By Pam Marshalla
Q: My client cannot produce some of the short vowels and I am having a terrible time teaching them to him. He cannot get his tongue in the right positions. Any suggestions? The problem we have teaching the vowels is that most of us have been training to think that it is all about tongue position. Tongue position is important when adults differentiate their vowels. But when children are learning all the vowels in infancy, it is the jaw that…
By Pam Marshalla
Q: My 5-year-old son has average intelligence but speaks in 3-5 word utterances. He had hearing problems earlier. The SLP at school wants to put him into a group. Can he be affected by the modeling of the other students who also have poor articulation? Isn’t a 1-to-1 setting better? I work in private practice because I always prefer the 1:1 situation, but a group can be useful for many reasons. Group work can be more motivating and fun. Language…
By Pam Marshalla
Q: My client had a tonsillectomy and adenoidectomy but she still sounds stuffy and nasal. Mom says she has always sounded this way. Suggestions? Voice is a very difficult topic for those of us who do not specialize in it. Many clients do not change their voice and resonance patterns after surgery because the “old voice” is just what they are used to. It’s the way they always have sounded. It’s them. Therapy intends to change that vocal quality. Unfortunately…
By Pam Marshalla
Q: Everyone seems to say that kids with Down Syndrome have apraxia. Is this right? Shouldn’t it be dysarthria? Any client with a speech problem and neuromuscular disorder has dysarthria. Period. That is the very definition of dysarthria. Dysarthria is a non-linguistic, neuromuscular disorder of expressive speech, characterized by impaired capacity to execute speech movements. Dysarthria defines a group of motor speech disorders that includes clients with muscle tone disturbance–– Low tone, high tone, mixed tone, fluctuating tone; It includes…
By Pam Marshalla
Q: I just started working with toddlers and preschool children and my colleague says that you can’t do an oral-peripheral exam on these little guys. What do you say? Do you do it and if so how? An examination of the oral mechanism’s structure certainly can be done on little kids. Come on people! Let’s get creative! I do oral exams on all clients regardless of age. With infants I just poke around in there and prop the mouth open…
By Pam Marshalla
Q: Do you know of any good books about remediating speech (not language) in children with Down syndrome? My client is 12 years old and I think it is time to concentrate more on intelligibility after years of language work. I answered this question through a personal exchange with the SLP, however I thought I would say a few things about the topic here on my blog. Always remember that with Down syndrome you always have dysarthria and that means that…
