By Pam Marshalla
Q: In your seminar on apraxia and dysarthria, you talked about how vowels (V) are more important to remediate than consonants (C) in children with very low language and severe motor speech disorders. Do you recommend the same thing for children who simply seem to be “late talkers”? Should I model the vowel instead of the consonant to obtain the words I am stimulating? With kids who just look like “late talkers”, I would model both the C and the…
By Pam Marshalla
Q: What is your argument when others say that we should not be doing oral motor techniques because there are two different motor pathways, one for speech and one for simple movement? I agree that simple non-task-specific exercises (i.e., “non-speech oral-motor exercises” or NS-OME) do not help speech. This is what recent research demonstrates. For example, if one were to ask a child to move the jaw up-and-down as an “exercise,” this indeed would have nothing to do with speech….
By Pam Marshalla
Q: I have heard you say that oral motor treatment is not new. What do you mean? Dr. Charles Van Riper, the “father” of articulation therapy said that techniques to manipulate mouth movements and positions, for speech sound production, were centuries old in Europe. In the 1960’s, Mildren Berry and Jon Eisenson said that articulation therapy was “as old as the Hitites.” Last year I began an investigation into the use of methods to facilitate oral (jaw, lip, and tongue)…
By Pam Marshalla
Q: What is the difference between “oral motor therapy” and “non-speech oral motor exercises”? Therapy is a process comprised of techniques. Exercise is one type of technique. This topic has been discussed extensively at the Oral Motor Institute in the article “Oral Motor Treatment vs. Non-speech Oral Motor Exercises: Historical Clinical Evidence of Twenty-two Fundamental Methods.” (Volume No. 2, Monograph No. 2, 9 April 2008.)
By Pam Marshalla
Q: My client has an inter-dental lisp, possibly a tongue thrust, a high narrow palate and an anterior open bite. He also has difficulty with /r/ in all positions. I only saw him one time and do not want to waste time in therapy. Should I send him to the orthodontist before beginning therapy? Is there anything I can do in terms of exercises to help him? This client represents most of what I call the 5-Part Problem: An anterior…
By Pam Marshalla
Q: How can we teach our five-year-old child on the autism spectrum to spit out his toothpaste after brushing? Perhaps you could start with a solid object, like a rubber ball. SAFETY TIP: Use a ball large enough to fit in his mouth but not too small that he might swallow it. Also make sure it doesn’t taste bad. Some rubber objects taste really bad. Have him learn to put the ball in his mouth and then “spit” it out…
By Pam Marshalla
Q: I have a fourth grade student who has trouble with the vowelized “L” sound. She can produce final “L” when paired with a high front vowel but not when paired with a low back vowel. Do you have any suggestions for helping her learn how to lower the back of her tongue in order to produce these sounds correctly? Your client can say /l/, but just does not know how to transition from every vowel position to the /l/…
By Pam Marshalla
Q: Do you have a resource for understanding pain in the jaw? I get severe headaches and facial pain from it. Team Approach: Temporomandibular joint (TMJ) pain can be a serious issue and needs to be evaluated by a team of professionals who know the TMJ. The team should include at least a physician, a dentist/orthodontist, and a professional who understands TMJ movement. Sometimes that third person is a physical or occupational therapist, a myofunctional therapist, or a speech-language pathologist….
By Pam Marshalla
Q: Do you have any suggestions for how to elicit the /k/ and /g/? Pre-speech Vocalization Use the velar raspberry because it is the infant’s precursor to /k/ and /g/. If the child can make a velar raspberry, he is articulating in the back and only needs to refine the sound. Practice the raspberry long and short, loud and soft, big and tiny. Shape it into /k/ if the raspberry is voiceless. Shape it into /g/ if the raspberry is…
By Pam Marshalla
Q: I am working with a 2 year old who is exhibiting labial, alveolar and velar assimilation. For example, gog for dog, pup for cup, pomb for comb, and bum for gum. He produces all of the phonemes correctly in isolation and in syllables. Receptive language skills are age appropriate. Where do I start to correct this? I’ve been with him for 6 weeks. I am discovering through my reading that assimilation usually resolves around 3 years of age. His…
