April 2008 - Marshalla Speech & Language

Month: April 2008

Autism and Mouthing Behavior

By Pam Marshalla

Q: Jessica is 26 months old and has a diagnosis of autism/PDD. She has started to respond to discrete trial instruction, however she presents with constant mouthing, licking, and biting her fingers. We have tried numerous things – chewing tubes, cold stimulation, vibration to the mouth, pressure, sweet, sour, salty, ignoring, and so forth. But the behaviors are increasing. Parents report constant licking and gnawing at furniture, books, and other household objects. Any suggestions you can give that might help…

Elocution and Intelligibility

By Pam Marshalla

Q: I have an older client who can pass an articulation test but who is very hard to understand in connected speech. I heard you talk about “elocution” in one of your classes. Can you refer me to any written material on how to do this? A client who can pass an articulation test but who has problems with intelligibility usually is mildly dysarthric. Thus, they have mild problems with prosody (rate, rhythm, stress, intonation, pitch, tone, volume), vowel clarity,…

Patience and the Lateral Lisp

By Pam Marshalla

Q: I have been working with a 10-year-old girl with a significant lateral lisp that affects all of her sibilant sounds. I have been focusing on establishing /s/ and /z/, but have not been able to progress very far because her ability to achieve the correct tongue position is so inconsistent. I have taught her the “Butterfly Position” to help her lift the side margins of her tongue, and am using the “Long T Method” from Frontal Lisp, Lateral Lisp….

Horn Programs and Articulation Therapy

By Pam Marshalla

Q: I have a student I’ve worked with for a few years and she has several problems. I have tried everything I know, and nothing seems to help. She cannot say R, J, Sh, or Ch. She has difficulty with exhalation (i.e. she cannot blow out a candle) and therefore her speech is very quiet. She cannot even yell very loud. I’ve done some oral motor therapy (horn blowing hierarchy) and other things to address this, but it has not…

Very Limited Speech

By Pam Marshalla

Q: I have a 3-year-old student with Joubert’s syndrome. Currently we are using sign and an AAC device for communication. She can move her mouth, grunt, say “buh”, and blow a whistle. She grunts more when we model the grunts back to her. Should this continue? And do you have any ideas on improving vowel phonation? This child is not making vowels because she is not using her voice. Her grunts and productions of periodic “buh” mean that she is just…

Techniques For “Long E”

By Pam Marshalla

Q: I cannot get my client with Down Syndrome to produce “Long E” (as in the word bee). I have tried using a tongue blade to get his tongue back. Do you have any other suggestions? To produce long E (/i/), the jaw must be high and the tongue must be wide, high, and tense in the back. If you are using a tongue blade to push the tongue back, you have several problems that are working against you. First,…