May 2009 - Marshalla Speech & Language

Month: May 2009

Diet Modifications and Apraxia

By Pam Marshalla

Q: I have a three-year-old client with apraxia. The mother recently has put the child on a fish oil regiment. I was wondering what your take was on this and if you have had experience with diet modifications. In 33 years as an SLP, I have seen many diet fads come and go – fish oil, whip cream, no potatoes and tomatoes, excess protein, limited protein, vegetarianism, veganism, increased electrolytes, no sugar, no food dyes or additives of any kind,…

Fear in Labeling Motor Speech Disorders

By Pam Marshalla

Q: This seems perhaps silly, but I have to admit that I am afraid of labeling a client with apraxia or dysarthria. Perhaps it is because I took no formal class on motor speech disorders while I was in college, and I have had to piece information together myself. Can you advise me? I too was afraid of motor speech for years. In fact people asked me to speak about it for some 20 years before I felt brave enough…

Frontal Lisp and Reverse Swallow

By Pam Marshalla

Q: Is it efficacious to work on a frontal lisp when a child has a reverse swallow, or does the swallow have to be addressed first or concurrently? In the ideal situation, the speech problem, the reverse swallow, the dentition problem (if any), and the oral habit (if any) are address all together in one plan or action. In the orofacial myofunctional literature, the recommendation generally is to work in the following order: Eliminate oral habits Establish correct oral rest…

“Believing” in “Oral Motor” – Lighten up!

By Pam Marshalla

Q: My supervisor will not let me use oral-motor techniques. She says there is no research to support them. What are your thoughts? First I say, “Ho-hum!” Aren’t we tired of this argument yet? Isn’t it time to get past this ridiculous war of words? Let’s lighten up! To by-pass “the oral-motor war,” I have been using the term “mouth movement” lately, as in: If you don’t believe in “oral-motor techniques,” fine. That’s okay. It’s not a religion any way….

Targeting “Un-Stimulable” Phonemes

By Pam Marshalla

Q: Does a client have to be stimulable for a sound, or sound class, before therapy should be initiated? No. Sometimes we target a phoneme or class for which the client is stimulable. Other times we teach the client a new phoneme or a new sound class for which the client is not stimulable. For example, the client who cannot pronounce R needs to learn R. He is un-stimulable for R and must learn it. I have worked with hundreds…

Outgrowing a Lateral Lisp

By Pam Marshalla

Q: Do you think a child should be able to outgrow a lateral lisp? I believe that a FRONTAL LISP is on the normal developmental continuum, but that the LATERAL LISP is not. To me, the lateral lisp is a motor pattern that is moving in the wrong direction, therefore, no matter how much maturity the client has, he will never reach correct production. The lateral lisp is an incorrect motor pattern as opposed to an immature motor pattern. An…

Preschool Plateaus

By Pam Marshalla

Q: My daughter is almost 4 and her speech is rarely understood by anyone outside of our family. While my daughter absolutely loves her therapist and has made some progress, she has been stuck at a plateau for a while. My daughter is very bright and has a high level of understanding and of vocabulary. However, she never says her word endings, many letters are omitted, she talks in a very rapid rate, S is always slurred, and she can’t…