Lateral lisp and Thrust

Hello Sandra; I attended one of your workshops in Pittsburgh a few years back. I am wondering if you might be able to provide some information/references on correcting a lateral tongue thrust. Many thanks!

So nice to hear from you.  I wish there were references or studies that could help SLPs with lateral lisps & “thrusts,” but I haven’t found any which instill any confidence, based on what I know is needed as a foundation prior to working on sounds. I believe you purchased the Myo Manual.  Do you still have it…intact?   I’ll go on the assumption that you do and I’ll try to give you some direction for the lateral “thrust”.  May I assume that he/she has the lisp along with the “thrust”?  Also, are the CH, SH, J(dj) and ZH likewise affected?  Are there other artic or voice or other issues?  What is his/her age and cognitive level?  The suctioning is usually very weak and incorrect with lateral problems.  I think you attended the short course, so we probably did not go over the examination section in detail.   Since it’s impossible to do that via email, I’ll direct you to portions of the Myo Manual that address those areas.  First and foremost, you must maximize and hopefully get him to pass…the proficiency exam # 1.  The last part of that exam deals with the posterior suction release.  This involves his having a good flat suction to the palate that he can maintain for 15 or more seconds, with the tip and body of tongue fitting well into the palatal arch.  When he is strong with that, he is to release only the back of the tongue, keeping the front on the alveolar ridge.  This should result in a “squishy” sound as the back of the tongue is released.  If it is more of a click or pop, then the tip was inadvertently released rather than remaining to alv ridge.  It may start out very slowly…very, very slowly until he gets the coordination aspect.  The goal is to increase it and repeatedly do it.  If this is difficult for you to understand, then he can start with the teeth closed and making the “horsey” sound and you will hear that squishy sound being emitted laterally.    If the arch is too narrow or on very rare occasions, too wide, then that would make this exercise impossible to perform correctly.    The Knotty Straw exercise may be critical for him.  The Diagonal Straw exercise should be undertaken and mastered only once the posterior suction release is strong and consistent.   The Elev Disk exercise for coordination is important to be sure that he is separating and differentiating the labial, mandibular and lingual movements/excursions.  Taking your time not to jump the gun in working through the program, he should, when ready, be given one at a time to master the following:  Water Slurp Swallow; Water Trap Swallow; To & Fro Swish; Goldfish Bowl.   These are very important in this case and are usually given one at a time and in the order that I wrote above. Without more information, I can’t make more suggestions for fear of giving incorrect advice.   If, for instance, this girl or boy is 4 years old as opposed to 10 years old, I would approach things differently.   Is the parent involved?  Is the child seen in school?  In a group?   I take everything into consideration when working with someone since these types of factors should be addressed to maximize our chance for success. I hope this helps you out and I look forward to hearing from you.