34 Chapter 2
working with articulation disorders may be those who are familiar with dif fer ent approaches
and employ the one most appropriate for the individual with the defect. The least effective clini-
cians, in our opinion, use the same remediation steps for all of their clients” (Plante & Beeson,
2004, p. 83).
Case Study 2-1: A Lisp in a 35-Year-Old Professor
Ophelia was a unique woman. An “army brat,” she was born in Eu rope, moved to the United
States when she was 6 years old, and boasts that she is triracial. Her mother is half Cherokee and
half Anglo, and her father is African American. She was intelligent, personable, and firmly com-
mitted to military ser vice. She was a captain in the army reserves and recently began teaching two
sections of the colloquium course at a private college. The course was entitled “Valuing Human
Diversity in the 21st Century.”
Ophelia also had a discernible lisp that the education system never identified. Perhaps it was
because Ophelia moved around so much or because much of her schooling was at army bases,
where speech pathology ser vices were often not available. When she became an adult, few people
commented on her lisp, and until she started receiving student comments that it was distracting,
she considered it unimportant. The dean of the college met with her to discuss the lisp and sug-
gested that she receive articulation therapy at the college’s speech and hearing clinic. Ophelia,
never one to avoid sensitive po liti cal issues, questioned the labeling of her speech as deviant. She
wondered why her speech, which was perfectly intelligible, was considered abnormal instead of just
another example of human diversity.
Whether because of her triracial background, her military experiences, or simply the fact
that she was intelligent, out spoken, and did not embrace trendy, po liti cally correct beliefs,
Ophelia did not accept the idea that she was deviant. She did not adhere to the conventional
wisdom that dif fer ent ways of speaking are necessarily pathological. Ophelia commented to the
dean that several faculty members at the college spoke with heavy Korean and Spanish accents
and they were not required to undergo therapy, although students complained that they could
not understand them. However, the dean insisted that she be evaluated and made it a condition
of her continued employment.
During the evaluation, Ophelia’s lisp was confirmed. She produced the “th” for the /s/ speech
sound. The speech error was consistently pres ent in the initial, medial, and final positions of syl-
lables and words. With careful modeling, Ophelia could produce the /s/ sound with proper tongue
placement. Ophelia’s oral and facial examination did not show muscle weakness or structural
abnormalities. Her teeth were not missing, jagged, or jumbled. Oral diadochokinesis was normal,
meaning that she could move her tongue rapidly from one position to another. The results of the
evaluation showed that Ophelia’s lisp was a result of improper learning of tongue placement dur-
ing /s/ production. The report suggested that because Ophelia had lisped for nearly three de cades,
her response or habit strength was well established. It would take extensive therapy to eliminate it.
After receiving the evaluation report, Ophelia met with the dean to discuss the required articu-
lation therapy. She maintained her beliefs and challenged the dean about lisping and the concept of
diversity. She noted that the college’s mission was to embrace diversity and celebrate human indi-
viduality. The college was trying to hire a diverse faculty and recruit students from multicultural
backgrounds. On the campus, a variety of accents and dialects existed, and those speakers were