By Pam Marshalla
Q: In your workshop on the lisps and R, you said that we now have numbers to define jaw stability. Can you share them here? Yes! I would love to! As we all know, the mouth can move in a range that far exceeds that necessary for correct speech articulation, therefore it has to have mechanisms to hold its moving parts in place. This process is called oral stability. Oral stability consists of three parts: jaw stability, lip stability, and…
By Pam Marshalla
Q: I struggle with a student who can say the R sound correctly in the prevocalic position but not unless I correct her. I say, “What’s a wabbit?” and then she corrects herself. She has been in therapy for a few months. Should I film her? And what else can I do to help her? If the R sounds correct, you are doing fine! She is on her way. Filming is always a great idea to help clue kids in…
By Pam Marshalla
Q: Do SLP’s need a background in orofacial myofunctional therapy? I am not a certified orofacial myologist, but I have taken many seminars on the topic. I attend their conventions periodically, and I read and have written for the IAOM Journal. I have found that concepts from orofacial myofunctional therapy have been very useful to me as another way to gain a broad perspective of oral movements. Throughout my career I have combined concepts from orofacial myology, feeding development and therapy, and…
By Pam Marshalla
Q: My client is having trouble with L. When he makes his L it sounds as though he is forming some type of constriction in the far back of his mouth. It almost sounds like a glottal stop, but it is not that far back. He can hear the error but cannot change it. This has been called a “Retroflex L”. It means that the client is lifting the back of his tongue instead of the tip of his tongue…
By Pam Marshalla
Q: Can phonemes like R and S be taught to adults? I have received an unusual number of questions recently about the effectiveness of articulation therapy with adults. Where is this notion that articulation therapy cannot be done with adults coming from? Articulation therapy is EASIER with adults because they can understand what you are talking about and they usually are highly motivated to change. The only time this is not the case is when the adult client has a significant…
By Pam Marshalla
Q: My client keeps lifting the tip of his tongue when I want him to lift the back for K and G. How can I get him to stop doing this? The simplest way is to use an inhibition technique. Hold down the tip with a tongue depressor and tell him to lift the back instead. I also might use some tactile stimulation in the form of gentle brushing to help him understand the difference between the back of the…
By Pam Marshalla
Q: My preschool client has no fricatives or affricates. Do you have advice for getting them started? The fricatives and affricates emerge out of the pre-speech raspberries. I would start there. The raspberries are made both with and without voice and in many places of articulation–– bi-labial, lingua-labial, lingua-velar, and nasal snort. I have my clients makes them big and sloppy at first. Then I teach them to make the soft and gentle. When I move on to the fricated…
By Pam Marshalla
Q: Can you give me a short course on stimulating the tongue to move? This is about as short and sweet as it could possibly be–– The first thing to understand about the oral mechanism is that the muscles of the facial structures are contiguous and integral to the skin. This is different from the entire rest of the body where skin and muscles form completely separate structures. This means that tactile stimulation is the most powerful way to “wake…
By Pam Marshalla
Q: I am targeting /f/ in the initial position. My client is able to produce /f/ at the word level; however, he adds a /v/ after the /f/ for every word; i.e., /fvood/ for /food/. I exhausted all techniques in my bag of tricks! I am currently having him whisper words and trying to add voicing back to the word; however, that /v/ keeps popping back up. Do you have any other ideas or advice on how to target this?…
By Pam Marshalla
Q: I am working with toddlers for the first time after a 10-year career with elementary school children. They are different! Can you guide me? This is what I would tell a graduate student–– With a toddler, the most important thing to change from therapy with older children is that you have to STOP trying to get him to do what you want him to, and you have to START doing what he is doing. In other words, stop saying,…
