Successful treatments have shown that causes are functional rather than physical: that is, most lisps are caused by errors in tongue placement or density of the tongue within the mouth rather than caused by any injury or congenital or acquired deformity to the mouth. The latter may be transcribed and, and, or the like.

A palatal lisp is where the speaker attempts to make a sibilant while the middle of the tongue is in contact with the soft palate, or with a posterior articulation of the sibilant.

In the extensions to the IPA, whistled sibilants are transcribed and.

A strident lisp results in a high-frequency whistle or hissing sound caused by stream passing between the tongue and the hard surface.The transcription for sibilants with nasal frication in the extensions to the IPA is and simple nasal fricatives are and. A nasal lisp occurs when part or the entire air stream is directed through the nasal cavity.The symbols for these lateralised sounds in the extensions to the International Phonetic Alphabet for disordered speech are and. It is also called 'slushy ess' or a 'slushy lisp' in part due to its wet, spitty sound. A lateral lisp occurs when the and sounds are produced with air-flow over the sides of the tongue.When a fronted lisp does not have a sibilant quality, due to placing the lack of a grooved articulation, the IPA transcription would be or variants thereof. The transcription in the International Phonetic Alphabet for interdental sibilants is and and for simple dental sibilants is and. Interdental lisping is produced when the tip of the tongue protrudes between the front teeth and dentalized lisping is produced when the tip of the tongue just touches the front teeth. A frontal lisp occurs when the tongue is placed anterior to the target.

These misarticulations often result in unclear speech. A lisp is a speech impairment in which a person misarticulates sibilants (, ,, ,, ,, ).

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