Pam Marshalla, Author at Marshalla Speech & Language

Author: Pam Marshalla

What is Evidence-Based Practice (EBP)?

By Pam Marshalla

The term Evidence-Based Practice (EBP) has been giving practicing SLP’s a lot of trouble recently. This is because some professionals have mistakenly assumed that an evidence-based practice requires that practicing therapists restrict their methods to only those that have been researched in a laboratory. This is a false interpretation of the EBP. The EBP actually integrates information from three sources: LAB, CLINIC, and CLIENT. Let’s review four references that explain this: 1. According to Carol Dollaghan (The handbook for evidence-based…

Articulation Procedure Basics

By Pam Marshalla

Q: When a child can produce his new sound correctly, do we go for the next level – syllabic level – in the same session? Don’t we have to dedicate a whole session for one goal to be sure that we have achieved the desired result? I always do as much as possible in every session I have with my clients. I try to work on phoneme, syllable, word, phrase, sentence, paragraph, and conversation all in the same session if…

Motivating /r/ Therapy

By Pam Marshalla

Q: I’m working on /r/ with a 4th grade boy that simply does not care about his speech. The parents are upset about his refusals and are blaming me for it! Help! A Few Ideas for the Client Let him opt out for now. Tell him he does not have to fix this now, and that he can do it later. Make it matter-of-fact and no big deal. Some kids will stay in therapy when they know they can get…

Postvocalic /r/

By Pam Marshalla

Q: My client has an initial position /r/. But I’m having a difficult time getting it in final position. How can I get this final /r/? Use his initial /r/ to teach the final /r/. I do it like this: Select a word that starts with /r/ that he can say well, like “rock”. And select a word that ends in /r/ that he cannot say, like “car.” Have the client say them in sequence: “Car-Rock.” The trick is to…

Toddlers and the Frontal Lisp

By Pam Marshalla

Q: Can you correct a frontal lisp in a toddler? We can help a child with a frontal lisp beginning at two years of age, however, most SLP’s hold off until these kids are 7, 8, or 9 years of age because of developmental norms. In a private practice, one can see these clients at any age, however one usually counsels the parents that the child does not really need therapy until later because the error is considered “normal” until…

Definition of Apraxia

By Pam Marshalla

Q: Does apraxia affect classroom learning? Strictly speaking, “apraxia” is a motor speech disorder. Therefore, it only effects the production of speech. But many of these children also have other problems- in comprehension, vocabulary, question comprehension, etc. To me, that means that the child has apraxia AND something else. The apraxia should only effect the expression of speech. That is a “purest” view. And you will read and hear of other views. This is my favorite definition of apraxia. Apraxia…

Jaw Stabilization for the Lateral Lisp

By Pam Marshalla

Q: I am working with a first grader who completely shifts his jaw to the left when he produces lateralized “Sh” and “Ch”. I am trying to work on his jaw, but it requires me to firmly give manual jaw stabilization even in isolation. Is it possible to change this strong habit of lateralizing the jaw? You are on the right track, but you are going about it in a less-than-optimum way. When we use manual jaw stabilization like you…

Age for Frontal Lisp Therapy

By Pam Marshalla

Q: Age what age should a child with an isolated Frontal Lisp be seen for therapy? When to see a child with a frontal lisp is a controversial thing. We CAN help a child like this from the age of two and older. But most SLP’s still hold off until they are older. Most school districts do not let a child like this enter therapy until age 7, 8, or 9 years of age. In a private practice, one can…

Prevocalic Voicing

By Pam Marshalla

Q: I have a preschool client who prevocalically voices everything – b/p, d/t, g/k, and so forth. Do you have any suggestions? Most kids get voicelessness in the final position months before they can do it in the initial position. Here is the order in which I usually work these sounds into the child’s phonological repertoire: Take a step back and work on final voiceless stops — /p/, /t/ and /k/. Use words like up, cup, eat, out, ick, book….

The Trouble with Augmentative Communication Devices (AAC’s)

By Pam Marshalla

Q: I struggle in using alternative and augmentative communication devices (AAC’s) with my early childhood clients. It seems that the kids can just as easily point to or gesture toward the objects, as point to the words or pictures. Also many of the kids get distracted by manipulating the device. What are your thoughts on this? I have had this same struggle many times. In fact, I actually hate using AAC devises, but I have used them when necessary. Most…