By Pam Marshalla
Q: I am an SLP in the schools. Often I am asked to address writing as a language goal. What are your thoughts regarding writing as a language goal? Grrrrrr! We are not “Writing-Language Pathologists,” or “Reading-Language Pathologists,” or “Literacy-Language Pathologists.” We are SPEECH-language pathologists! I hope I was not unclear in this response.
By Pam Marshalla
Q: I have a ten-year-old client who is very hard to understand, although he has no specific phoneme errors. We’ve started doing a pacing board which is helpful. I know that oral-motor exercises are taboo these days, but I feel in some way I have to address motor weakness. The greatest and most effective technique for dysarthria is EXAGGERATION of speech. This is spoken of in virtually all books on traditional articulation therapy and more modern texts on motor speech…
By Pam Marshalla
Q: Can you give our family advice about stimulating speech, language, and feeding in a 14-month old girl with Pierre-Robin Syndrome? She is making some sounds and is pretty smart. We have read your book Becoming Verbal with Childhood Apraxia and it has helped us understand about stimulating sound and word productions. Although she continues to be fed through a G-tube, she now is eating many different foods orally. Let me just make some straightforward statements about how I would…
By Pam Marshalla
There is a question that arose in a seminar recently that I want to share. I was teaching on apraxia, and using the 23 methods of jaw, lip, and tongue facilitation as the main focus of the class. The question was about a three-year-old boy who had no other consonants but /d/. He was speaking single words of 1-3 syllables, but his productions were limited to CV structure. Thus, telephone would be produced as “deh-duh-doh.” The question the therapist had…
By Pam Marshalla
Q: My 5-year-old is in articulation therapy with a speech pathologist for half-hour per week to treat a lateral lisp. Is this intense enough? And what is the best thing for me to do at home to help her practice? One half-hour session per week with homework activities is intense enough for a lateral lisp. That is precisely what I give my clients. Success all depends upon whether or not the therapist knows what he or she is doing. The…
By Pam Marshalla
Q: I am looking for something to assist us with a student who stimulates by licking everything in sight. Are there any strategies for decreasing this behavior? It interferes with his attending during class. I have worked so little with kids on the autism spectrum that I do not know how to answer this. I have never had to extinguish a behavior like this. I can say this however: I would not consider this an oral-motor problem. This is a…
By Pam Marshalla
Q: I have a child who can successfully produce R in all positions except in the post-vocalic position following O, as in “four,” “pour,” “door,” or “or.” Any advice you have would be great. If the client produces a truly great R in all other ways except the sequence following O, then this is a matter of helping him maintain a good-sounding O and then transitioning successfully to the final R he already can do. Here’s how I would do…
By Pam Marshalla
Q: I am seeing a 4-year-old boy with cerebral palsy. He is pocketing food and liquids on his weaker right side. Choking occurs at home, although we have not seen it at school. What can I do to help? I have had no dysphagia training at all. A feeding problem in a child with cerebral palsy can be a serious issue because the child is in danger of aspiration. I do not give out this type of advice as a…
By Pam Marshalla
Q: I have a child who has weakness in his tongue as evidenced by slight tremors when protruding. What exercises do you recommend to strengthen the tongue to increase articulatory precision? Have you ever taken a class of mine? If so you will recall that I never recommend exercises to strengthen the tongue. Instead I recommend activities to inhibit abnormal movements, and to facilitate appropriate oral stability and mobility. This is a very important question you have asked. Do you…
By Pam Marshalla
Q: I have a 1st grade student with moderate to severe apraxia who can make the /h/ sound in isolation but cannot co-articulate it. I’ve written the letter /h/ on an index card, and a vowel on another card. I have had him touch the H card and make /h/, and then touch the vowel card and make it. And we have increased the speed as we go but he ends up dropping the /h/ every time. Is there another…
