Pam Marshalla, Author at Marshalla Speech & Language

Author: Pam Marshalla

Recommendations for Polymicrogyria

By Pam Marshalla

Q: My client is a five-year-old with polymicrogyria. He drools severely, eats only purees, basically is non-verbal, and has a non-verbal IQ of about 85. He is labeled as apraxic. Can you give me advice on how to proceed? I had not heard of this disorder, so I Googled it and found quite a bit under “polymicrogyria ” and “children with polymicrogyria.” Apparently it is a developmental malformation of the human brain characterized by an excessive number of small convolutions on the…

Therapy is On-Going Diagnosis

By Pam Marshalla

Q: Many SLPs write to me with questions about sibilants that are distorted––inter-dental, frontal, whistled, palatal, lateral, and so forth. I have given lots of advice about these errors, but sometimes I can’t. Why? Sometimes I can give no advice for fixing errors on the sibilants because the errors are distorted in such refined ways that there is no way to determine what exactly is going on without seeing and hearing the error myself. If you have taken classes of…

“It hurts”: Helping Clients Handle Oral Input

By Pam Marshalla

Q: When I try to use a tongue depressor or any other tool in my client’s mouth, he backs off right away and says, “It hurts.” He does this even before I use the tool to touch his mouth or do anything. I don’t think he’s hypersensitive. I think he’s refusing just to refuse. He is four-years-old and I am trying to elicit a K and a G. I think you are right. A little guy like that may use…

R-Blends

By Pam Marshalla

Q: I attended your R seminar and have been having great success. However, I do not know what to do with R-Blends. I can’t seem to get Tr, Dr, and so forth. That is a great question, and represents a topic I never seem to get to in my seminars. I also did not describe it very well in my R book, so here is the best way I have been able to describe what I do to date ––…

Hammer’s Cues for Apraxia

By Pam Marshalla

I recently attended a seminar on apraxia taught by David Hammer, SLP. It was fabulous and I highly recommend it to all my readers! David uses a combination of verbal cues, object cues, and gestural cues together in his work with apraxic children. He bases this speech training on the theory that children with apraxia need a multisensory approach that focuses on phoneme sequencing. The verbal cues he uses are names and phrases that describe the outstanding place, manner, and…

Low Tone and Mild Artic

By Pam Marshalla

Q: My teen client has low tone, mild articulation problems, problems with intelligibility, and imprecision of articulation (interdental lingua-alveolars, F/Th, and distorted R). He has a slack jaw and forward tongue posture at rest. His tongue appears flaccid. Cognitive skills are okay. I went to your class called 21st Century Articulation Therapy and am trying to figure out which methods to use to address low tone in speech. Also what should I do about the tongue thrust? In terms of…

Michelle Obama’s “Shtreet” for “Street”

By Pam Marshalla

Q: I have a 21-year-old client with above average intelligence who says “shtreet” for “street.” He also says “undershtanding” for “understanding” and “shtretch” for “stretch.” He seems to do this on purpose. Any comments? It has been my observation that a certain segment of the population––especially those under 25 years of age––uses an “Sh” for “S” substitution in “Str” clusters. The result is “shtreet” and the other examples you have given above. Even Mrs. Obama does this. In the 1970’s, this…

Differentiating “Articulation,” “Oral Motor,” and “Phonology”

By Pam Marshalla

Q: I still cannot seem to explain to colleagues the difference between articulation, oral motor, and phonology. Can you help me one more time? This is the line of thinking I use. It may help you explain these ideas to others–– Movements are used to make phonemes. Phonemes are used to make syllables. Syllables are used to make words. Words are used to make phrases. Phrases are used to make sentences. Sentences are used to make paragraphs. Words, phrases, sentences,…

Teaching the Spanish R

By Pam Marshalla

Q: Do you know how to teach the Spanish R? I believe there are YouTube videos of Spanish-speaking people teaching this sound. I would search around there for ideas. I have had to teach a trilled R to only a few people in my career. Here are two different approaches that have worked for me–– Bilabial Raspberry Have the client produce a bilabial raspberry. Then have him produce a raspberry with the front of the tongue pressing firmly up against…

Exposed Upper Teeth

By Pam Marshalla

Q: One of my high school students has a tense upper lip, which interferes with correct productions of P, B, and M, although she can produce labials in structured tasks. She also chews with her mouth open and makes smacking sounds. The resting position of her mouth often reveals her teeth, and her tense upper lip is noticeable. How can I improve her articulation as well as her looks and eating habits? Your client needs a program of orofacial myology…