Month: August 2010

Strengthening the Tongue?

By Pam Marshalla

Q: I have a child who has weakness in his tongue as evidenced by slight tremors when protruding. What exercises do you recommend to strengthen the tongue to increase articulatory precision? Have you ever taken a class of mine? If so you will recall that I never recommend exercises to strengthen the tongue. Instead I recommend activities to inhibit abnormal movements, and to facilitate appropriate oral stability and mobility. This is a very important question you have asked. Do you…

Initial /h/

By Pam Marshalla

Q: I have a 1st grade student with moderate to severe apraxia who can make the /h/ sound in isolation but cannot co-articulate it. I’ve written the letter /h/ on an index card, and a vowel on another card. I have had him touch the H card and make /h/, and then touch the vowel card and make it. And we have increased the speed as we go but he ends up dropping the /h/ every time. Is there another…

Before /r/ Can Emerge – Early /r/ Therapy

By Pam Marshalla

Q: I have a severely apraxic sixth grader who omits /r/ in blends. Is it appropriate to teach her to use /w/ instead in order to increase intelligibility? For example, can I teach her to say “bwick” for “brick”? I always take the liberty of teaching w/r in these cases. The /w/ holds the place until the client is ready for /r/. This is exactly what many typically developing children do in the younger years. I also add a schwa…