Dear Doctor Teresa,

My four-year old daughter has a lisp. We actually think she sounds cute. I am a little worried, however, that this won't be cute when she gets older. My friends say she will grow out of it. Is this true?

S.A., Brooklyn, NY

Dear S.A.,

There are many sound substitutions that are perfectly normal and expected as children learn to speak. Some lisps fall in to this category.

A frontal lisp, where children make a "th" sound for an 's' or 'z' sound such as "thilly" for silly is ok until the child is about 4.5 years of age. If they do not start self correcting by this age, an visit with a speech-language pathologist is wise. You do not want to wait much past this age if there is a problem. Lisps that get early attention can often be correct successfully and in a fairly short time period. The longer you wait the more ingrained habits become and can become very hard to fix.

If the lisp is a lateral lisp, where the 's' sound is created with air escaping from the sides of the tongue, this is a concern. The lateral lisp is not a normal developmental process and should be assessed by a speech-language pathologist when observed, a lisp such as this is not known to self correct.

When we talk, we want people to listen to what we say, not how we are say things. A lisp can be distracting to listeners and undermine an otherwise good message.

Good luck,

Dr. Teresa