By Pam Marshalla
Q: How often do you see your clients? I always set once per week as my “must have” level. That is unless they are only on consult, follow-up, or the later stages of carryover. Over 35 years, I have found that once per week is sufficient for most kids, both the easy kids and the low functioning ones. Easy kids can do perfectly well with once per week, and low functioning clients do not move fast enough to warrant more…
By Pam Marshalla
Q: I have a preschool client who talks with his mouth closed. He can imitate me when I model an open mouth posture, but he always closes it when he says a word. I know that he is struggling with motor planning, but I just don’t know where to go from here. Any advice? This client can open his mouth, meaning that the mechanics are good. He also can imitate the posture, meaning that he has control over this movement….
By Pam Marshalla
Q: Why does an oral habit like thumb sucking effect the oral structures in some children but not others? I have seen kids who suck their thumbs who have no dental problems, and I have seen kids who suck their thumbs who have terrible open bites. As I understand things, any oral habit can affect oral structures depending upon the following three factors–– Frequency –– How often the client engages in the habit. Once per day? Ten times per day?…
By Pam Marshalla
Q: My 5-year-old client substitutes N for L. I cannot seem to help him make the sound oral and not nasal. These are the types of things I would try… Use a Vowel Have her open her mouth wide and say “Ah.” Then have her prolong “Ah” for 5 seconds or more. Then have her continue to say “Ah” while she lifts and lowers her tongue-tip up to the alveolar ridge about 5 times. Tell her, “Don’t try to say…
By Pam Marshalla
Q: Would you agree with the following statement: Children with apraxia will respond to structured production of increasingly difficult syllable shapes, while children with dysarthria need supplementing with oral motor exercises to address muscle weakness. Before I answer your question, let me say a few things about “muscle weakness” and dysarthria because many SLPs––including professors of articulation and phonology––do not seem to understand this area very well. The muscle weakness seen in dysarthria can have many different causes, and the…
By Pam Marshalla
Q: My son is 2 years and 2 months, and he jargons mostly. His therapists can’t seem to figure out if this is apraxia or autism. Why is this? It can be very difficulty to determine if a child has autism or apraxia when they are under three years of age. This is because so many of the problems overlap. Both disorders cause the child to be non-verbal or minimally so. Both cause much refusal to follow directions and answer…
By Pam Marshalla
Q: I have a student with Down syndrome who stutters. Her private SLP has diagnosed her as having apraxia, and insists that the fluency problem is part of the apraxia. Can this be right? Many therapists assign the label of apraxia to children with Down syndrome, but I believe that this is an incorrect diagnosis. Dysarthria should be the assigned disorder. Please note the following definitions: Dysarthria Dysarthria comprises a group of speech disorders resulting from disturbances in muscular control….
By Pam Marshalla
Q: How long should it take to establish midline airstream when a client has a lateral lisp? This depends upon what you are talking about. Are you trying to figure out how long it should take you to obtain the client’s first midline sibilant, or to finish the entire program? To be very honest, an SLP with no specific training on how to treat a lateral lisp may NEVER figure out how to get a correct set of midline sibilant…
By Pam Marshalla
Q: I am an SLP from Greece, and I’ve been working with a five-year-old girl with lateral lisp for four months. She still cannot produce a clear “S”. I am interested in buying your book on this subject, but I’d like to know whether these techniques apply only to English. Also, I have heard some SLPs claim that a lateral lisp cannot always be cured. I have never met a lateral lisp that could not be fixed except in the…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in September, 2011. Download the original PDF here. *** Making Speech Targets Salient Classic Auditory Training Tools for Amplifying Speech By Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Making Speech Targets Salient One of the most important things we do in articulation therapy is to make speech units stand out so the client can focus on them. Our most important tool for making speech units salient is our own…
