By Pam Marshalla
Q: I have a 9-year-old male client with Asperger’s who sucks him thumb. I read your book How to Stop Thumbsucking and have had success with other children, but not this one. Advice? I have never faced this but I think this all boils down to what makes sense for him. It seems that the only things that get through to these clients are the things they can plug into their own logic. If you can figure out what makes…
By Pam Marshalla
Q: My client has low tone and many deviant phonological processes. Is this common? Does this mean he has dysarthria? How should my treatment look different from traditional articulation or phonological therapy? Yes! If the child has hypotonia then this is dysarthria. Whenever you have muscle tone problems of a global nature, then dysarthria is the diagnosis. Dysarthria is a speech movement problem that is the result of muscle tone disturbance. (See definitions below) It is common for children with…
By Pam Marshalla
Q: My client can produce only the schwa––“Uh.” He is 3-years-old and pretty smart. But he cannot imitate any consonants or vowels at all. What can I do? This is what I would be thinking about––– Teach him to prolong the sound he has––the schwa. And teach him to tolerate your hands on his jaw. Once he can prolong his schwa and tolerate your hands, move his jaw up-and-down while he is vocalizing. If he can prolong his sound while you…
By Pam Marshalla
Q: I am using your eyedropper method for a non-verbal 5-year-old girl in the trainable cognitive level. She also has a neuromuscular disorder. We do it for 15 minutes and then she gets bored. Do you have advice? This is not the type of activity that you do for 15 minutes. Weave it in-and-out of other SL activities you are doing. Use the dropper procedure every 90 seconds while she is otherwise engaged. You want to stimulate her to swallow…
By Pam Marshalla
Q: Is there an age constraint for starting self-awareness techniques for carryover? My son is 6 years old. Carryover ideas should start right from the first day of therapy, no matter the client’s age. That means that you are planning for and thinking about and stimulating for carryover from the first day, and you are dropping in ideas here and there. For example, let’s say your child is learning to keep his tongue in his mouth. He can work on…
By Pam Marshalla
Q: What type of articulation therapy should be provided for children with Mobius Syndrome? I have only seen a few children with Mobius Syndrome, and those were seen for diagnosis only. As I understand it, facial paralysis is the main problem and the paralysis can involve some or all of the facial muscles, particularly the upper lip in most cases. The breadth and scope of the paralysis will guide speech involvement. One client I saw had paralysis only in the…
