Pam Marshalla, Author at Marshalla Speech & Language

Author: Pam Marshalla

Counseling Parents About Articulation Deficit

By Pam Marshalla

Q: What do you tell parents when they ask what caused their child’s articulation disorder? First I draw whatever conclusions I can from the child’s medical and physical history. For example, I explain how the child’s errors might be related to his positive history of ear infections, oral injury, structural deficit, neuromuscular disorder, sensorimotor dysfunction, and so forth. Second, I draw conclusions from information I have about the client’s cognitive level. For example if the client is four-years-old, but he…

Teaching “Sh”

By Pam Marshalla

Q: Do you have any techniques for teaching Sh for a client who can do a correct S? There are several easy things that usually work well if the client already can do an S. Use a Sequence: Have him make an S, and then slide into a whispered (voiceless) Y. Then have him do the same thing with the lips rounded. The sound of Sh often will be heard during the transition between the two sounds if the client…

Stimulating Lip Movement

By Pam Marshalla

Q: What can I do from a muscle-based perspective to engage the upper lip? There have been many methods of stimulating lip movement in the articulation, motor speech, oral motor, feeding, dysphagia, and orofacial myofunctional literature. The following sources are my favorite ones for activities to facilitate lip mobility. [Presented alphabetically] Dworkin, J. P. (1991). Motor speech disorders: A treatment guide. St. Louis: Mosby. Garliner, D. (1981) Myofunctional therapy. Coral Gables: Institute for Myofunctional Therapy. Marshalla, P. J. (1992). Oral…

Evidence Based Practice – Chopping Down Trees To Save The Forest

By Pam Marshalla

Q: I have heard you say that you have a real problem with Evidence-Based Practice (EBP). Why would you be opposed to something that so clearly will help and protect our clients? I am not against using EBP. I am for EBP. However, I am concerned about several recent results of the EBP philosophy. I am especially opposed to three new ideas: I am against throwing out everything we have learned through a century of trial-and-error speech-language therapy just because we…

Oral Motor Treatment and Non-Speech Oral Motor Exercises (NSOME)

By Pam Marshalla

Once again I shall take a run at the question of what oral motor treatment is, and what are the differences between oral motor treatment and non-speech oral-motor exercises. This answer ensued from an email dialogue I was having with someone very concerned that SLP’s have begun to use non-speech oral-motor exercises INSTEAD of methods to facilitate sound and word productions. I tried to explain how this is wrong. ALL methods to improve speech are “oral” techniques, and they are…

The R Crisis

By Pam Marshalla

Q: My 12-year-old son cannot say R, however I am not so sure if that is the only problem. Many people do not understand him, a great crisis for him as he starts junior high this fall. He talks very fast. We tried a home program, but I really don’t know what I’m doing. Help! Your letter points directly to the articulation crisis occurring in this country: Many SLP’s are graduating from universities with absolutely no idea how to fix…

Orofacial Myology Information

By Pam Marshalla

Q: How can I find out about orofacial myofuctional therapy? Go to the website for the International Association of Orofacial Myology. According to their website, “The IAOM provides information about Orofacial Myological disorders including: tongue thrust, improper mouth posture and incorrect swallowing patterns.”

Inhibiting Lip Interference During Phoneme Learning

By Pam Marshalla

Q: How do you get a client to stop puckering, pursing, retracting, and tensing the lips when learning R? To get rid of lip interference when working on R (or any other sound) you need a way to hold the lips back. The child can use his fingers or a Lip Retractor. Fingers: Have the client use his own fingers to pull back the lips.Have the client place one or two fingers inside his mouth at the corners of the…

Lisps and Missing Front Teeth

By Pam Marshalla

Q: I have heard you say that if kids have problems with sibilants and are missing their front teeth you prefer not to see them until their teeth come in. Could you explain your rationale? Without front teeth true stridency cannot be produced. Stridency is produced as the midline air stream hits the front teeth and then escapes between them. Without front teeth, a client would have to be taught a compensatory movement. He would have to produce his sibilants…

Becoming Verbal With Autism and Apraxia

By Pam Marshalla

Q: My son is 9 years old and has been diagnosed with autism and apraxia. He is non verbal and low-to-medium functioning. We are trying to determine the best methodology to help him talk more. I read a lot about your Apraxia experience but nothing about your experience with Autism. Since my son has Autism as well I was hoping if you could give me your expert opinion on what to do as I am trying to determine what is…