Author: Pam Marshalla

Evidence-Based Practice and Oral Motor Research

By Pam Marshalla

Q: I am a graduate student and I am writing a paper on the efficacy of oral motor exercises in children with articulation difficulties.  Having attended a seminar of yours, I am wondering if there are researchers you could point me to who have used EBP in their research. Please see the articles we have published on the Oral Motor Institute website. OMI home page List of published articles

Assymetrical Lips Position on Sibilants

By Pam Marshalla

Q: My client has been in therapy for a long time for many error phonemes, and now we are working on the sibilants. He is doing them well now, but he tends to pull his right cheek to the side. It sounds correct but looks funny. Does the facial position matter if it sounds okay? If it sounds correct, I would not worry about that cheek pulling to the side until he is well on his way toward establishing the…

Prespeech and Cleft Palate

By Pam Marshalla

Q: I work with infants and often reference the developmental material you present in Apraxia Uncovered. I have a little fellow with an unrepaired cleft palate. He is doing all the skills prior to raspberries and none after. Should I stimulate the raspberries with him? Are raspberries possible with an unrepaired cleft? How much intraoral pressure is needed for them? I have not worked with babies like this, so I don’t really know the answer to any of your questions. I would…

Maturation as a Therapy Strategy

By Pam Marshalla

Q: Do you think that physical maturation alone can be all that a particular client may need to help his speech improve? Yes, clearly some children outgrow their speech problems. But the only way to know this is to let time pass without therapy. I sometimes recommend that a child go 6-12 months with no therapy to see what happens. I make sure the parents know that I am doing this and why. Often the parents and I alone, or…

Lateral Lisp and Young Kids

By Pam Marshalla

Q: How young do you see children with a lateral lisps? Most SLPs leave the lateral lisp alone until age 6-8. However, I and many other therapists address it earlier with children 4 and 5 years of age. I work on the following with younger kids– I make sure that T and D are midline and not lateral. If they are lateral, I straighten them out. I use a straw for this– They produce T into the straw held outside…

Pervasive Question Inflection

By Pam Marshalla

Q: Your Vowel Tracks program was great and the child I am writing about now has all his vowels. His language is improving but most staff cannot understand him because his prosody is drawling, singsong-ish, and inflection is always up at the end of each statement like a question. Any thoughts about how to approach this? The interesting thing about this rising intonation pattern used on statements is that I hear many young people use this today. They say things…

A Crooked Tongue on R

By Pam Marshalla

Q: I have been teaching R using your L-to-R sliding and tapping methods. However the further back my client tries to pull his tongue-tip the more it pulls to his left. He cannot keep it at midline past the middle of his palate, and he is not able to get a good R. I have not encountered this, but these are the methods I would use to address it– Have him use his finger, or another tool, and trace down…

Blowing the Nose

By Pam Marshalla

Q: How do you teach a child to blow his nose? This has worked for me a few times- Teach them to pant in-and-out though the mouth. Then teach them how to sniff in and out through the nose. Once they can get the air moving in and out through the nose, teach them to push breathe more deeply with each sniff in and out. Gradually put more emphasis on the outgoing air. Gradually make the outward sniff a blow…

Putty Bite Blocks

By Pam Marshalla

Q: I recently read an article that indicated bite blocks could be made from dental impression compound. Have you heard of this or tried doing it? Do you have any suggestions on how this could be accomplished, the efficacy of doing it, and the material that would suit the job best? I have not used this method myself, but James Dworkin wrote about it in 1991. Dworkin came out of the Darley, Aaronson, and Brown school of thought on motor…