May 2011 - Marshalla Speech & Language

Month: May 2011

Homework for Open Mouth Posture?

By Pam Marshalla

Q: I have a preschooler with an open mouth posture and forward tongue carriage. What homework for parents would you suggest? Should the Mom remind her to keep her mouth closed during play? Treatment and homework activities depend completely upon the cause of the problem. She keeps her mouth open too much of the time. Why? The answer to that question guides your assignment of any activities, whether they are performed in the therapy room or at home. There can…

The OM Controversy (again…)

By Pam Marshalla

Q: I am a special education advocate and I would like to discuss oral motor exercises with someone. An SLP at a district I’m working with stated, “There is no evidence that oral motor exercises are helpful for speech.” Is that true? This area is a mess. Professionals who bash oral-motor generally can be accused of the following: They don’t know what the term “evidence-based practice” really means. They are confusing the concepts of “evidence-based practice” with the concept of…

When to Treat Later-Developing Sounds

By Pam Marshalla

Q: At what age should my school speech therapist begin working on my son’s “R” sound? Would you address it before “S,” “Z,” and “Th”? When do you address these errors? Do missing teeth affect the decision making in this process at all? Yours is a very simple yet complicated question. First, these are what we call “later-developing sounds.” When a child has errors on these sounds, most SLP’s in the public schools wait until the kids are 7, 8,…

Stimulating L

By Pam Marshalla

Q: How do you teach L for a client who cannot do it at all? These are the types of things I do in whatever order fits the needs of the client: Primitive Movement Teach a primitive L that is made with jaw movement. Have the client stick out his tongue-tip so that it sits between the teeth, and then have him move the jaw up-and-down. This is going to sound and look like the way a baby “lolls” –…

Facilitating Sh, Zh, Ch, and J

By Pam Marshalla

Q: I have been using your cornerstone approach from Frontal Lisp, Lateral Lisp successfully with my students for /s/ and /z/. It has been very helpful! Thank you! However I have a couple of students who are left with a lateral Sh (“shoe”), Ch (“chop”), J (“jump”) and Zh (“beige”). I have been combing your book and working very hard doing oral motor for lateral margins and the bowl shape, but I am still having difficulty with sound production. Help!…

Scoring System on the Marshalla Oral Sensorimotor Test (MOST)

By Pam Marshalla

Q: I was very excited to get your test, the MOST. Can you explain the scoring system to me? We had to design the Marshalla Oral Sensorimotor Test (MOST) so that therapists who had no prior information about oral-motor assessment could administer and score it. Original Design I originally designed a 7-point scoring system, with one score for Pass, and six different scores for Fail. The seven-point scoring system was designed to reveal subtle differences in oral motor skill between one…

Elements of Carryover

By Pam Marshalla

Q: I still have many high school students that have not corrected articulation errors. How long you continue to try to get these teens to carryover productions into conversation after years of no progress? I would answer your question with a series of questions to ponder about your approach to therapy with these kids. These are the things I would think about: Are you working directly on carryover activities? Are you giving them speech assignments to do outside of therapy?…

Lip Trainer

By Pam Marshalla

Q: Do you know anything about the Lip Trainer? Do you think it has any uses in articulation therapy? I have not used a Lip Trainer, however, it looks just like another version of the Lip Gym, which I have used to increase action of the orbicularis oris (OO). These types of devices can be used to facilitate action of the OO. Two basic methods of muscle stimulation are employed: Stretching and Resistance. Stretching A muscle is stretched to activate…