By Pam Marshalla
Q: Sometimes parents fight and argue with me when I mention dismissing their child who no longer needs speech services. Where in the ASHA guidelines does it say that it is unethical to provide services for an individual who does not need it? This is in ASHA’s Code of Ethics although it’s phrased funny and therefore somewhat buried… It is letter I under Principle of Ethics 1 – Rules of Ethics. The important part of the guideline here is where it…
By Pam Marshalla
Q: My male client is five years of age. He has developmental artic errors and slurred speech. He also add a schwa at the ends of words: “Baby” is “baby-uh” and “Sand” is “Sand-uh.” What would account for this and how would you address this kind of speech sound error? Developmental errors are normal in a five year old but slurred speech is not. Something is going on. This sounds like mild dysarthria. I see the addition of the schwa…
By Pam Marshalla
Q: I work with a 6th grade student who has myotonic dystrophy. This is my 5th year working with this student. We have been working on P, B, and M for all of that time. At this time he can say these sounds correctly much of the time in therapy but has a horrible time with carry-over and self monitoring. He refuses to use video or voice recording or a mirror to help with this. Any thoughts on how I…
By Pam Marshalla
Q: My 5-year-old has been in speech therapy since he was 2. After many years of therapy, he pronounces a word right during speech and at home speech activities and he uses them in a sentence, however he’s not carrying over with conversational speech. His SLP tells me to correct him when he says a word wrong, but I’m correcting nearly every word he says which makes him get frustrated and not even want to talk to me. I don’t…
By Pam Marshalla
Q: I recently started working with a student with a right side unilateral lisp caused by jaw and tongue instability. He also has a midline bulge. Right now we are working on maintaining a stable jaw. Do I focus on tongue position as well? It sounds like he is shifting both his jaw and his tongue to one side. If so, stabilize the jaw first and use a straw to analyze what is going on with the airstream with the…
By Pam Marshalla
Q: Would you work on a lateral lisp in a 3-year-old? How? Most therapists would not treat a lateral lisp in a 3-year-old, but one could, and some do. Use the “Long T Method” and make it playful. Hold one end of a straw in front of the central teeth and have the child make a T. The airstream should go into the straw and amplify. Now make it “longer” — aspirate it. It won’t sound like “S” but it…
By Pam Marshalla
Q: I am an SLP and a mother with a four-year-old boy who has a frontal lisp. Do you think I should work with him, and if so, what simple things could I do at home? I always tell parents we do not have to work on a frontal lisp in a preschool child, but we usually do anyway because the parents want it. I find that the absolute key to remediation of the frontal lisp has three essential parts:…
By Pam Marshalla
Q: Do you have any tips for promoting good /r/ and /l/ in toddlers? Not to correct the phonemes directly, but to set the child up for future success by doing certain oral activities? Most would agree that we do not have to correct R and L in toddlers, but the idea that we can set them on the right development path is right on. This is what I do to set a child on the right developmental path for…
By Pam Marshalla
Q: My client misarticulates all the lingua-alveolar consonants–– T, D, N, L, S, Z. Can you give me some advice for how to fix them? Designing methods to “fix” a phoneme all depends upon what is wrong with it. Therefore in order to recommend methods to address these lingua-alveolars, one would need to know–– Are they completely absent from the client’s repertoire? Are they backed? Are they lateralized? Are they interdentalized? Are they nasalized? Is there a lack of plosiveness…
By Pam Marshalla
Q: My preschool client backed all lingua-alveolars until I taught him D. But not — it is distorted (his tongue looks funny) and the other sounds aren’t coming. Help! Most kids with a restricting lingua frenum use what the elocutionists used to call “thick speech” meaning that it was speech produced without the tongue bowled. The tongue was humping, bulging, or what the researchers today would call arching upward. This is probably what your client is now doing on D,…
