Month: July 2011

Fixing the Inhaled R

By Pam Marshalla

Q: I have a nine-year-old client who inhales as she tries to say R. I have never seen this before. Do you know how to address this? There is a very simple old-time solution for this using a straw, a few sheets of tissue paper, and a few small cotton balls: Teach About Exhalation Place a cotton ball on the table and give the child the straw to hold at her mouth.  Have the child blow through the straw at…

Getting a 2-Year-Old to Cooperate

By Pam Marshalla

Q: My son is 2-years and 5-months. His therapist seems frustrated by his stubborn personality and his continual effort to get out of doing his speech cards. I know we can help him more if he would only try. Can you suggest anything?   It sounds like the therapist is trying to work with him as though he were four or five years of age.  He’s only two and a half!  Children this young should balk at doing speech cards. …

Oral-Motor and Evidence-Based-Practice Misinformation

By Pam Marshalla

Q: I am now so thoroughly frustrated with the field of speech pathology, I’m tempted to throw in the towel… Or should I say throw in the bite blocks? I think the whole question of oral-motor therapy has gotten totally out of hand, and I no longer know what to believe. In this age, from every corner, we are encouraged to follow the evidence-based practice. In the absence of any hard evidence, I don’t know whether I ought to try…

Exercise Routines

By Pam Marshalla

Q: Which of your books do you suggest for teaching me the number of repetitions or the amount of seconds for engaging in oral-motor exercises? I do not teach oral-motor techniques exercise routines.  I teach oral-motor techniques to facilitate sound production.  Therefore none of my books will give you that type of information.  In general I do not measure the number of trials, or the number of seconds —  I teach techniques to facilitate new movements for phoneme productions.  The…

A Challenge to the Oral-Motor Naysayers

By Pam Marshalla

Q: I am a professor and clinical supervisor in a prestigious university program. I do not see jaw or tongue movement problems in the articulation and phonology clients I supervise. Are you saying that someone like me does not have good observation skills? No. I am not saying that you have poor observations skills.  I am saying that you have not been trained to see what is happening right in front of you. Consider this: An SLP must go through…

Widening the Tongue

By Pam Marshalla

Q: The handout from your live class on the lisps has a method called the “Medial Squeeze.” What is it, and what is it for? The Medial Squeeze is a method I developed to get the tongue to widen.  The tongue needs to sit wide on the floor of the mouth at rest, it needs to be wide for a normal swallow, and it needs to stay wide during speech movement. Some of our clients squeeze the tongue medially during…

How to Suppress the Gag

By Pam Marshalla

Q: In a few of your blogs you mention that sometimes we have to teach a client to suppress his gag reflex. Why would you need to suppress the gag, and how does one go about doing it? The gag needs to be suppressed only if it is interfering with oral motor learning for speech and/or feeding. Severe Cases In the most severe of these cases, excessive gagging causes children to be unwilling to move and explore with the mouth. …

Using the Tongue Bowl Reflex

By Pam Marshalla

Q: What is the purpose of stimulating the Tongue Bowl Reflex (TBR)? Isn’t a reflex passive movement? What are we trying to achieve when using a reflex like this? I have chosen to answer your question with material from my next book, The Marshalla Guide to 21st Century Articulation Therapy.  The following is abstracted from my chapter called “The Speech Reflexes: Stimulating Automatic Speech Movements”: Theory Reflexes are considered the first movements in the process of human movement development.  Speech…