Q: My client has cerebral palsy. His articulation is really good but he is dysfluent. Can you help me? I am sorry, but I am completely unqualified to answer any questions about fluency.
Cerebral Palsy and Dysfluencies
By Pam Marshalla
Month: July 2012
Putty Bite Blocks
By Pam Marshalla
Q: I recently read an article that indicated bite blocks could be made from dental impression compound. Have you heard of this or tried doing it? Do you have any suggestions on how this could be accomplished, the efficacy of doing it, and the material that would suit the job best? I have not used this method myself, but James Dworkin wrote about it in 1991. Dworkin came out of the Darley, Aaronson, and Brown school of thought on motor…
Recommendations for Polymicrogyria
By Pam Marshalla
Q: My client is a five-year-old with polymicrogyria. He drools severely, eats only purees, basically is non-verbal, and has a non-verbal IQ of about 85. He is labeled as apraxic. Can you give me advice on how to proceed? I had not heard of this disorder, so I Googled it and found quite a bit under “polymicrogyria ” and “children with polymicrogyria.” Apparently it is a developmental malformation of the human brain characterized by an excessive number of small convolutions on the…
Therapy is On-Going Diagnosis
By Pam Marshalla
Q: Many SLPs write to me with questions about sibilants that are distorted––inter-dental, frontal, whistled, palatal, lateral, and so forth. I have given lots of advice about these errors, but sometimes I can’t. Why? Sometimes I can give no advice for fixing errors on the sibilants because the errors are distorted in such refined ways that there is no way to determine what exactly is going on without seeing and hearing the error myself. If you have taken classes of…
“It hurts”: Helping Clients Handle Oral Input
By Pam Marshalla
Q: When I try to use a tongue depressor or any other tool in my client’s mouth, he backs off right away and says, “It hurts.” He does this even before I use the tool to touch his mouth or do anything. I don’t think he’s hypersensitive. I think he’s refusing just to refuse. He is four-years-old and I am trying to elicit a K and a G. I think you are right. A little guy like that may use…
R-Blends
By Pam Marshalla
Q: I attended your R seminar and have been having great success. However, I do not know what to do with R-Blends. I can’t seem to get Tr, Dr, and so forth. That is a great question, and represents a topic I never seem to get to in my seminars. I also did not describe it very well in my R book, so here is the best way I have been able to describe what I do to date ––…
Hammer’s Cues for Apraxia
By Pam Marshalla
I recently attended a seminar on apraxia taught by David Hammer, SLP. It was fabulous and I highly recommend it to all my readers! David uses a combination of verbal cues, object cues, and gestural cues together in his work with apraxic children. He bases this speech training on the theory that children with apraxia need a multisensory approach that focuses on phoneme sequencing. The verbal cues he uses are names and phrases that describe the outstanding place, manner, and…