By Pam Marshalla
Q: I have a 3rd grader I have worked with since the age of 3. He has worked on a wide variety of phonemes through the years. I am ready to dismiss because I have been unable to make a difference recently. I have used all tricks in the book, yet his tongue still moves very poorly. Without full mobility of the tongue, I am beside myself. He speaks fast and is a smart boy however he is persistently unintelligible…
By Pam Marshalla
Q: I have a student with a lateral lisp whose does not have proper jaw alignment. The jaw at rest and during speech is moved over to the right. My thoughts are that the misalignment of the jaw is causing lateralization of the sibilants. Is this correct? What are your thoughts? You are right. The jaw has to be in a stable midline position to produce a correct midline sibilant. I divide lateral lisps into several categories according to whether…
By Pam Marshalla
Q: My client in second grade cannot make /t/ or /d/ at all. I have tried all kinds of things to activate the tongue tip, but he still persists on saying /k/ and /g/. How can I elicit /t/ and /d/? Since you have tried so many techniques to facilitate refined tongue-tip elevation that haven’t worked, I would revert to a more infantile way to elicit these anterior consonants. This is the way babies learn to make a /d/: They…
By Pam Marshalla
Q: I have a client with a unilateral lisp. I have noted symmetrical facial posture at rest and non-speech tasks. However he exhibits a unilateral retraction of his cheek that corresponds to his lateralization. I realize that lateralized productions reflect the tongue position more than the cheek position, but I am trying to determine what is happening inside the mouth during these times. How do I tell what he is doing with his tongue? As you have rightly surmised, cheek…
By Pam Marshalla
Q: I need information on evaluating oral-motor skills in school age articulation/phonological cases as well as appropriate oral-motor exercises/goals for educational IEP’s/settings. The only test I know of that will give you a standard score for oral motor skills is my test called the MOST — The Marshalla Oral-Sensorimotor Test. It is available through SuperDuper Publications. The MOST was normed on kids 4;0 – 7;11. It will give you individual scores for jaw, lips, tongue, velum, respiration, phonation, and oscillating oral movements….
By Pam Marshalla
Q: Can you explain the “cycles approach”? To work in cycles means to work only one week at a time on target phonemes or phonological processes. Therapy progresses through the weeks regardless of whether the client masters the target. For example, the client may have trouble maintaining /s/ in the clusters Sp, St, Sk, Sm, Sn, Sl, Sw, Str, Spr, and so forth. Using cycles, therapy would address one cluster per week. For more information, read the original authors. Look…
By Pam Marshalla
Q: Does a short frenulum interfere with “R” production? A short frenum will prevent the client from learning what I call the “Tip R.” Most call it the “Retroflex R.” But a short frenum should not prevent the client from learning a “Back R.” My book called Successful R Therapy describes these two different positions for this elusive phoneme.
By Pam Marshalla
Q: The clinic I work for recently purchased your CD lecture called Vowel Tracks. I have a B.A. in psychology and work with children in the Autism Spectrum Disorder as a behavior analyst. I loved your product! Have you published any articles in peer-reviewed journals showing results that prove this methodology is effective with children who have very low intelligibility? Vowel Tracks is based on my own 35 years of clinical experiences and classic phonetics research on the vowels. I…
By Pam Marshalla
Q: I am an SLP in the schools. Often I am asked to address writing as a language goal. What are your thoughts regarding writing as a language goal? Grrrrrr! We are not “Writing-Language Pathologists,” or “Reading-Language Pathologists,” or “Literacy-Language Pathologists.” We are SPEECH-language pathologists! I hope I was not unclear in this response.
By Pam Marshalla
Q: I have a ten-year-old client who is very hard to understand, although he has no specific phoneme errors. We’ve started doing a pacing board which is helpful. I know that oral-motor exercises are taboo these days, but I feel in some way I have to address motor weakness. The greatest and most effective technique for dysarthria is EXAGGERATION of speech. This is spoken of in virtually all books on traditional articulation therapy and more modern texts on motor speech…
