Month: September 2009

The Trouble with Augmentative Communication Devices (AAC’s)

By Pam Marshalla

Q: I struggle in using alternative and augmentative communication devices (AAC’s) with my early childhood clients. It seems that the kids can just as easily point to or gesture toward the objects, as point to the words or pictures. Also many of the kids get distracted by manipulating the device. What are your thoughts on this? I have had this same struggle many times. In fact, I actually hate using AAC devises, but I have used them when necessary. Most…

Lateral Lisp and Dysarthria

By Pam Marshalla

Q: My client had a stroke when he was a baby, and he has both slurred speech and a lateral lisp. Do you think he can learn to develop a central groove for the sibilants? Only time will tell. In the meantime, focus your therapy less on individual phonemes and more on improving intelligibility by helping him learn to speak up, speak out, and over-exaggerate. Exaggeration is the method recommended most often for clients with dysarthria.

Big Tongue

By Pam Marshalla

Q: How can you tell if a client’s tongue is too big? Usually a tongue that looks too big actually is a tongue that is low in tone. These clients usually have an unstable jaw and an unstable tongue. I.e., the jaw is low and the tongue is low and forward. The client also may have upper respiratory problems that are forcing him to keep the mouth open and carry the tongue forward in order to create a bigger oro-pharyngeal…