Month: May 2013

Damaged Tongue-Tip

By Pam Marshalla

Q: My elementary-age client injured her tongue-tip. It has been a few weeks post the accident and her speech is moderately distorted and she still complains of pain. Her doctor says she is just trying to get attention. Do you have experience with this?   I have worked with a few patients who had injury to the tongue-tip.  In my experience it can take up to a year to fully recover from it.  If some of the nerves were damaged,…

Help for Adult with Articulation and Feeding Problems

By Pam Marshalla

Q: I am an SLP with a lisp and mild problems with chewing and swallowing. I receive SL services as a child, but I quit too early and have not completely remediated my errors. What would you recommend? I would recommend that you find an SLP who is trained in orofacial myology to oversee your work on speech, eating, swallowing, and probably oral rest.  An orofacial myofunctional therapist who knows what s/he is doing would be of great help to…

When to Use the Dropper

By Pam Marshalla

Q: My 6-year-old male client drools has language and cognitive problems but no articulation problems, but he drools a lot. I know of your dropper technique. Should I use the dropper with him or just tell him to swallow every 90 seconds? As I am sure you know, a technique is just a technique. Therapy is all about finding out if a certain technique works for a certain client. Therefore in regard to this specific technique, if he can swallow on…

Low Cognition and SLP: Therapy vs. Babysitting and School Culture

By Pam Marshalla

Q: I am very frustrated working in the public school. I am forced to see very low functioning children 2-4 times per week, and even with this much therapy they are not progressing in vocabulary, phonemes, nothing. Am I doing something wrong? Let me be very blunt here. Warning! Those of you who don’t know me need to be warned that I do not speak with political correctness. I find it to be an imposition on our freedom of speech…

Starting Over in Apraxia Research

By Pam Marshalla

Q: I have heard you complain about research in the area of apraxia. Why do you think it is so poor? Think about this: APRAXIA occurs in the ABSENCE of neuromuscular disorder while DYSARTHRIA occurs in the PRESENCE of neuromuscular disorder. Now think about this: ALL the research in speech that has been done on apraxic kids since the beginning of time has been done without any assessment of their muscle tone.  Researchers have just been assuming that tone is…

Differentiating Between Apraxia and Dysarthria

By Pam Marshalla

Q: What would to do in an evaluation to differentiate between CAS and dysarthia?  Specifically would you rule out muscle weakness? The definitions of apraxia and dysarthria speak for themselves–– APRAXIA is a motor speech disorder that occurs in the ABSENCE of neuromuscular problems. It is a problem in the perception of movement, and therefore it causes problems in planning movement.  The result is severe articulation and phonological deficit. DYSARTHRIA is a motor speech disorder that occurs in the PRESENCE…