By Pam Marshalla
Q: My school district has been suggesting that we work on stopping before s-clusters, and I thought that would be a mistake leading to lots of frustration for both the SLPs and the students. Do you have any comments? I think that whenever we set policy –– “my district has been suggesting that we work on stopping before s-clusters” –– we are forgetting the individual child. There is no hierarchy or policy that should “work.” What “works” is what works…
By Pam Marshalla
Q: When my 4-year-old client says a word that begins with a vowel, he adds /h/ before it –– “Ate” sounds like “Hate.” What are your thoughts? Let me answer this according to four different scenarios –– 1. Client generally uses no frication at all: If the client was not yet using any fricatives or affricates, and the extra appearances of H were just a fluke, then I would stimulate all eleven sounds for a while till the whole set…
By Pam Marshalla
Q: I am an SLP and my 12-month-old daughter is developing a lateral lisp on her first words! Help!!! I believe this to be one of the worst positions in which an SLP can find him- or herself. We can teach midline sibilants to very young children, even toddlers, if we approach the acquisition of frication/stridency the way an infant does. I would do these three things now –– 1. Teach her to make a lingua-labial raspberry. Put the tongue…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in mid- 2011. Download the original PDF here. *** What Evidence-Based Practice (EBP) Really Means Q: It is surprising to me that you find it reasonable to pass on non-evidence based ideas. I don’t think this meets a best practice standard at all. I’m curious to know how you demonstrate efficacy this way. The term “Evidence-Based Practice” has been bandied about and distorted. EBP does not mean that we only…
By Pam Marshalla
Q: In my therapy with kids who have the stopping process, I typically start with S-clusters and S in the postvocalic position. It seems they develop the idea of “fricative-ness” more easily this way and, from there, they more easily go on to prevocalic S. I find that starting with prevocalic S often leads to a lot of frustration because they learn “sock” as “stock,” and so forth. Can you comment on this? First, we have such a mess in…
By Pam Marshalla
Q: My client is beginning to use S-blends, but she does so with an interdental lisp. Do I treat the phonological process first and let her lisp, or treat the lisp first and then the process? Or should I do both concurrently? I am worried about reinforcing the lisp. I would work on the phonology first to stimulate the use of the phoneme within the language. Then I would address place of articulation. That’s the way I would organize it…
By Pam Marshalla
Q: I have a six-year-old male client that has phonological and articulation problems. What should I target first in therapy? Therapy always is based on the differential diagnosis. It is impossible to answer that question without information about the client’s entire phonological and articulation repertoire. Selection of therapy targets will be very different depending upon many factors. One makes decisions about therapy based upon a complete overview of what is going on. If you read through this blog, you will…
By Pam Marshalla
Q: I have an elementary client who figured out how to say R all by herself, but she shifts her jaw to one side to accomplish it. I have tried to get her to stop lateralizing the jaw, but then she can’t produce R. Should I worry about this? I would not try to take her away from what she has achieved on her own. She is proud of it! Instead, let her keep producing the R with the jaw…
By Pam Marshalla
Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…
By Pam Marshalla
Q: I have an adult Chinese student with /r/ and /l/ problems. She produces these phonemes with additional sounds I cannot describe in words. Can you give me any tips in correcting them? I think your best method for correcting this would be to have her say the sounds enough times that you will be able to imitate them exactly. Then model for her what she is doing and help her hear what she is doing wrong. And then help…
