By Pam Marshalla
Q: I read your explanation on how to teach a child to say R without nasality. I used a tube to help him as you suggested, and he now understands the difference between oral and nasal sounds. However, he still cannot produce the vocalic /r/ without it sounding hypernasal. I have tried everything and I was wondering if you have any suggestions! You have to tell him NOT to say R. Instead, have him say his nice oral vowel with…
By Pam Marshalla
Q: What do you say to parents who want to know how much longer speech therapy will continue? I have been seeing an 8-year-old boy for two years for auditory processing, and for both receptive and expressive language skills. He is making good progress but could honestly be in therapy for a few more years. It sounds like this client may never have “normal” speech and language, and he could use help for as long as he can get it….
By Pam Marshalla
Q: How do oral rest and the neutral position impact articulation? Should we be concerned about these subjects in clients with an articulation/phonological deficit? So very many of our clients have problems with oral rest posture and the neutral position that I get at least one email per week from all over the world from SLP’s trying to figure out what to do about it. I will have a chapter devoted to this topic in my next book to be…
By Pam Marshalla
Q: Do you have any recommendations or suggestions for building a basic oral motor therapy kit? There are literally thousands of objects one could use as an aid to oral movement in articulation therapy. I call them “the toys and tools of articulation training.” Charles Van Riper called them “phonetic placement devices” and wrote: “Every available device should be used to make the student understand clearly what positions of tongue, jaw, and lips are to be assumed” (Van Riper, 1954)….
By Pam Marshalla
Q: I saw a client with /r/ problems and dismissed him after he could produce /r/ with reminders on picture-naming tasks. I saw him again a year later and his /r/ had deteriorated. Should this have happened? Should I put him back in therapy, or do you think that this will take care of itself? What I have done with these kids is the following: You let him go too quickly. Never dismiss a client until the process of articulation…
By Pam Marshalla
Q: Do you think that a 21-year-old client who is not stimulable for /r/ can learn it? A client who is not stimulable for /r/ is just as likely to learn it in therapy as one who is not. The therapy is designed to teach it to him. The idea of “stimulability” comes from the phonology literature. When a client has multiple misarticulations we work on the next phoneme for which the client seems stimulable. The same idea does not necessarily…
By Pam Marshalla
Q: My 12-year-old grandson has cerebral palsy. He understands everything at age level but he is very hard to understand. He is getting very little speech help. How can we help him at home? Expressive speech is divided into Consonants, Vowels, Syllables, and Intonation Patterns. Most SLP’s focus on Consonants. I would suggest that you focus on Vowels, Syllables and Inflection instead. In other words, have your grandson practice important words, and instead of focusing on getting the consonants correct,…
By Pam Marshalla
Q: I have a student who has been in therapy for /s/ for a while now and, although he is able to produce the /s/ sound, his mom thinks it is now too sharp and unnatural. Do you have any advise for this? When we are talking about refining an /s/ like you describe, this all auditory work combined with subtle tongue, lip, and perhaps jaw changes. This is the essence of articulation refinement for all phonemes for all clients….
By Pam Marshalla
Q: Which of your books do you suggest for teaching me the number of repetitions or the amount of seconds for engaging in oral-motor exercises? I do not teach oral-motor as if it was an exercise routine; I teach oral-motor techniques to facilitate sound production. Therefore, none of my books will give you that type of information. I do no measures of number of trials, or number of seconds, etc.. Instead I teach how to facilitate a movement to achieve…
By Pam Marshalla
Q: I received the email you sent regarding collecting suggestions for carryover that you intend to compile in a book. It is surprising to me that you find it reasonable to pass on non-evidence based ideas submitted by therapists. I don’t think this meets a best practice standards at all. Will you measure the merit of these ideas? I’m curious to know how you propose to demonstrate efficacy. What you seem to propose is to collect and disseminate ideas that…
