By Pam Marshalla
Q: I was at your Improving Intelligibility workshop this winter. On your handout, in regard to teaching voicelessness, you write: “Teach popping with p, t, k.” I did not write anything down and as I look back over the material I have no idea what “popping” is or how to teach it. Help! Ah yes, “Popping” is a term I made up. Let me explain… When children first learn [p], [t] and [k], they do so with productions that are…
By Pam Marshalla
Q: In your book, Successful R Therapy (pg 62), I read about how to help a client with hypernasality on R. That helped a lot. But I need help with the actual teaching part. How do I get the student to say the R without the nasal sound? Your client first needs to discover that sound comes out his nose and mouth differentially, and he needs to control this as he makes R. Use a flexible tube about 18 inches long and…
By Pam Marshalla
Q: It seems that children have an easier time understanding the Tip R. However, I know therapists that teach the Back R and seem to like it. Which method do you have more success with and why? In my book, Successful R Therapy, I state that the Tip R is much easier. It is easier to see, describe and understand. And it requires a more primitive movement pattern. Simply curling the tip up and back is something that babies do while vocalizing. I…
By Pam Marshalla
Q: Do you have any computer software recommendations for a student with verbal apraxia? I am not your resource for this kind of information. Find a therapist in your area who has expertise in computer hardware and software. Most school districts and children’s hospitals have at least one person on staff whose job it is to keep up with these products. Also talk to the software companies that sell the equipment. They have salespeople who will teach you all about…
By Pam Marshalla
Q: What is oral motor therapy? How do you define it and what is its purpose? This is the definition I use: Oral-motor therapy (OMT) is the process of facilitating improved jaw, lip and tongue function. Oral-motor techniques can be used in any of the following therapies: articulation, phonology, dysphagia, feeding, orofacial myology, and occupational or physical therapy. You can discover the importance of speech movements by engaging in a simple procedure. Count aloud from one to ten. Did anything move?…
By Pam Marshalla
Q: My six-year-old daughter has oral and verbal apraxia and developmental coordination disorder. She has a difficult time keeping up her levels of concentration throughout the school day. One teacher tells me that Hannah needs to “attend” and that she is concerned about Hannah’s “attention deficit.” Do you know of any resources that would help explain how her diagnosis affects her ability to focus? Probably the best place to begin is The Out-of-Sync Child and succeeding books (The Out-of-Sync Child…
By Pam Marshalla
Q: We have a 7-year-old son who has a diagnosis of moderate autism. About a year ago it was suggested that he has apraxia as well. He is completely nonverbal. We have read Becoming Verbal with Childhood Apraxia. Using some of your suggestions, he now imitates about four sounds. It is so frustrating because as soon as we get him to imitate a sound, he loses mastery of an old one – one step forward, one step back. He attends…
By Pam Marshalla
Q: My granddaughter, Stephanie, is 4-1/2 years old and diagnosed with apraxia. She was born with the cerebellum not fully developed and is classified as having cerebral palsy. Her speech is non-existent, although I can get her to make a variety of sounds in different pitches. In class she seems not to be attending at all. The SLP reported that until Stephanie can let her touch her face and put a spatula on her tongue, she can do little. She…
By Pam Marshalla
Q: I am a speech-language pathologist at a children’s hospital. I have a boy that I see for therapy who is severely (whole body) apraxic. He has been coming to therapy for years at this hospital and has been through multiple therapists. He is intelligible and we are currently working on /l/ and /l/-blends. He substitutes n/l. I feel like he has reached a plateau. He also receives therapy in school. He has most sounds except vowels, diphthongs, some blends,…
By Pam Marshalla
Q: My 3-year-old client with cerebral palsy continues to have so much saliva when he speaks. I am seeking information about how to address all the saliva and bubbles that he produces during speech. The key is to help your client: Suction and swallow more often during everyday activities Suction and swallow with greater efficiency Maintain lip closure during oral rest The real help is found by doing oral-motor and feeding work. Medications or surgery sometimes are necessary in severe cases….
