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Is a Lisp Normal in Preschool?

As children begin to develop their speech and language skills, it is important to remember that speech sounds are acquired in specific patterns around approximate age ranges. Therefore, most Blog-Lisp-Main-Landscapechildren go through periods of development where their overall speech intelligibility is reduced.

In order to understand if a lisp is considered normal, one must first understand what a lisp actually is. Lisps can present themselves in a different manner, primarily as lateral and interdental, with misarticulations primarily on /s/ and /z/, though productions of “sh,” “ch,” and “j” are typically impacted as well. In order to accurately produce these speech sounds, airflow needs to be channeled down the middle of the tongue.

A lateral lisp occurs when the airflow passes over the sides of the tongue, which causes significantly distorted production of the targeted speech sounds. The manner of the production will have a “slushy” quality, and lateralized productions of speech sounds can be difficult to correct.

Another common lisp is the interdental lisp, in which the tongue protrudes between the upper and lower teeth distorting the airflow that is forced through the space during speech production. This type of lisp is often heard as a substituted “th” rather than an accurate /s/ or /z/.

In the preschool years, children are expected to have mastery of early speech sounds, and errors on later-developing speech sounds are considered typical. Therefore, distortions of /s/ and /z/ that present themselves as a lisp are often seen in children this age. However, around the age of five when children enter kindergarten, they should be more accurate with their speech sound production skills.

If a child continues to present with difficulty on particular sounds, further assessment may be beneficial. This is particularly true if the child presents with a lateralized lisp, as speech-language therapy is warranted to help re-mediate the place and manner of the errors. Evaluation is also recommended if the child presents with either inconsistent productions of speech sounds, or is significantly difficult to understand, regardless of age.

Read our blog on what to expect in a pediatric speech and language evaluation.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Meet-With-A-Speech-Pathologist

Why Is A Full Occupational Therapy Evaluation Beneficial When My Child’s Only Difficulty is Handwriting?

Child practicing handwriting

Handwriting is a complex task that involves many prerequisite skills, including visual skills, ocular motor control, body awareness, fine motor planning, shoulder stability, and hand and finger strength. Each prerequisite skill contributes to efficient and fluid handwriting:

  • Visual skills are needed to accurately distinguish and interpret letters and shapes on a page, essential for writing. Ocular motor control is needed to move one’s eyes across the paper to write in an organized manner.
  • Body awareness is required to accurately move the hands for writing, as well as knowing how much force is needed to make marks on the paper with the pencil or pen.
  • Fine motor planning is needed so that your child can easily identify, plan and execute the task of writing letters, words and sentences.
  • Shoulder stability is required to control the pencil.
  • Hand and finger strength is required for endurance that is needed to write many letters to form words and sentences. Hand strength is also needed for an appropriate grasp on the pencil.

In order to address handwriting in therapy, it is imperative for the occupational therapist to assess your child’s current level of functioning in each of the above areas. The root cause of your child’s handwriting difficulties may be his or her struggle in either one area or multiple areas. A full occupational therapy evaluation is very comprehensive; it allows the therapist to get a baseline level of performance to identify your child’s strengths and weaknesses in the prerequisite skill areas, and unveil the source of your child’s difficulty with handwriting.

Following the evaluation, your therapist will develop goals based on your child’s performance and design a treatment program that concentrates on improving these foundational skills, and ultimately improve his or her handwriting organization and legibility.

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Diagnosing ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurological conditions that affects between 3 to 6 percent of school-aged boy jumping on couch children.  Children with this condition exhibit significant issues with their ability to pay attention to tasks, inhibit their impulses and/or regulate their behavior.   In order for the diagnosis to be made, one has to witness significant impairment in regards to attentional regulation and/or activity level within multiple settings.  This means that the child must exhibit the concerns within the home, school, after-school program, sports team, etc.  In reality, the diagnosis can be made by a pediatrician or health care provider that is able to ascertain levels of functioning in the various domains by observing behavior or collecting parent and teacher report forms.

In the Neuropsychology Department at North Shore Pediatric Therapy, we focus on a comprehensive evaluation of a child’s functioning, including cognitive functioning, academic achievement, attentional regulation, executive functioning and social/emotional functioning.  Now, if the diagnosis can be made by a parent and teacher report, one must ask why a comprehensive evaluation should be mandated.  The answer to this is that over 45% of children that have been diagnosed with ADHD meet clinical criteria for multiple neurodevelopmental conditions.  Children with ADHD often present learning disabilities, emotional concerns and deficits with social regulation.  Sole treatment of the inattention may improve attentional regulation; however, there are other unaddressed concerns that may still linger.

Research has continuously demonstrated that the most common treatment of ADHD is a combination of pharmacological intervention, behavioral therapy, parent training, and teacher education.  Pharmacological intervention consists of stimulant medications that help to improve the child’s ability to attend to tasks.  A recent research article, which was even reported in an October edition of the Chicago Tribune, indicated that the majority of children who have been diagnosed with ADHD and are prescribed medication report significant improvement within their daily lives.  In the past, the main identification of improvement within children with ADHD was based upon teacher report.  Parents can now feel comfortable when asking their child if medication is helping. Behavior therapy focuses on the modification of the child’s environment to improve the frequency and duration of positive, on-task behaviors while extinguishing negative behaviors.  Parent and teacher education has a primary intent on discussing expectations within the home and school settings as well as possible modifications to ensure success.


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Preparing For Your Child’s Speech & Language Evaluation

Mother and Child looking up resourcesPreparing for a speech and language evaluation can feel overwhelming for a parent. It might feel nerve-wracking to have concerns about your child’s communication, as well as meeting a new health-care provider in an unfamiliar place. If you have already scheduled your child’s speech and language evaluation, then you’ve taken an important step in helping your child grow and succeed. Research has well-documented the benefits of speech-language therapy, as well as the importance of intervening early on.

8 Steps to Prepare for your Child’s First Speech & Language Evaluation:

1. Set aside time to reflect on your child’s speech-language skills

What aspects of communication seem to be difficult for your child? What aspects of communication are easier for your child? When did you first become concerned about your child’s communication? Be as specific as possible, and provide any examples you can think of.

2. Write your concerns down, and bring them to the evaluation

You may even keep a daily log of concerns as they arise throughout the week before the appointment. Your input is extremely important to your child’s speech therapist. During the evaluation, the therapist will spend about 60-90 minutes with your child. While a lot will be accomplished in that time, it’s also helpful for the therapist to learn more about how your child communicates in other settings as well (e.g. at school, at home, during play-dates, etc).

3. Write your questions down. Bring specific questions for your child’s therapist

It may be tough to remember all your concerns and questions during the actual evaluation session, so writing them down will ensure that you get your questions answered.

4. If possible, send any documents or paperwork to the therapist before the evaluation

This includes any reports you might have from previous therapies (e.g. Early Intervention, school IEP’s, etc.) Sending paperwork ahead of time gives your therapist more time to learn about your child and plan the evaluation session.

5. Print out directions to the evaluation

Reviewing directions ahead of time will allow you to plan for traffic, parking, and ensure arriving on time. Arriving late to the appointment cuts into the evaluation time, and results in parents and children feeling stressed.

6. Talk to your child about the evaluation ahead of time

Talk to them about where they will be going, and what will happen. Use positive and upbeat language to put your child at ease. Reassure your child that you will be there waiting for them, and can’t wait to hear all about what they did! If you have any questions or concerns about the transition into the evaluation (e.g. your child is unable to separate, your child has anxiety, etc), contact the therapist ahead of time to plan out the best strategy.

7. Arrive a few minutes early

This will ensure that you have enough time to submit any paperwork, and calmly transition your child into the clinic. Children rely heavily on their parents’ cues about whether or not to be worried. If parents feel stressed or anxious, the children may likely feel stressed or anxious too.

8. Finally, trust your child’s therapist

Remember that your child’s therapist conducts speech-language and feeding evaluations all the time. They are well-trained in their field, and work with a variety of children everyday. Your therapist is there for you and your child, and can’t wait to see your child grow and succeed.

If you are still unsure if a Speech and Language Evaluation is right for your child, please contact us here to talk with a Family-Child Advocate, who can help determine the next best step for you and your family!