By Pam Marshalla
Q: My client had a xyanotic episode at 4-days of age. She had no verbal language until about 24 months. She is now 33 months and is talking quite a bit with delay. But what is throwing me for a loop is that she has changed “mommy” from “Mee-mee” to “Mah-mee” and now to “Hah-mee.” She also substitutes H for other M words. I’ve never seen this. Can you explain it? I don’t have all the info I would need…
By Pam Marshalla
Q: My two-year-old client with Down syndrome has dysphasia and the classic forward tongue posture. Which of your books will guide me to work on oral-motor skills so I can strengthen the oral structure for swallowing and speech? Therapy is rarely about “strengthening” oral movements. Therapy for developing expressive speech in a toddler with Down syndrome usually includes the following: Activities to encourage a wide variety of oral movement through feeding and oral play activities. Activities to get the…
By Pam Marshalla
Q: Have you ever seen a child add final consonants to words that don’t need them? My 3-year-old male client adds T to the end of everything. I have seen this with a few kids who used a few different phonemes: T and S mostly. I usually consider it overgeneralization of their new knowledge about final consonants, and I don’t worry about it. I do not believe that I ever had to do anything about it, and I just let…
By Pam Marshalla
Q: This child is nine years old, medically fragile, functioning in the severe-profound cognitive level, blind, deaf, and on a feeding tube. We want to teach him to cough in order to clear his lungs regularly. Do you have suggestions? WARNING!! I am not a medical professional and all of the following should be taken with extreme caution. This is what I was taught to do by an OT years ago. Get medical clearance for these procedures before using them…
By Pam Marshalla
Q: I want to get your feedback on my experience with speech apps. I am a seasoned professional and I work the old fashioned way –– with toys, games, books, drawing, coloring, etc.. But I have grad student interns who work with me and I always have them show me what they do in therapy with their iPads. At first I was excited (and envious), but then I noticed the kids were engaged with and pressing the screens, but they…
By Pam Marshalla
Q: How can I get my client with Down syndrome (DS) to keep her tongue inside the mouth during speech? A client with Down syndrome has low tone, dysarthria, and lack of oral stability. The oral mechanism is supposed to be stabilized in a certain way during speech. The jaw should move up-and-down in a very small restricted range that is high, and the tongue should anchor its movements in the back against the back lateral teeth or palate. Children…
