By Pam Marshalla
Q: I have an R-student who is just about ready for dismissal. He can do almost all postvocalic R sounds, but not ER all by itself. Thus, he can say, “deer,” “door,” “dare,” and “dart.” But he cannot say “dirt.” Help! Your client is almost there! He only needs to learn how separate the ER-part from the preceding vowels he has it attached to. In other words, he needs to learn to isolate ER from the VOWEL+ER’s he is doing….
By Pam Marshalla
Q: I have a client with prevocalic voicing. He substitutes b/p, d/t, and g/k in initial position. Do you see this much? What suggestions do you have? Prevocalic voicing is probably one of the most common phonological error patterns in young children, especially those with motor speech disorders. There are many ways to address this: 1. We can use minimal pairs to help the client hear the differences between the phonemes and to emphasize the way the meaning changes with…
By Pam Marshalla
Children who cannot say many words need help learning how to imitate sounds and words. The best way to do this is to imitate the child.
By Pam Marshalla
Q: Is oral-motor therapy beneficial in treating a child with Goldenhar syndrome with one-sided facial weakness? If you are asking for “proof” of this, no. But your question reveals perhaps a limited understanding about what the term “oral-motor therapy” means. Let me explain… Speech is movement, and whenever part of the speech movement mechanism is impaired, then therapy needs to address that movement impairment. The term “oral-motor techniques” simply refers to any of the myriad ways in which we facilitate…
By Pam Marshalla
Q: I have a 3rd grader I have worked with since the age of 3. He has worked on a wide variety of phonemes through the years. I am ready to dismiss because I have been unable to make a difference recently. I have used all tricks in the book, yet his tongue still moves very poorly. Without full mobility of the tongue, I am beside myself. He speaks fast and is a smart boy however he is persistently unintelligible…
By Pam Marshalla
Q: I have a student with a lateral lisp whose does not have proper jaw alignment. The jaw at rest and during speech is moved over to the right. My thoughts are that the misalignment of the jaw is causing lateralization of the sibilants. Is this correct? What are your thoughts? You are right. The jaw has to be in a stable midline position to produce a correct midline sibilant. I divide lateral lisps into several categories according to whether…
By Pam Marshalla
Q: My client in second grade cannot make /t/ or /d/ at all. I have tried all kinds of things to activate the tongue tip, but he still persists on saying /k/ and /g/. How can I elicit /t/ and /d/? Since you have tried so many techniques to facilitate refined tongue-tip elevation that haven’t worked, I would revert to a more infantile way to elicit these anterior consonants. This is the way babies learn to make a /d/: They…
By Pam Marshalla
Q: I have a client with a unilateral lisp. I have noted symmetrical facial posture at rest and non-speech tasks. However he exhibits a unilateral retraction of his cheek that corresponds to his lateralization. I realize that lateralized productions reflect the tongue position more than the cheek position, but I am trying to determine what is happening inside the mouth during these times. How do I tell what he is doing with his tongue? As you have rightly surmised, cheek…
