By Pam Marshalla
Q: I am a SLP graduate student looking for some evidence-based practice to implement for a client diagnosed with childhood apraxia of speech. I watched the YouTube videos of your hand cues for placement, and I think they would work great. I was wondering if you had any research to support these cues, or if you obtained research elsewhere to support them. A therapist doesn’t look for an evidence-based practice: A therapist creates one. The EBP is formed when a…
By Pam Marshalla
Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored on April 29th, 2011. Download the original PDF here. *** The King’s Speech was Dysarthric, Too An analysis of treatment procedures reveals that fluency was not the only issue Discussions of the Oscar winning movie, The King’s Speech, have focused on the problem of stuttering and its impact on communication. This certainly has been a boon to our profession and a help to public understanding of this…
By Pam Marshalla
Q: I have a 9-year-old boy on my caseload who may have a mild dysarthria. He passes an articulation test but his connected speech is unintelligible. I’ve read all your posts that relate to this, and I understand the goals of elocution to target. Do you have a format that works best for teaching elocution? Should I start with lists of sentences, children’s poetry, or do you have another route or format to suggest? Great question! The absolute best way…
By Pam Marshalla
Q: I work at a clinic where my supervisor does not believe in apraxia. She says that all of these children have phonological deficit. What are your thoughts on this? I sympathize with your supervisor in that I too struggled for many years with questions of apraxia–– What is it? How is it diagnosed? How is apraxia different from a severe phonological disorder? The problem we are having is that we have taken the term “apraxia” from the adult neurological…
By Pam Marshalla
Q: I have heard you say that jaw sliding to the left or right can cause one type of lateral lisp. I have also heard you say that this type of jaw instability is seen in children with dysarthria. Are you saying that a lateral lisp is a form of dysarthria? Excellent question! No. I am not saying that a lateral lisp is a form of dysarthria. I am saying that clients with expressive speech deficit often have problems in…
By Pam Marshalla
Q: I recently heard the term “pop out words” accredited to you and used to describe words a child may say once but then not repeat. Can you explain this phenomenon to me, why it happens, and why I should be concerned about it. I use the term “pop-out words” to refer to the way children produce a clear word occasionally but who cannot say the word on demand. For example, one essentially non-verbal child called out “Turkey” on Thanksgiving…
By Pam Marshalla
Q: I was appalled by your comments that speech-language pathologists should not teach reading! Reading is a part of language! Why not teach reading? In my opinion, reading teachers teach reading, and speech-language pathologists teach speech and language. This is my opinion and I am sticking to it. You may have a different opinion if you would like. Your opinion will not appall me, and I would suggest that mine not appall you. Sounds like a big waste of energy…
By Pam Marshalla
Q: What reading programs do you use with children who have apraxia or dysarthria? I do not teach reading. It is my opinion that the SLP has no business teaching kids to read. We are speech-language pathologists, not reading specialists. I’m sorry to disappoint. I do not go along with things just because they are popular points of view. In my opinion it is unethical for SLP’s to be teaching reading. Therefore I do not keep up with reading programs….
By Pam Marshalla
Q: Do you have any advice on working on reading with a six-year-old child with severe apraxia and dysarthria? This child is having many difficulties with phonological and phonemic awareness and is struggling in all academic areas. Are there any reading programs that you know of that would help? I am already working on phonological awareness skills with her. First, if he is struggling in “all academic areas” there is more wrong than just apraxia and dysarthria. Apraxia and dysarthria…
