By Pam Marshalla
Q: I am seeing a 5-year-old male with interdental S, T, D, N, and L. He can say every sound correctly when reminded to keep back teeth together. Do I address all sounds at once or just S first? Should I still do cornerstone approach since he is stimulable or just work on drill and carryover? As you know, each child is different. This is the process of trial and error. You will have to figure out what works best…
By Pam Marshalla
Q: I have two girls with Down syndrome who grind their teeth on a regular basis. They are the same age and function at about the same level. What strategies would you use to help with this area? This is a tough question. We have no widely accepted strategies to eliminate tooth grinding other than the dental guard recommended by dentists. But my thinking has always been that if you can pinpoint the cause, then you can design a solution…
By Pam Marshalla
Q: My 7-year-old male client has a robotic speech presentation that interferes with intelligibility. He has low tone in the trunk and poor breath support. Do you have suggestions? Usually a robotic voice makes an unintelligible child more intelligible. So maybe your client is using the robotic presentation to help him be more intelligible. In other words, maybe he knows (unconsciously) that when he speaks with equal stress on each syllable more people can understand him more often. He may…
By Pam Marshalla
Q: My student has very uncoordinated oral movements and severely unintelligible speech. He is unable to elevate his tongue-tip, and therefore does not produce any alveolars. His S and Z are very frontal––like Th––and he reduces S-blends. How do I teach alveolars, and do I concentrate on S-blends or correct production of S and Z? Your client requires a whole semester class on how the body works, and how that plays into speech movement development. Questions like yours are the…
By Pam Marshalla
Q: I bought your book Frontal Lisp, Lateral Lisp recently and am trying your “Long T Method.” My client can do T but not Ts. Is there still hope that I can use the Long T method or should I skip to something else? I only tried an aspirated T during one session so far. Patience! One session is not enough to know if a method will work or not. Also, you seem to be trying to get him to…
By Pam Marshalla
Q: I have had success with your “Long T Method” for teaching S and Z with my adolescent lateral lisper, but he continues to break down in reading and in conversation, he can do Sh and Zh on words, but he can’t do Ch or J at all. Where do I go from here? Can I expect braces to help improve his speech? Braces will not help. This is not a tooth problem. It is a tongue movement problem. You…
By Pam Marshalla
Q: I am confused over the term NS-OME (Non Speech Oral Motor Exercises). Some people are saying that we cannot use things like toothettes, bite sticks, whistles, or straws in therapy. I use many things like this in therapy. Shouldn’t we do whatever we can to help our clients learn to make speech sounds? Your question is a good one. Yes, we are supposed to use whatever we can to help our clients learn to produce speech sounds. Van Riper…
By Pam Marshalla
Q: My school district has been suggesting that we work on stopping before s-clusters, and I thought that would be a mistake leading to lots of frustration for both the SLPs and the students. Do you have any comments? I think that whenever we set policy –– “my district has been suggesting that we work on stopping before s-clusters” –– we are forgetting the individual child. There is no hierarchy or policy that should “work.” What “works” is what works…
By Pam Marshalla
Q: When my 4-year-old client says a word that begins with a vowel, he adds /h/ before it –– “Ate” sounds like “Hate.” What are your thoughts? Let me answer this according to four different scenarios –– 1. Client generally uses no frication at all: If the client was not yet using any fricatives or affricates, and the extra appearances of H were just a fluke, then I would stimulate all eleven sounds for a while till the whole set…
By Pam Marshalla
Q: I am an SLP and my 12-month-old daughter is developing a lateral lisp on her first words! Help!!! I believe this to be one of the worst positions in which an SLP can find him- or herself. We can teach midline sibilants to very young children, even toddlers, if we approach the acquisition of frication/stridency the way an infant does. I would do these three things now –– 1. Teach her to make a lingua-labial raspberry. Put the tongue…
