Category: Apraxia and Dysarthria

Is a Diagnosis of Apraxia Necessary for Therapy?

By Pam Marshalla

Q: Is it necessary to get a diagnosis of apraxia with a young child who does not talk, or can we just proceed with therapy? The answer to that depends upon the rules and regulations of your treatment center or school, and whether or not insurance providers are involved. But in my opinion, as far as the actual therapy is concerned, you do not need a diagnosis to start. Just start. Time in treatment will tell you increasingly more about…

Sound-Activated Toys

By Pam Marshalla

Q: I was listening to your audio tape called Apraxia Uncovered and heard you say that voice-activated toys are great for getting children to vocalize. Where can I find these? I know of no speech company that is selling these toys now, but I searched online and found many for sale at various venues. Some are overpriced, but if you take the time to look around online, I am sure you will find at least one at a reasonable price….

Oral Motor Treatment and Non-Speech Oral Motor Exercises (NSOME)

By Pam Marshalla

Once again I shall take a run at the question of what oral motor treatment is, and what are the differences between oral motor treatment and non-speech oral-motor exercises. This answer ensued from an email dialogue I was having with someone very concerned that SLP’s have begun to use non-speech oral-motor exercises INSTEAD of methods to facilitate sound and word productions. I tried to explain how this is wrong. ALL methods to improve speech are “oral” techniques, and they are…

Becoming Verbal With Autism and Apraxia

By Pam Marshalla

Q: My son is 9 years old and has been diagnosed with autism and apraxia. He is non verbal and low-to-medium functioning. We are trying to determine the best methodology to help him talk more. I read a lot about your Apraxia experience but nothing about your experience with Autism. Since my son has Autism as well I was hoping if you could give me your expert opinion on what to do as I am trying to determine what is…

Toddler With Autism

By Pam Marshalla

Q: My son is 2 1/2 years old and has a great level of oral motor difficulty and has been diagnosed with autism. He has only one word that he can produce on command, and that is “mom.” He tries very hard to talk and things come out a jumble. We are working on letter sounds with him as he really enjoys letters. He can make the sounds for the letters S, M, H, A, U, E. It sometimes takes…

Elocution and Intelligibility

By Pam Marshalla

Q: I have an older client who can pass an articulation test but who is very hard to understand in connected speech. I heard you talk about “elocution” in one of your classes. Can you refer me to any written material on how to do this? A client who can pass an articulation test but who has problems with intelligibility usually is mildly dysarthric. Thus, they have mild problems with prosody (rate, rhythm, stress, intonation, pitch, tone, volume), vowel clarity,…

Very Limited Speech

By Pam Marshalla

Q: I have a 3-year-old student with Joubert’s syndrome. Currently we are using sign and an AAC device for communication. She can move her mouth, grunt, say “buh”, and blow a whistle. She grunts more when we model the grunts back to her. Should this continue? And do you have any ideas on improving vowel phonation? This child is not making vowels because she is not using her voice. Her grunts and productions of periodic “buh” mean that she is just…

Pacifiers and Apraxia

By Pam Marshalla

Q: Our son is 28 months old and just starting to talk. He may be apraxic and he sucks a pacifier all day and night. He seems to be very bright. What is your opinion about the pacifier? I have seen otherwise normally-developing two-year-olds who do not talk at all become completely verbal within a few weeks after their pacifier is tossed out. I always recommend elimination of the pacifier in cases of speech delay, except in those rare cases…

Vowels in Late Talkers

By Pam Marshalla

Q: In your seminar on apraxia and dysarthria, you talked about how vowels (V) are more important to remediate than consonants (C) in children with very low language and severe motor speech disorders. Do you recommend the same thing for children who simply seem to be “late talkers”? Should I model the vowel instead of the consonant to obtain the words I am stimulating? With kids who just look like “late talkers”, I would model both the C and the…

Differentiating My Books: ‘Apraxia Uncovered’ and ‘Becoming Verbal With Childhood Apraxia’

By Pam Marshalla

Q: Can you tell me how your books “Becoming Verbal with Childhood Apraxia” and “Apraxia Uncovered, The Seven Stages of Phoneme Development ” are different? Which one should I read first? Think of Becoming Verbal with Childhood Apraxia as Part 1. It is about how to get kids more vocal, verbal, communicative, imitative and interactive, and how to get them to play with the sounds they make. Read it first. Think of Apraxia Uncovered, The Seven Stages of Phoneme Development as Part…