By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in mid- 2011. Download the original PDF here. *** What Evidence-Based Practice (EBP) Really Means Q: It is surprising to me that you find it reasonable to pass on non-evidence based ideas. I don’t think this meets a best practice standard at all. I’m curious to know how you demonstrate efficacy this way. The term “Evidence-Based Practice” has been bandied about and distorted. EBP does not mean that we only…
By Pam Marshalla
Q: In my therapy with kids who have the stopping process, I typically start with S-clusters and S in the postvocalic position. It seems they develop the idea of “fricative-ness” more easily this way and, from there, they more easily go on to prevocalic S. I find that starting with prevocalic S often leads to a lot of frustration because they learn “sock” as “stock,” and so forth. Can you comment on this? First, we have such a mess in…
By Pam Marshalla
Q: My client is beginning to use S-blends, but she does so with an interdental lisp. Do I treat the phonological process first and let her lisp, or treat the lisp first and then the process? Or should I do both concurrently? I am worried about reinforcing the lisp. I would work on the phonology first to stimulate the use of the phoneme within the language. Then I would address place of articulation. That’s the way I would organize it…
By Pam Marshalla
Q: I have a six-year-old male client that has phonological and articulation problems. What should I target first in therapy? Therapy always is based on the differential diagnosis. It is impossible to answer that question without information about the client’s entire phonological and articulation repertoire. Selection of therapy targets will be very different depending upon many factors. One makes decisions about therapy based upon a complete overview of what is going on. If you read through this blog, you will…
By Pam Marshalla
Q: I have an elementary client who figured out how to say R all by herself, but she shifts her jaw to one side to accomplish it. I have tried to get her to stop lateralizing the jaw, but then she can’t produce R. Should I worry about this? I would not try to take her away from what she has achieved on her own. She is proud of it! Instead, let her keep producing the R with the jaw…
By Pam Marshalla
Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…
By Pam Marshalla
Q: I have an adult Chinese student with /r/ and /l/ problems. She produces these phonemes with additional sounds I cannot describe in words. Can you give me any tips in correcting them? I think your best method for correcting this would be to have her say the sounds enough times that you will be able to imitate them exactly. Then model for her what she is doing and help her hear what she is doing wrong. And then help…
By Pam Marshalla
Q: My adult daughter needs help with her R. Is this something you can do with her by way of this Blog? Therapy to remediate an incorrect R is like voice training: It cannot be done on paper or in a QA format like this. Your daughter needs to find a live therapist with whom she can work, either together in an office or via live on-line video chatting. Either should work okay if the therapist knows what he/she is…
By Pam Marshalla
Q: My student can do R in all words and in all positions, but he prolongs it. Do I need to teach him NOT to do this? I would teach it to him if it did not go away by itself within a reasonable period of time. I am not sure what that reasonable period of time is, but I would be willing to give him 6 months to a year to straighten this out. I probably would give him…
