August 2012 - Marshalla Speech & Language

Month: August 2012

Prespeech and Cleft Palate

By Pam Marshalla

Q: I work with infants and often reference the developmental material you present in Apraxia Uncovered. I have a little fellow with an unrepaired cleft palate. He is doing all the skills prior to raspberries and none after. Should I stimulate the raspberries with him? Are raspberries possible with an unrepaired cleft? How much intraoral pressure is needed for them? I have not worked with babies like this, so I don’t really know the answer to any of your questions. I would…

Maturation as a Therapy Strategy

By Pam Marshalla

Q: Do you think that physical maturation alone can be all that a particular client may need to help his speech improve? Yes, clearly some children outgrow their speech problems. But the only way to know this is to let time pass without therapy. I sometimes recommend that a child go 6-12 months with no therapy to see what happens. I make sure the parents know that I am doing this and why. Often the parents and I alone, or…

Lateral Lisp and Young Kids

By Pam Marshalla

Q: How young do you see children with a lateral lisps? Most SLPs leave the lateral lisp alone until age 6-8. However, I and many other therapists address it earlier with children 4 and 5 years of age. I work on the following with younger kids– I make sure that T and D are midline and not lateral. If they are lateral, I straighten them out. I use a straw for this– They produce T into the straw held outside…

Pervasive Question Inflection

By Pam Marshalla

Q: Your Vowel Tracks program was great and the child I am writing about now has all his vowels. His language is improving but most staff cannot understand him because his prosody is drawling, singsong-ish, and inflection is always up at the end of each statement like a question. Any thoughts about how to approach this? The interesting thing about this rising intonation pattern used on statements is that I hear many young people use this today. They say things…

A Crooked Tongue on R

By Pam Marshalla

Q: I have been teaching R using your L-to-R sliding and tapping methods. However the further back my client tries to pull his tongue-tip the more it pulls to his left. He cannot keep it at midline past the middle of his palate, and he is not able to get a good R. I have not encountered this, but these are the methods I would use to address it– Have him use his finger, or another tool, and trace down…

Blowing the Nose

By Pam Marshalla

Q: How do you teach a child to blow his nose? This has worked for me a few times- Teach them to pant in-and-out though the mouth. Then teach them how to sniff in and out through the nose. Once they can get the air moving in and out through the nose, teach them to push breathe more deeply with each sniff in and out. Gradually put more emphasis on the outgoing air. Gradually make the outward sniff a blow…