By Pam Marshalla
Q: At what age should a child be able to blow bubbles or a horn? My two-year-old client, who I suspect has apraxia, cannot blow and he is very hard to understand. We have no data on when children should be able to blow bubbles or a horn. However, I have been observing the blowing skills of young children for 40 years. I have observed scores of children trying to blow out their birthday candles and my experiences can be summarized…
By Pam Marshalla
Q: You said something in a class recently that I did not write down, and I wish I had. It was about the relationships between oral motor, phonemes, and phonology in therapy. Can you repeat it here? I think you are referring to this statement: Movements create the phonemes that are used in phonological patterns to express the language for use in conversation and literacy.
By Pam Marshalla
Q: My two-year-old son has Pierre Robin Syndrome and cleft palate. He had oral surgery at 6-days of age, and again at 9 months. He makes a few sounds like “Eh-eh-eh,” “Mmmmm,” “Baba,” and “Papapa.” There has been little if any vocal play until just recently. Receptive skills are good and he signs many words. Can the syndrome be a cause for his delay? I need suggestions. Yes, the syndrome is most assuredly the cause of the delay. Surgeries and…
By Pam Marshalla
Q: My student is unable to produce the Sh sound and it sounds very slushy. When he tries to say the sound, I noticed that he puffs up his cheeks with air. How can I get him to not do this and make that air flow come out the front? Here is what Nemoy and Davis (1937) would have done–– Have him make a Long E–– “Eeeeeeeee.” Make it be a strong, exaggerated, very smiley, and prolonged E. Super-exaggerate it….
By Pam Marshalla
Q: I heard you say that Van Riper was your greatest hero of all time in the profession, but then you said you had others that you didn’t mention. Who else do you admire in the field? What an interesting question! Okay, here are the people that have been the most influential to me, presented in categories that are the most important to my work. Articulation The one-and-only Charles Van Riper wins this top place of honor because he is…
By Pam Marshalla
Q: I still don’t get how to explain the difference between “articulation” and “phonology” and “oral motor.” Can you take a run at that again? I think my last answer to this was way too involved. Here is the short and sweet of it using phoneme M as an example in a very simplified way: Articulation ARTICULATION concerns the mechanics of sound production: The position assumed by the jaw, lips, tongue, and velum during production of a phoneme. For example, the…
By Pam Marshalla
Q: Why do you keep harping on about the evidence-based practice (EBP)? I keep “harping on” about the EBP for four main reasons: Because therapists from all over the world continue to submit questions to me about the EBP. Because therapists in my seminars continue to tell me about the problems they are having with the EBP––problems they are having with certain colleagues, administrators, or parents because of it. Because therapists in my seminars continue to tell me that they…
By Pam Marshalla
Q: My client backs every lingua-alveolar phoneme. He can do a rudimentary L once in a while, but he substitutes k/t, g/d, and ng/n all the time. What can I do? You probably are trying to get your client to elevate the tongue-tip to learn T, D, N, and L. This is to assume that the child can be taught to produce these sounds in the adult form. You have to revert back to teaching your client how to produce…
By Pam Marshalla
Q: My four-year-old client has apraxia and jaw instability. The mom wants to know if jaw stability will improve on its own. There is no way to know that. Certainly jaw stability improves with time, but it may not improve in this child without help. He is developing oral motor patterns that may stay with him until he receives therapy to change them. He should have jaw stability by now, so the question is, why doesn’t he? Whatever is preventing…
By Pam Marshalla
Q: My client has no incisors and an underbite, and she distorts both S and Z. These errors sound like a lateral lisp, however when I use your straw testing method, there is no airflow coming out the sides, only the front. My colleague tells me that this is a lateral lisp. But how can it be if the air doesn’t come out the sides? Your colleague is wrong: If the airstream is not coming out the sides (as tested…
