Category: Oral Motor

Standardized Oral Motor (OM) Tests

By Pam Marshalla

Q: I need information on evaluating oral-motor skills in school age articulation/phonological cases as well as appropriate oral-motor exercises/goals for educational IEP’s/settings. The only test I know of that will give you a standard score for oral motor skills is my test called the MOST — The Marshalla Oral-Sensorimotor Test. It is available through SuperDuper Publications. The MOST was normed on kids 4;0 – 7;11. It will give you individual scores for jaw, lips, tongue, velum, respiration, phonation, and oscillating oral movements….

Vibration

By Pam Marshalla

Q: I am currently working with infants in a multidisciplinary team. The motor therapists are inclined to recommend vibration for oral motor issues. I would like your recommendations regarding the use of oral vibration for kids with low oral tone who have tongue protrusion, decreased speech intelligibility, and difficulty managing food. What are our best practice guidelines for the use of vibration? Any information you have would be very helpful to me. I know of no “best practices guidelines” for…

Restricting Lingua Frenum

By Pam Marshalla

Q: I am working with a three-year-old with a very restricted lingual frenum, a shortened velum, and significant tongue protrusion. The parents want to try therapy before consulting medical advice about a frenectomy. We have made nice progress thus far. The child chews hard and soft solids with a mushing pattern. No coughing, choking, gagging has ever been observed or reported. She is now able to lateralize her tongue left and right independently of the mandible, and within the past…

Attaining and Maintaining Intelligibility with Dysarthria

By Pam Marshalla

Q: I have a ten-year-old client who is very hard to understand, although he has no specific phoneme errors. We’ve started doing a pacing board which is helpful. I know that oral-motor exercises are taboo these days, but I feel in some way I have to address motor weakness. The greatest and most effective technique for dysarthria is EXAGGERATION of speech. This is spoken of in virtually all books on traditional articulation therapy and more modern texts on motor speech…

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…

Licking Habit and Autism

By Pam Marshalla

Q: I am looking for something to assist us with a student who stimulates by licking everything in sight. Are there any strategies for decreasing this behavior? It interferes with his attending during class. I have worked so little with kids on the autism spectrum that I do not know how to answer this. I have never had to extinguish a behavior like this. I can say this however: I would not consider this an oral-motor problem. This is a…

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…

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….

Object-Biting Habit

By Pam Marshalla

Q: I have a 7-year-old boy who has a habit of biting on pencils, shirt collars, hair, his baseball glove, and so forth. He has no speech problems. Others are noticing it and commenting. The boy is not aware of it and says it “tastes good.” What do you think? There does not seem to be a heightened anxiety or fatigue factor. In light of your oral motor practice, what program should be followed? If a client like this came…

Oral Stability and the Frontal Lisp

By Pam Marshalla

I receive weekly questions about the severe frontal lisp. The questions always are about how to keep the tongue inside the mouth for speech. We are talking here about the client who has:  Interdental tongue placement on all the sibilants: S, Z, Sh, Zh, Ch, J Interdental tongue placement on all the lingua-alveolar sounds: T, D, N, L Open mouth resting posture Reverse swallow (infantile suckle-swallow, tongue-thrust swallow) From a motor perspective, the severe frontal lisp with interdental tongue placement…