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….
By Pam Marshalla
Q: What do you tell parents when they ask what caused their child’s articulation disorder? First I draw whatever conclusions I can from the child’s medical and physical history. For example, I explain how the child’s errors might be related to his positive history of ear infections, oral injury, structural deficit, neuromuscular disorder, sensorimotor dysfunction, and so forth. Second, I draw conclusions from information I have about the client’s cognitive level. For example if the client is four-years-old, but he…
By Pam Marshalla
Q: Do you have any techniques for teaching Sh for a client who can do a correct S? There are several easy things that usually work well if the client already can do an S. Use a Sequence: Have him make an S, and then slide into a whispered (voiceless) Y. Then have him do the same thing with the lips rounded. The sound of Sh often will be heard during the transition between the two sounds if the client…
By Pam Marshalla
Q: My 12-year-old son cannot say R, however I am not so sure if that is the only problem. Many people do not understand him, a great crisis for him as he starts junior high this fall. He talks very fast. We tried a home program, but I really don’t know what I’m doing. Help! Your letter points directly to the articulation crisis occurring in this country: Many SLP’s are graduating from universities with absolutely no idea how to fix…
By Pam Marshalla
Q: How do you get a client to stop puckering, pursing, retracting, and tensing the lips when learning R? To get rid of lip interference when working on R (or any other sound) you need a way to hold the lips back. The child can use his fingers or a Lip Retractor. Fingers: Have the client use his own fingers to pull back the lips.Have the client place one or two fingers inside his mouth at the corners of the…
By Pam Marshalla
Q: I have heard you say that if kids have problems with sibilants and are missing their front teeth you prefer not to see them until their teeth come in. Could you explain your rationale? Without front teeth true stridency cannot be produced. Stridency is produced as the midline air stream hits the front teeth and then escapes between them. Without front teeth, a client would have to be taught a compensatory movement. He would have to produce his sibilants…
By Pam Marshalla
Q: I have been working with a 10-year-old girl with a significant lateral lisp that affects all of her sibilant sounds. I have been focusing on establishing /s/ and /z/, but have not been able to progress very far because her ability to achieve the correct tongue position is so inconsistent. I have taught her the “Butterfly Position” to help her lift the side margins of her tongue, and am using the “Long T Method” from Frontal Lisp, Lateral Lisp….
By Pam Marshalla
Q: I have a student I’ve worked with for a few years and she has several problems. I have tried everything I know, and nothing seems to help. She cannot say R, J, Sh, or Ch. She has difficulty with exhalation (i.e. she cannot blow out a candle) and therefore her speech is very quiet. She cannot even yell very loud. I’ve done some oral motor therapy (horn blowing hierarchy) and other things to address this, but it has not…
By Pam Marshalla
Q: I cannot get my client with Down Syndrome to produce “Long E” (as in the word bee). I have tried using a tongue blade to get his tongue back. Do you have any other suggestions? To produce long E (/i/), the jaw must be high and the tongue must be wide, high, and tense in the back. If you are using a tongue blade to push the tongue back, you have several problems that are working against you. First,…
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…
