Articulation Archives - Page 27 of 34 - Marshalla Speech & Language

Category: Articulation

Advice for Pierre-Robin Syndrome

By Pam Marshalla

Q: Can you give our family advice about stimulating speech, language, and feeding in a 14-month old girl with Pierre-Robin Syndrome? She is making some sounds and is pretty smart. We have read your book Becoming Verbal with Childhood Apraxia and it has helped us understand about stimulating sound and word productions. Although she continues to be fed through a G-tube, she now is eating many different foods orally. Let me just make some straightforward statements about how I would…

Parent Seeking Advice About the Lateral Lisp

By Pam Marshalla

Q: My 5-year-old is in articulation therapy with a speech pathologist for half-hour per week to treat a lateral lisp. Is this intense enough? And what is the best thing for me to do at home to help her practice? One half-hour session per week with homework activities is intense enough for a lateral lisp. That is precisely what I give my clients. Success all depends upon whether or not the therapist knows what he or she is doing. The…

Learning “Or” – Final /r/

By Pam Marshalla

Q: I have a child who can successfully produce R in all positions except in the post-vocalic position following O, as in “four,” “pour,” “door,” or “or.” Any advice you have would be great. If the client produces a truly great R in all other ways except the sequence following O, then this is a matter of helping him maintain a good-sounding O and then transitioning successfully to the final R he already can do. Here’s how I would do…

Strengthening the Tongue?

By Pam Marshalla

Q: I have a child who has weakness in his tongue as evidenced by slight tremors when protruding. What exercises do you recommend to strengthen the tongue to increase articulatory precision? Have you ever taken a class of mine? If so you will recall that I never recommend exercises to strengthen the tongue. Instead I recommend activities to inhibit abnormal movements, and to facilitate appropriate oral stability and mobility. This is a very important question you have asked. Do you…

Initial /h/

By Pam Marshalla

Q: I have a 1st grade student with moderate to severe apraxia who can make the /h/ sound in isolation but cannot co-articulate it. I’ve written the letter /h/ on an index card, and a vowel on another card. I have had him touch the H card and make /h/, and then touch the vowel card and make it. And we have increased the speed as we go but he ends up dropping the /h/ every time. Is there another…

Before /r/ Can Emerge – Early /r/ Therapy

By Pam Marshalla

Q: I have a severely apraxic sixth grader who omits /r/ in blends. Is it appropriate to teach her to use /w/ instead in order to increase intelligibility? For example, can I teach her to say “bwick” for “brick”? I always take the liberty of teaching w/r in these cases. The /w/ holds the place until the client is ready for /r/. This is exactly what many typically developing children do in the younger years. I also add a schwa…

Frontal Lisp, Tongue Thrust, Ankyloglossia, Low Tone, and Tactile Defensive Behavior

By Pam Marshalla

Q: I have a 5-year-old client who has a tongue thrust on all the sibilants. She also has ankyloglossia, and is low in tone around her mouth and lips. She has a tonic bite reflex and holds her cheeks very tightly when I brush her teeth. She has sensory issues and is very uncomfortable (although cooperative) during teeth brushing. She tends to have an open mouth position and her lips are oftentimes wet. None of this affects her speech intelligibility….

Where to Buy Therapy Toys and Tools

By Pam Marshalla

Q: Where do you purchase the toys and tools shown in your presentations? I purchase my toys and tools all over the place. I always have my eye open for something new that I can use. The following summarizes my main sources: Toothbrushes, Floss, Floss Handles, Dental Picks, Tongue Cleaners Any retail store that sells teeth cleaning products. Baby Chew Toys, “Sippy Cups,” Baby Spoons, Baby Toothbrushes Any retail store that sells baby products. Soda Straws, Milkshake Straws, Coffee Stirrers,…

Nasalized /l/ and /r/

By Pam Marshalla

Q: I have a client who makes a nasal sound for L and R. He has no other nasal problems. What can I do? This is all a matter of ear training. This is a client who can move his velum, but he has a habit of lowering it when he makes certain sounds, in this case, L and R. In other words, the client does not have a velo-pharyngeal insufficiency or incompetency. He simply has a habit of lowering…

Prosody Goals

By Pam Marshalla

Q: I’m wondering what kind of goals you would write for targeting prosody. How do I make it measurable? Prosody entails projection, rate, rhythm, stress, pause, pitch, intonation, and cadence. I would write separate goals for each area impacted. In terms of measuring success before and after, I would take measures where possible. For example, I might count the number of words the client speaks per minute and compare that to the old norms. Where measures like that are not…