By Pam Marshalla
Q: My son is 2 1/2 years old and has a great level of oral motor difficulty and has been diagnosed with autism. He has only one word that he can produce on command, and that is “mom.” He tries very hard to talk and things come out a jumble. We are working on letter sounds with him as he really enjoys letters. He can make the sounds for the letters S, M, H, A, U, E. It sometimes takes…
By Pam Marshalla
Q: Do you recommend therapy breaks for preschoolers with phonological delay? For example, summer off after the year of early childhood in a public school? I have usually found that a break from therapy (especially in the summer) is a fruitful experience for kids. Most often they come back to therapy having made considerable progress on their own. It always seemed to me that all that sunshine, gross motor activity, and new experiences helped them move along. Plus, they are…
By Pam Marshalla
Q: Jessica is 26 months old and has a diagnosis of autism/PDD. She has started to respond to discrete trial instruction, however she presents with constant mouthing, licking, and biting her fingers. We have tried numerous things – chewing tubes, cold stimulation, vibration to the mouth, pressure, sweet, sour, salty, ignoring, and so forth. But the behaviors are increasing. Parents report constant licking and gnawing at furniture, books, and other household objects. Any suggestions you can give that might help…
By Pam Marshalla
Q: I have an older client who can pass an articulation test but who is very hard to understand in connected speech. I heard you talk about “elocution” in one of your classes. Can you refer me to any written material on how to do this? A client who can pass an articulation test but who has problems with intelligibility usually is mildly dysarthric. Thus, they have mild problems with prosody (rate, rhythm, stress, intonation, pitch, tone, volume), vowel clarity,…
By Pam Marshalla
Q: I have been working with a 10-year-old girl with a significant lateral lisp that affects all of her sibilant sounds. I have been focusing on establishing /s/ and /z/, but have not been able to progress very far because her ability to achieve the correct tongue position is so inconsistent. I have taught her the “Butterfly Position” to help her lift the side margins of her tongue, and am using the “Long T Method” from Frontal Lisp, Lateral Lisp….
By Pam Marshalla
Q: I have a student I’ve worked with for a few years and she has several problems. I have tried everything I know, and nothing seems to help. She cannot say R, J, Sh, or Ch. She has difficulty with exhalation (i.e. she cannot blow out a candle) and therefore her speech is very quiet. She cannot even yell very loud. I’ve done some oral motor therapy (horn blowing hierarchy) and other things to address this, but it has not…
By Pam Marshalla
Q: I have a 3-year-old student with Joubert’s syndrome. Currently we are using sign and an AAC device for communication. She can move her mouth, grunt, say “buh”, and blow a whistle. She grunts more when we model the grunts back to her. Should this continue? And do you have any ideas on improving vowel phonation? This child is not making vowels because she is not using her voice. Her grunts and productions of periodic “buh” mean that she is just…
By Pam Marshalla
Q: I cannot get my client with Down Syndrome to produce “Long E” (as in the word bee). I have tried using a tongue blade to get his tongue back. Do you have any other suggestions? To produce long E (/i/), the jaw must be high and the tongue must be wide, high, and tense in the back. If you are using a tongue blade to push the tongue back, you have several problems that are working against you. First,…
By Pam Marshalla
Q: Our son is 28 months old and just starting to talk. He may be apraxic and he sucks a pacifier all day and night. He seems to be very bright. What is your opinion about the pacifier? I have seen otherwise normally-developing two-year-olds who do not talk at all become completely verbal within a few weeks after their pacifier is tossed out. I always recommend elimination of the pacifier in cases of speech delay, except in those rare cases…
By Pam Marshalla
Q: You use the term “Butterfly Position” in Successful R Therapy. Is this something new? Did you make this up, or does it come from somewhere else? I made up the term “Butterfly Position” in 1978 during a workshop I was teaching. I have used the term ever since in workshop handouts and books I have written. The “Butterfly Position” refers to the ability to shape the tongue into a position that has a low midline and high sides. This…
