Author: Pam Marshalla

Losing R: Therapy Regression

By Pam Marshalla

Q: I have an elementary age male client that was attaining an adequate R, but then we had scheduling problems and he lost it. I cannot get it anywhere now. Help! When I have a client like this, I start from scratch. I assume they can do nothing that I worked on with them, and I re-visit all we have done before. Slow way down. Do not assume any generalization. Review, review, review what he could already do and solidify…

Following Sanitary Procedures

By Pam Marshalla

Q: Recently I came across an SLP who was using oral-motor tools but not following sanitary procedures. Ahhhhhh! What resources can I share with her? SLPs must follow sanitary procedures at all times when touching a client in, on, or around the mouth with the hands or other objects. The following notes are from my upcoming book, The Marshalla Guide. Sanitizing the Hands Wash the hands with a sanitizing soap. Dry the hands with a paper towel and dispose of…

Slow Dysarthric Speech and Peer Awareness

By Pam Marshalla

Q: I am serving a student with moderate acquired dysarthria impacting speech intelligibility due to impaired respiration, phonation, coordination, speech rate and articulatory precision. She is six-years old and her accident was 2 years ago. She can follow directions well and is aware that she sounds different than her peers. The most obvious speech quality is the slow rate, pausing, and unnatural phrasing. Her peers tend to ignore her when she is speaking because these qualities make her sound so…

Speech is Movement

By Pam Marshalla

Q: I have been to one of your workshops and heard you say, “Speech is movement.” Is that something you made up or does it come from something you read? “Speech is Movement” is my therapeutic motto. It is a quote I got from the 20th century’s first greatest motor speech scientist in Stetson, R. (1928). Motor Phonetics: A Study of Speech Movements in Action. USA: North Holland.

Tracheal Stop: Learning the “Place of Articulation”

By Pam Marshalla

Q: My nearly 3-year-old client makes a substitution for /k/ which comes from the throat. The closest I have found online is to describe it as a uvular stop. Have you heard this substitution before and how would you describe it. Any thoughts on how to treat it? Infants start out by making stops and fricatives all along the vocal track from anterior to posterior — Bi-labial Labial-dental Lingual-labial Lingual-dental Lingual-alveolar Lingual-velar Tracheal Glottal Then they learn to restrict what…

Mastering Vocalic R

By Pam Marshalla

Q: What is the secret for vocalic R? I have students who can produce prevocalic R very well yet when it comes to Ar, Or, and Ir, and so forth, they flounder. Any tips for this? The key to mastery of vocalic R first is to realize that tongue position for prevocalic R and postvocalic R are exactly the same. The difference is in the transitions movements. Transitions Movements When we produce a prevocalic R at the beginning of a…

The Whistled S

By Pam Marshalla

Q: My client makes a whistling sound when he says S. Do you have advice? A high-pitched “whistled S” is the result of an airway space in the mouth that simply is too narrow causing whistling instead of true frication. All you have to do is get him in front of a mirror and have him start experimenting with how much air he is letting out. He may need to pull the tip of his tongue back a little, or…

Top 75 SLP Websites & Blogs for 2015

By Pam Marshalla

Recently, this blog was featured in Kidmunicate’s list of their favorite Top 75 Speech Pathology Websites for 2015 . I am honored to be listed as #52! Thank you, dear readers, for your continued support of my work and our profession —  especially those of you who’ve been reading for all 9 years that this blog as been around! (Or all 30-ish years of my writing career!) And thank you to Kidmunicate for selecting my blog.

Evaluation & Diagnosis: The Best List of CAS Characteristics

By Pam Marshalla

Q: Do you have a list of diagnostic indicators for young children with CAS? The best I have found has been from a seminar I attended by Dr. Barbara Davis in 2010. This is what I put together from her handout: Characteristics of Apraxia Barbara Davis does research in the area of childhood apraxia of speech and she presented a summary of research in this area at a recent seminar (Davis, 2010). She reported that the incidence of apraxia is…

Introducing S to Your Client

By Pam Marshalla

Q: My 4-year-old client has no strident sounds and I was thinking about starting with S. Is this right? And how should I teach it? Whether or not to start with S as your first strident sound depends entirely on the client. Here is advice to get you going: Expand Your Horizons Don’t just look at the strident sounds (S, Z, Sh, Zh, CH, and J). Look at all 11 fricatives and affricates together—Th, Th, F, V, S, Z, Sh,…