Pam Marshalla, Author at Marshalla Speech & Language

Author: Pam Marshalla

Never Too Late For a Lingua Frenectomy

By Pam Marshalla

Q: Is there an age when surgically altering the lingua frenulum is too late? It is never too late to surgically alter a lingua frenum for improved speech function, except perhaps in the case of degenerative disease. The surgery simply frees the tip of the tongue. It allows the tongue a greater range of movement no matter the age. However, just because the tip is clipped does not mean there is an instant fix to speech. Some clients get very sloppy…

Comparison OMT and NS-OME

By Pam Marshalla

Q: In your class on apraxia, I listened while you described the difference between an “oral-motor technique” (OMT) and a “non-speech oral-motor exercise” (NS-OME). I understood what you were saying at the time, but when I got home and looked at my notes, I found that I didn’t quite get it. Can you give an example to explain this to me? The OMT and the NS-OME are two completely different concepts. The difference between them has to do with the…

Exhaling Appropriately During Speech

By Pam Marshalla

Q: My inattentive three-year-old client suddenly has begun talking on both exhalation and inhalation. Do you have any suggestions to promote proper breathing for speech? The airflow toys can help teach young children all about the direction of airflow. These include horns, whistles, kazoos, harmonicas, sirens, and spirometers. A toy that works upon exhalation only (horn, whistle) can teach a child about moving air outward. Teach him “Blow out.” (These toys will not sound when inhaled.) A toy that works…

Minor Toddler Articulation Errors

By Pam Marshalla

Q: I have a client, 2.5 years, who substitutes “F” for “K,” “B,” “D,” “G,” and “T” in initial “R” and “L” clusters. “W” replaces the glides. I am not concerned about the glides. Is the child just over-learning the “F” sound? The replacement of a single phoneme for a cluster is called “Coalescence.” Hodson and Paden define this as the “replacement of two adjacent phonemes by a single new one which retains features from both of the original phones”…

Thumbsucking to Move Facial Bones?

By Pam Marshalla

Q: Do you have any thoughts on thumb sucking as a way to move facial bones? One of my four-year-old clients is a frequent thumb sucker. A professional on my team wants to encourage the habit to move this child’s facial bones as part of her craniosacral therapy. The therapist says that the child’s thumbsucking is “a pathological compensation for a structural anomaly.” Now the staff thinks that this child’s thumb sucking is okay. What do you have to say about…

Homework for Open Mouth Posture?

By Pam Marshalla

Q: I have a preschooler with an open mouth posture and forward tongue carriage. What homework for parents would you suggest? Should the Mom remind her to keep her mouth closed during play? Treatment and homework activities depend completely upon the cause of the problem. She keeps her mouth open too much of the time. Why? The answer to that question guides your assignment of any activities, whether they are performed in the therapy room or at home. There can…

The OM Controversy (again…)

By Pam Marshalla

Q: I am a special education advocate and I would like to discuss oral motor exercises with someone. An SLP at a district I’m working with stated, “There is no evidence that oral motor exercises are helpful for speech.” Is that true? This area is a mess. Professionals who bash oral-motor generally can be accused of the following: They don’t know what the term “evidence-based practice” really means. They are confusing the concepts of “evidence-based practice” with the concept of…

When to Treat Later-Developing Sounds

By Pam Marshalla

Q: At what age should my school speech therapist begin working on my son’s “R” sound? Would you address it before “S,” “Z,” and “Th”? When do you address these errors? Do missing teeth affect the decision making in this process at all? Yours is a very simple yet complicated question. First, these are what we call “later-developing sounds.” When a child has errors on these sounds, most SLP’s in the public schools wait until the kids are 7, 8,…

Stimulating L

By Pam Marshalla

Q: How do you teach L for a client who cannot do it at all? These are the types of things I do in whatever order fits the needs of the client: Primitive Movement Teach a primitive L that is made with jaw movement. Have the client stick out his tongue-tip so that it sits between the teeth, and then have him move the jaw up-and-down. This is going to sound and look like the way a baby “lolls” –…

Facilitating Sh, Zh, Ch, and J

By Pam Marshalla

Q: I have been using your cornerstone approach from Frontal Lisp, Lateral Lisp successfully with my students for /s/ and /z/. It has been very helpful! Thank you! However I have a couple of students who are left with a lateral Sh (“shoe”), Ch (“chop”), J (“jump”) and Zh (“beige”). I have been combing your book and working very hard doing oral motor for lateral margins and the bowl shape, but I am still having difficulty with sound production. Help!…