Treating a Young Child Who Stutters' Lateral Lisp: A Case Study

Abstract

Purpose: This case study describes treatment recommendations for young children who stutter who present with articulation (i.e., motor-based) errors impacting the child's ability or desire to communicate. Recommendations for children who stutter with speech sound disorders have previously focused on phonological (e.g., language-based) errors; however, remediation of motor-based errors require a more direct treatment approach. Method: The case is a 3-year-old female who stutters with concomitant lateralized productions of sibilants, including /s/ and /z/. A literature review was conducted when developing the treatment plan to identify treatment elements that might best support the child's development of her speech sound skills and overall communication. Evaluation results and treatment progress data are reported across 8 months of treatment. Results: As a result of the provided motor-based approach with modifications to facilitate a positive speaking environment, the child improved her production of sibilants at the word level from 69% occurrence of lateralizations to 9%, her attitudes about her communication improved, and her stuttering severity remained the same. Conclusion: A motor-based treatment plan to improve speech sound accuracy is appropriate when working with a child who stutters with articulation errors. Individualized treatment plans should consider the motoric and emotional demands on the child during the sessions to limit the potential interaction between the speech sound treatment and stuttering. Several treatment options are discussed to help clinicians tailor treatment plans to the needs of individual children.