Author: Pam Marshalla

What is a Tongue Thrust?

By Pam Marshalla

Q: Is four years old too early to address a tongue thrust? The term “tongue thrust” has had many meanings through the years. It can mean: A strong forward thrusting of the tongue following the swallow. A reverse swallow pattern. An infantile suckle-swallow pattern. An interdental tongue protrusion on all lingua phonemes.. An interdental tongue protrusion on all the lingua-alveolar phonemes. An interdental tongue protrusion on the all the sibilants. An interdental tongue protrusion on only S and Z. To…

Teaching Co-articulation Movements

By Pam Marshalla

Q: I have a student, who has been working on R, and who can make it at the word and sentence levels, but who cannot seem to co-articulate automatically. He still articulates each sound individually within words. For example he does not automatically round his lips for the word “core.” When I say the word “core” my mouth stays rounded for the entire word however they don’t do this. Why don’t their minds just naturally catch on to coarticulation after…

Fixing an Inhaled S

By Pam Marshalla

Q: My client inhales on S. I have tried using a straw and a cotton ball to teach him about airflow. He does fine with these, but he doesn’t transfer the skill to S. Help! Your client probably continues to inhale on S because he “thinks” he is trying to say S. He has an auditory/motor memory for his own S that he is continuing to access. You have to help him learn to block access to this memory. Here…

Explaining “Articulation” and “Oral Motor”

By Pam Marshalla

Q: I have been arguing with a colleague about “oral motor” and “articulation.” She does not seem to know what an articulation deficit is. She disputes the notion of an “articulation deficit,” and claims that there are only “phonological deficits.” Can you help me? I know what I mean, but I can’t seem to put it in the right words for her to grasp. I need help explaining what an “articulation deficit” is, and help in relating this to “oral…

The Roots of Oral-Motor Therapy: A Personal View

By Pam Marshalla

This opinion paper was originally posted as a downloadable PDF on my website, authored in March, 2011, and revised in April, 2011. Download the original PDF here. *** The Roots of Oral-Motor Therapy: A Personal View By Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Time The 1970’s was a time when SLP’s begin to work in multidisciplinary and transdisciplinary teams with OT’s, PT’s and other professionals. For the first time, SLP’s and motor specialists were sharing their thoughts and ideas regarding therapy with…

Resistance: The Most Powerful Oral Motor Technique

By Pam Marshalla

Q: What can I do to help my client learn to elevate his tongue-tip to produce /t/ and /d/? Any part of the tongue can be taught to elevate by providing something against which it can press. This is called “resistance.” (Resistance is not used to build strength. That is a misconception of the “anti-OM” crowd). Instead, resistance is used to develop specific new movement patterns. Press down lightly on the tongue-tip with a tool and ask the client to…

Lateral Lisp and Obesity?

By Pam Marshalla

Q: My daughter has a lateral lisp and obesity. The SLP cannot seem to get her to make the correct sounds. Can obesity interfere with learning these sounds? I have never faced this situation with any client. However, from what I know about tongue function and the lisps, I do not see how obesity might interfere with learning correct tongue position for S, Z, Sh, Zh, Ch, or J. Perhaps your SLP does not know how to fix a lateral…

Lip-Biting Habit

By Pam Marshalla

Q: My client constantly bites her lower lip until it swells and bleeds. She is highly intelligent, five years old, hypertonic, and has vision difficulties. Do you have suggestions? I have never faced this situation, but I believe that the principles of helping a child stop any oral habit would apply. You have to help the child recognize what she is doing, help her understand the problems it causes, help her develop a goal for stopping, set up a reward…

Don’t Let the Issue of Evidence-Based Practice Get You Down!

By Pam Marshalla

Q: I have been reading your book Becoming Verbal with Childhood Apraxia. The ideas sound great and very interesting, but I did not see a complete reference list. Are there specific research studies that support the techniques that you were describing in your book? The examples included were helpful. I need some more support because of the emphasis on the evidence-based practice. There is no reference list at the end of the book because these are all my original thoughts…

Articulation Therapy vs. Speech Improvement

By Pam Marshalla

Q: There seems to be a shocking lack of knowledge “out there” about how to do articulation therapy. I recently saw a girl with an R distortion who had been in therapy with another therapist for a year with no progress. I was able to get a correct sound from her in 15 minutes! The mother was amazed that I actually worked on tongue movement and placement. I agree, and I think I know why this is occurring. The tried-and-true…