By Pam Marshalla
Q: I have a client who makes a nasal sound for L and R. He has no other nasal problems. What can I do? This is all a matter of ear training. This is a client who can move his velum, but he has a habit of lowering it when he makes certain sounds, in this case, L and R. In other words, the client does not have a velo-pharyngeal insufficiency or incompetency. He simply has a habit of lowering…
By Pam Marshalla
Q: I’m wondering what kind of goals you would write for targeting prosody. How do I make it measurable? Prosody entails projection, rate, rhythm, stress, pause, pitch, intonation, and cadence. I would write separate goals for each area impacted. In terms of measuring success before and after, I would take measures where possible. For example, I might count the number of words the client speaks per minute and compare that to the old norms. Where measures like that are not…
By Pam Marshalla
I receive weekly questions about the severe frontal lisp. The questions always are about how to keep the tongue inside the mouth for speech. We are talking here about the client who has: Interdental tongue placement on all the sibilants: S, Z, Sh, Zh, Ch, J Interdental tongue placement on all the lingua-alveolar sounds: T, D, N, L Open mouth resting posture Reverse swallow (infantile suckle-swallow, tongue-thrust swallow) From a motor perspective, the severe frontal lisp with interdental tongue placement…
By Pam Marshalla
Q: I am scheduled to see a 14-year-old male with a lisp on /s/. He recently got braces and the dentist told his mother that the child had better see a speech language pathologist if the braces are to help at all. Can you help me organize this diagnosis? Focus on the speech first. You must know exactly what phonemes are affected. Look at ALL of them, not just /s/. Look at all the sibilants, and all other phonemes, especially the…
By Pam Marshalla
Q: I read your explanation on how to teach a child to say R without nasality. I used a tube to help him as you suggested, and he now understands the difference between oral and nasal sounds. However, he still cannot produce the vocalic /r/ without it sounding hypernasal. I have tried everything and I was wondering if you have any suggestions! You have to tell him NOT to say R. Instead, have him say his nice oral vowel with…
By Pam Marshalla
Q: What do you say to parents who want to know how much longer speech therapy will continue? I have been seeing an 8-year-old boy for two years for auditory processing, and for both receptive and expressive language skills. He is making good progress but could honestly be in therapy for a few more years. It sounds like this client may never have “normal” speech and language, and he could use help for as long as he can get it….
