By Pam Marshalla
Q: Can you give me some ideas about getting my clients to use final consonants? Here are a few ideas. These can be used alone or in combinations together. Auditory Bombardment Read a list of words that all have the same phoneme in the final position: cat, hat, rat, light, boat, kite, meat… Do this while the client is playing quietly at a table task such as drawing or clay. The client’s job is to listen. Amplification Amply your productions…
By Pam Marshalla
Q: I have an 8-year-old student, in a regular second grade classroom. She can say a few words and carries a diagnosis of apraxia. She is below average in intelligence. The parents are insisting on sign language training only and are refusing other forms of augmentative communication – computer, pictures, etc. She can do up to five signs in sequence with prompting, but verbal speech is not coming along. She is failing further and further behind in academics because of…
By Pam Marshalla
Q: Where do you get the very specific word lists you use for the articulation training you describe for R and the Lisps? You are talking about organizing word lists by vowels when working on phoneme R or the sibilants. I use a variety of dictionaries, thesauruses, and rhyming dictionaries. I also use the popular book called 40,000 Selected Words: Organized by Letter, Sound, Syllable by Valeda Blockcolsky, Joan M. Frazer, and Douglas H. Frazer. I always keep on hand a…
By Pam Marshalla
Q: I have heard you say that although most school districts seem to have excellent entrance criteria for therapy, they tend to have very poor exit criteria. Could you speak to this in regard to a client’s willingness to participate and in regard to cognitive level? Because I have been in private practice for 25 years, I have not had to agree with anyone on exit criteria, and therefore I have taken it on a case-by-case basis. In all honesty,…
By Pam Marshalla
Q: What is your opinion about writing goals for oral motor exercises when a client has a functional articulation disorder? My training would suggest that working on oral motor skills is appropriate only when there is a motor speech disorder. When asked how to write OM goals, I say, “Don’t write OM goals!” Oral movement is not your goal. The speech sound production is your goal. Write speech goals. Speech is movement. Whether you are working with clients who have…
By Pam Marshalla
Q: The lead SLP at my agency will not allow me to attend Pam Marshalla’s workshop on R therapy. She feels that Pam’s book suggests an oral motor approach that is not evidence-based. I think there is some confusion in our profession about the difference between placement techniques and oral motor exercises as a isolated activity. I work for a progressive educational agency that seems to be running scared of any controversial terms. Honestly, the amount of misunderstanding about oral…
By Pam Marshalla
Q: What is your opinion of PROMPT? I have a parent that believes that this is the only method to use with her apraxic child. I have tried to explain there are other methods to try. I am not PROMPT trained because of the time and expense. I also have not been formally trained in PROMPT, but I have seen it in action. It is a very good approach, perhaps one of the best for apraxia. But it is not…
By Pam Marshalla
Q: How can I get my client to elevate the tongue-tip instead of the blade to produce lingua-alveolar phonemes? Following my 22 Fundamental Methods of Facilitating Jaw, Lip, and Tongue Movements, I would do one or more of the following: Assist – Lift the tip with a tongue depressor. Associate – Find one phoneme in which the client elevates the tip, and use that phoneme movement to teach the others. Contrast – Contrast tongue-tip elevation with tongue-back elevation. Cue –…
By Pam Marshalla
Q: I have a kindergarten student who slides her jaw side-to-side during conversational speech, resulting in a lateral lisp. I have used a bite block program but it has not helped. She has good jaw strength. She can hold large bite blocks in her teeth bilaterally and speak without dropping them. But her speech isn’t any better. What should I do? This is not a strength problem. I am sure her oral mechanism is strong enough to support speech. This is…
By Pam Marshalla
Q: I am working with a 7-year-old in first grade. He has received services since 3-years of age privately and at school. He is making very slow progress in speech, and is having great difficulty comprehending and completing first grade work. His speech is characterized mostly by jargon with a few intelligible words, so some meaning may be derived. He is able to produce two-syllable words but falls apart with more complexity. He occasionally produces three-word intelligible utterances such as…
