An Educator With A Frontal Lisp
Case Summary
- Man in his mid-forties with a frontal lisp and fast rate of speech
- His personal goal was to achieve higher end of term student evaluations
- Duration of therapy: 10 weeks then 20 weeks
Therapy Goals
Main Outcomes
- Complete resolution of frontal lisp
- Use of appropriate rate of speech during all communication contexts more than 80% of the time
Narrative Of Our Work
Kevin* approached Well Said: Toronto Speech Therapy to discuss two concerns: his frontal lisp and his rate of speech. The frontal lisp had persisted since childhood. He attended speech therapy as a child, but wasn't motivated to practice and the lisp was not corrected. He spoke to a relative speech therapist who works with children who advised him that at his age (mid-40s) that it was unlikely that his lisp would ever be resolved. Regarding his rate of speech, he reported that his students often commented in the instructor evaluations that he spoke too quickly and was hard to understand.
We helped Kevin to prioritize his goals: first, the frontal lisp and second, the rate of speech. Next, we systematically worked through changing his pronunciation of the S and Z sounds. This took 10 weeks from start to finish. During the 10 weeks, Kevin attended weekly appointments with our speech-language pathologist, Melissa James, and completed 10 minutes of practice each day.
After the 10 weeks focusing on completely resolving the frontal lisp, we took a break from our work for a few months. Kevin was both surprised and thrilled that he no longer had a lisp. He did note that his relative commented that his speech sounded great.
Within a few months, Kevin contacted us again. This time Kevin wanted to work on reducing his rate of speech.
Using awareness developing strategies, like auditory discrimination for "too slow" speech, "just right" speech and "too fast" speech, we helped Kevin understand and recognize when he was speaking too quickly. Targeting the awareness is always the first step. Next, we started at the phrase level and practiced speaking an appropriate rate. Within 8 weeks we had progressed through a hierarchy of phrase, sentence, short answers, long answers, and conversation.
Next, we needed to tackle generalization, applying the skills used in the session to real life. We started by establishing manageable units for this step. From easiest to hardest, Kevin identified four distinct communication contexts, rating them from easy to most difficult: at home with family, out with friends/peers, speaking at work to research assistants, and lecturing.
We launched the new appropriate way of speaking at home. Kevin implemented his practices (pace and breathing) when reading to his children and conversing with his wife. Kevin tracked his progress through journaling and logging his success. Once Kevin 80% speaking success rate in the home, he progressed to the next tier: speaking with friends/peers. We advanced through the rest of the levels in a similar fashion. In a short amount of time Kevin was able to speak at an appropriate rate while delivering a lecture.
Kevin checks in with us on a monthly basis via telehealth (similar to Skype or Facetime) after his goals were achieved to ensure that he maintained his skills.
*Names and identifying details have been changed to protect confidentiality.