By Pam Marshalla
Q: What can we do to make the back of the tongue elevate for /k/ and /g/? We can use the Tongue Retraction Response (TRR) as follows: Tactile stimulation down the midline of the tongue from anterior to posterior causes the entire tongue to retract back and up toward the velum. The response occurs about half-way down the tongue, and is elicited after the Tongue Bowl Response (TBR) and before the Tongue Gag Response (TGR). I also have called the…
By Pam Marshalla
Q: My twin clients have been in therapy for a long time and now can produce all the consonants except /r/ and /s/ in clusters. However, vowels sounds are still inconsistent and their speech is choppy and “staccato-like.” Intelligibility is low. First, kids learn vowels best in isolation, not embedded in the middle of words. Second, choppy and staccato-like rhythm pattern usually is related to diphthongs that are not fully developed. Listen carefully to the diphthongs. You can use the…
By Pam Marshalla
Q: How should we write IEP goals for oral-motor? The answer I always give is: DON’T. Our goals are not to improve jaw, lip or tongue function. Our goals are to improve speech. Write SPEECH goals. Oral-motor techniques are just that: TECHNIQUES. Oral-motor techniques are used to help us achieve the speech goals we have set. For example, let’s say that we are working with a child who has no back sounds – no [k] or [g]. Our therapy techniques…
By Pam Marshalla
Q: One doctor says my two-year-old daughter has apraxia and another does not believe so. Can you tell me what is going on here? I am afraid that you have entered the “apraxia twilight zone.” The subject of apraxia in children is a controversial and confusing one. First, some professionals insist that apraxia in children does not exist. Others insist it does. Since we have no formal way to diagnose the problem medically (e.g, no CAT scan) the diagnosis is…
