Sudden appearance of thrusting in 4 year old

Q: My client has a slibling who is  a 4 year old who hasn’t ever had speech errors. But about 4 weeks ago, he started thrusting his tongue out during /s/ productions. According to mom, he has never done this before. It was right before Christmas, so I told her we can discuss it after the holidays. My question is “Is it EVER normal for a child to thrust his/her tongue while learning different speech sounds?” Should we be concerned if it spontaneously started even when he wasn’t doing it before? Should we wait and see for a few more weeks?

A:  This is a tough one to answer without a lot more information.  Sometimes an articulation “problem” might not be apparent to a parent when a child is three years old, but when conversation increases around four years of age, things such as a lisp, for example, become more obvious.  Thus, the propensity for an artic disorder might have been there all along.  With children a bit older, it is sometimes linked to the condition of losing one or more incisors and the tongue seeks stability by pushing through the space; however, it seems as if this child is too young for that.  A recent bout of long term congestion/allergies, etc. could possibly contribute to airway issues, thus causing an obligatory “tongue thrust” to keep the airway open.  Other than these noted above, I have not heard of or seen other reasons for a sudden appearance of tongue forward positioning when it had not been present previously.

I would be happy to join you and them on a ZOOM if you and they want to share part of a session. Since he is the sibling of your client, the parent may appreciate having a second opinion. I hope this helps.

My best,

Sandra