By Pam Marshalla
Q: Does a client have to be stimulable for a sound, or sound class, before therapy should be initiated? No. Sometimes we target a phoneme or class for which the client is stimulable. Other times we teach the client a new phoneme or a new sound class for which the client is not stimulable. For example, the client who cannot pronounce R needs to learn R. He is un-stimulable for R and must learn it. I have worked with hundreds…
By Pam Marshalla
Q: Do you think a child should be able to outgrow a lateral lisp? I believe that a FRONTAL LISP is on the normal developmental continuum, but that the LATERAL LISP is not. To me, the lateral lisp is a motor pattern that is moving in the wrong direction, therefore, no matter how much maturity the client has, he will never reach correct production. The lateral lisp is an incorrect motor pattern as opposed to an immature motor pattern. An…
By Pam Marshalla
Q: My daughter is almost 4 and her speech is rarely understood by anyone outside of our family. While my daughter absolutely loves her therapist and has made some progress, she has been stuck at a plateau for a while. My daughter is very bright and has a high level of understanding and of vocabulary. However, she never says her word endings, many letters are omitted, she talks in a very rapid rate, S is always slurred, and she can’t…
By Pam Marshalla
Q: My preschool client uses a whisper instead of a “real voice” when he talks. We are using PECS with him, and he can build sentences up to 5 words. Do you have suggestions for developing his voice? First, he needs to be seen by a physician – an ENT – to determine if there is a medical reason for his lack of voice: nodules, polyps, paralysis, malformation, etc.. You need this so you know what you are working with….
By Pam Marshalla
Q: I have a preschool student who produces vocalic /r/ with more of a [ng] phoneme. If I address it, what can I do? There are always several ways to attack a question about articulation therapy. Let me offer two basic ideas to try: Normal Path of Development You could teach the client to substitute w/r instead if she can do a /w/ correctly without nasality. Teach her to say “Rabbit” as “Wabbit” and so forth. That puts her development…
By Pam Marshalla
Q: What do you recommend to encourage carryover of articulation skills in an older child with a frontal lisp? Note: I am writing a book entitled Carryover Techniques in Articulation and Phonological Therapy which will elaborate on this answer in great detail. [EDIT: Book released 2010]. My book Frontal Lisp, Lateral Lisp has a full chapter on carryover techniques for the lisps including: Auditory Acceptance – The process a client goes through to accept the way his new sound sounds. Determination…
By Pam Marshalla
Q: I was interested in gaining some additional information on elocution as you discussed in a recent seminar. “Elocution” refers to diction, pronunciation, and enunciation. “Elocution is the proper and graceful management of the voice, the countenance, and gesture in speaking” – Marcus Tullius Cicero, 106 – 43 BC Elocution is about speaking a little louder, speaking up, speaking out, holding the head up while speaking, looking others in the eye, using polite language, and engaging the listener. Elocution also…
By Pam Marshalla
Q: My client with a lateral lisp can produce /s/ in words but does not carry over to conversation. Are there strategies you would recommend? You are expecting him to skip from words to conversation. It rarely happens that quickly. Help him build through the traditional sequence- words, phrases, sentences, paragraphs, and conversation. You are helping him gradually take control of his expressive speech. Be patient! This can take up to a year. Make sure your practice material is void…
By Pam Marshalla
Q: My client produces a /t/ at the same time he says /p/. And he produces /d/ at the same time he says /b/. How can I prevent the tongue from elevating during /p/ and /b/? You need to inhibit tongue tip elevation. It might be done like this: Place a tongue depressor into the mouth, straight in from the front at midline, so that the blade sits on top of the front of the tongue. With the tongue depressor…
By Pam Marshalla
Q: I have a student with a restricting lingua frenulum that limits his tongue mobility and impacts his speech intelligibility. What do you write in the referral letter to the physician? Write a letter that explains how the restricting lingua frenulum is impacting as many of the following six areas as you can: speech, oral rest, preparation for swallow, the swallow, health, and social appearance. The letter is sent in the hopes that the primary physician will refer the client…
