies, which caused nasal congestion and open-mouth breathing.  She also had enlarged tonsils, which pushed her tongue forward to make way for her tonsils.  With her mouth usually open, her tongue rested against her lower teeth, and it pushed between her upper and lower incisors every time she swallowed, somewhere between 500 and 1000 times per day.

Lauren is a drop-dead beauty with golden blonde hair and luminous sky-blue eyes.  But she was missing one of her front teeth.  That is not so unusual for a 7-year-old girl, but Lauren had been missing that tooth for several months; and that is way too long for a permanent tooth to erupt.  It turned out that her tongue was resting in the exact spot where that tooth was supposed to erupt, and her tongue wasn’t letting anything, tooth included, grow into that space.

Dr. Walls had made a good call; Lauren had a frontal lisp whenever she produced a word containing ‘s’ or ‘z’; that is, she kept her tongue in its favorite unhealthy resting position against her teeth, which made her talk with a frontal lisp.

More importantly, she was not making any ‘r’ sounds correctly, not a single one, including the ‘r’s in every one of her proper names.  Most speech therapists acknowledge  that ‘r’ is one of the last sounds to finally  emerge for developing children, but truth be told, 75% of 4 year olds can say ‘r’ correctly.

If children don’t have the musculature to say ‘r’ correctly by the time they are 7, there is a serious problem.  And the longer parents and therapists wait to start working on the ‘r’ sound, the longer it will take to correct it.  And in some cases, distorted ‘r’ sounds are resistant to treatment after 7 years of producing them incorrectly…..very resistant to treatment.

Lauren and I delved into the tongue thrust program.  She did lip strengthening exercises and eventually learned to breathe through her nose with her lips closed.  She learned to bite, chew and swallow her food correctly, and she practiced for 3 meals a day.

Next thing we knew….voila!   Her tongue was back where it belonged, which allowed her front teeth to erupt perfectly straight without braces. In addition, her tongue was now in speech-ready position, so she self-corrected her own ‘s’s and ‘z’s. But, unfortunately, there was still that incorrigible distorted ‘r’!

It was about that time that her family invited me to Lauren’s dance recital. I sat with them and watched Lauren perform.

I was blown away by her talent.  She could tap her feet with the rhythmic execution of the Irish Dancers of Riverdance. She could kick her legs in the air with the agility and grace of the New York City Rockettes. It wasn’t just her feet that impressed me, it was her passion and her ability to engage her audience with her twinkly eyes and charming smile.

I was truly impressed with this little 7- year- old girl who could dazzle the audience with her talent and stage presence.  I told myself; this little girl is going to be famous some day; she is going to be a star.

But I couldn’t have her on stage giving her acceptance speech with distorted ‘r’ sounds.  I cringed as I imagined her thanking her “mothuh and fathuh fuh theuh suppot.”

From that moment on, I was on a mission to clean up those ‘r’s. I called in Lauren’s mother, and we worked as a team to perfect Lauren’s ‘r’s. After doing hundreds of “tongue bowls” and “surfboard tongues”, Lauren eventually became stimulable for one perfect ‘er’.  It was slow and exaggerated, but it was an ‘er’.  Lauren was able to say words beginning with ‘r’ by separating the ‘r’ from the rest of the word….”er – ake” (rake), “er – ong” (wrong) and “er – ock” (rock).   She progressed from there to words ending with ‘er’ and then words with ‘r’ in the middle.  I assigned homework, and Lauren completed it at least two times a day.   It is rare to see that level of discipline in a child at age 7.

Because of her medical history, it took another year to totally clean up Lauren’s ‘r’ sounds. It was worth the effort.

Lauren never has to think about her ‘r’ sounds any longer.  She gives speeches in class and converses freely and clearly with her family and friends. She has moved on to bigger and better things.  She is an award-winning dancer with scores of trophies, an honor student at Francis Parker, and she is a happy, adjusted teenager with a boatload of friends.

As a rule of thumb, ‘r’ sounds typically come in by the time a child is 4.  If a child is not able to repeat an ‘r’ word after you by the time he is 5, have him evaluated by a speech-language pathologist who has experience with speech-sound disorders.  If the child has tongue weakness, exercises can be started to strengthen the tongue as young as age 4.  And at that age, the exercises will be more efficacious, because the bad habits will be less ingrained, and the tongue will be less resistant to treatment.

Growing up these days is tough enough.  It is not cool to have a speech disorder, especially after 2nd grade.  And speech disorders are so preventable if they are properly diagnosed and treated early.  Even older children who lisp or distort their ‘r’ sounds can be helped with proper diagnosis and treatment.

Equally important, every child has a gift to share with the world.  But it’s much harder to share that gift if you can’t communicate clearly.  You don’t want people listening to the way you talk, you want them listening to what you say.

If you know a child who is wrestling with a speech disorder, call us at 858.509.1131.

It is never too early or too late to seek help.

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