By Pam Marshalla
Q: My 10-year-old student with a profound hearing loss and a recent cochlear implant cannot produce any back sounds. We have tried all of the elicitation techniques (tongue depressors, lying on back, gargling) which usually result in her using a glottal plosive instead. Do you have any other suggestions? I am not sure what you mean by “all of the elicitation techniques.” You mention using a tongue depressor, but you do not say HOW you used it. It’s all about…
By Pam Marshalla
Q: My 6-year-old male client keeps his lips in a perpetual smile that is interfering with intelligibility when he speaks. He appears to have low muscle tone. He also has great difficulty producing multisyllabic words. I am wondering where to begin? Your client has lip retraction associated with mild dysarthria. How do I know he has dysarthria? Because he has speech distortion related to neuromuscular disturbance. That is the very definition of dysarthria. I have written the following about lip…
By Pam Marshalla
Q: A pediatrician recommended that a 4-year-old child receive speech therapy for R distortion. When do you recommend starting therapy for R? In my seminars I always say that a preschool child CAN be helped with R, but most therapists don’t feel it is necessary that young. School-based therapists almost never see these kids that young, but therapists in private practice often do. Therapists in private practice do so not because they feel it is absolutely necessary but because the…
By Pam Marshalla
Q: My 2-year-old daughter has to get her four front teeth extracted because of decay. The doctor told me that there could be speech disorders. She doesn’t speak as much as other kids of her age and she started walking a little late. After these teeth are extracted I am worried that she is going to stop trying to talk and become even more timid. What can I do? You have two things going on that have different impacts on…
By Pam Marshalla
Q: My 4th grade client substitutes a nasal snort for his sibilants. Have you written about this? The escape of nasal sound on the sibilants is fairly common and has been called by various terms in the traditional literature––nasal lisp, nasal snort, recessive s-lisp, and nasal stigmatism. Peterson-Falzone and Graham (1990) used the phrases phoneme-specific nasal emission and posterior nasal frication to describe nasalized sibilants. I have written a whole chapter about how to work with resonance problems like this…
By Pam Marshalla
Q: Do you know if chewing tools are effective in correcting open mouth posture in a 2-year-old? Is there any research on this? The question reveals that you are assuming too much one-to-one correspondence between methods of oral stimulation and results. Chewy tools are designed to facilitate up-and-down jaw movements, and to increase the amount of time a client keeps his jaw in the “up” position. That is all they will do. To assume that chewing on a chewy tool or…
