By Pam Marshalla
Q: I have a student with a lateral lisp whose does not have proper jaw alignment. The jaw at rest and during speech is moved over to the right. My thoughts are that the misalignment of the jaw is causing lateralization of the sibilants. Is this correct? What are your thoughts? You are right. The jaw has to be in a stable midline position to produce a correct midline sibilant. I divide lateral lisps into several categories according to whether…
By Pam Marshalla
Q: My client in second grade cannot make /t/ or /d/ at all. I have tried all kinds of things to activate the tongue tip, but he still persists on saying /k/ and /g/. How can I elicit /t/ and /d/? Since you have tried so many techniques to facilitate refined tongue-tip elevation that haven’t worked, I would revert to a more infantile way to elicit these anterior consonants. This is the way babies learn to make a /d/: They…
By Pam Marshalla
Q: I have a client with a unilateral lisp. I have noted symmetrical facial posture at rest and non-speech tasks. However he exhibits a unilateral retraction of his cheek that corresponds to his lateralization. I realize that lateralized productions reflect the tongue position more than the cheek position, but I am trying to determine what is happening inside the mouth during these times. How do I tell what he is doing with his tongue? As you have rightly surmised, cheek…
By Pam Marshalla
Q: I need information on evaluating oral-motor skills in school age articulation/phonological cases as well as appropriate oral-motor exercises/goals for educational IEP’s/settings. The only test I know of that will give you a standard score for oral motor skills is my test called the MOST — The Marshalla Oral-Sensorimotor Test. It is available through SuperDuper Publications. The MOST was normed on kids 4;0 – 7;11. It will give you individual scores for jaw, lips, tongue, velum, respiration, phonation, and oscillating oral movements….
By Pam Marshalla
Q: I am currently working with infants in a multidisciplinary team. The motor therapists are inclined to recommend vibration for oral motor issues. I would like your recommendations regarding the use of oral vibration for kids with low oral tone who have tongue protrusion, decreased speech intelligibility, and difficulty managing food. What are our best practice guidelines for the use of vibration? Any information you have would be very helpful to me. I know of no “best practices guidelines” for…
By Pam Marshalla
Q: I have been a little put off by your comments about the beliefs of young therapists. As I am sure you realize, everyone starts out as a “young therapist” at one time. Your comments do little to support your new peers in the field. I realize that what you say might accurately portray some “young therapists.” Would you also agree that this is not always the case? It is a challenge for new therapists to establish trust with a…
By Pam Marshalla
Q: Can you explain the “cycles approach”? To work in cycles means to work only one week at a time on target phonemes or phonological processes. Therapy progresses through the weeks regardless of whether the client masters the target. For example, the client may have trouble maintaining /s/ in the clusters Sp, St, Sk, Sm, Sn, Sl, Sw, Str, Spr, and so forth. Using cycles, therapy would address one cluster per week. For more information, read the original authors. Look…
By Pam Marshalla
Q: Does a short frenulum interfere with “R” production? A short frenum will prevent the client from learning what I call the “Tip R.” Most call it the “Retroflex R.” But a short frenum should not prevent the client from learning a “Back R.” My book called Successful R Therapy describes these two different positions for this elusive phoneme.
By Pam Marshalla
Q: The clinic I work for recently purchased your CD lecture called Vowel Tracks. I have a B.A. in psychology and work with children in the Autism Spectrum Disorder as a behavior analyst. I loved your product! Have you published any articles in peer-reviewed journals showing results that prove this methodology is effective with children who have very low intelligibility? Vowel Tracks is based on my own 35 years of clinical experiences and classic phonetics research on the vowels. I…
By Pam Marshalla
Q: I am working with a three-year-old with a very restricted lingual frenum, a shortened velum, and significant tongue protrusion. The parents want to try therapy before consulting medical advice about a frenectomy. We have made nice progress thus far. The child chews hard and soft solids with a mushing pattern. No coughing, choking, gagging has ever been observed or reported. She is now able to lateralize her tongue left and right independently of the mandible, and within the past…
