By Pam Marshalla
Q: I am scheduled to see a 14-year-old male with a lisp on /s/. He recently got braces and the dentist told his mother that the child had better see a speech language pathologist if the braces are to help at all. Can you help me organize this diagnosis? Focus on the speech first. You must know exactly what phonemes are affected. Look at ALL of them, not just /s/. Look at all the sibilants, and all other phonemes, especially the…
By Pam Marshalla
Q: How do oral rest and the neutral position impact articulation? Should we be concerned about these subjects in clients with an articulation/phonological deficit? So very many of our clients have problems with oral rest posture and the neutral position that I get at least one email per week from all over the world from SLP’s trying to figure out what to do about it. I will have a chapter devoted to this topic in my next book to be…
By Pam Marshalla
Q: Do you have any recommendations or suggestions for building a basic oral motor therapy kit? There are literally thousands of objects one could use as an aid to oral movement in articulation therapy. I call them “the toys and tools of articulation training.” Charles Van Riper called them “phonetic placement devices” and wrote: “Every available device should be used to make the student understand clearly what positions of tongue, jaw, and lips are to be assumed” (Van Riper, 1954)….
By Pam Marshalla
Q: Which of your books do you suggest for teaching me the number of repetitions or the amount of seconds for engaging in oral-motor exercises? I do not teach oral-motor as if it was an exercise routine; I teach oral-motor techniques to facilitate sound production. Therefore, none of my books will give you that type of information. I do no measures of number of trials, or number of seconds, etc.. Instead I teach how to facilitate a movement to achieve…
By Pam Marshalla
Q: I am working with a first grader who completely shifts his jaw to the left when he produces lateralized “Sh” and “Ch”. I am trying to work on his jaw, but it requires me to firmly give manual jaw stabilization even in isolation. Is it possible to change this strong habit of lateralizing the jaw? You are on the right track, but you are going about it in a less-than-optimum way. When we use manual jaw stabilization like you…
By Pam Marshalla
Q: Age what age should a child with an isolated Frontal Lisp be seen for therapy? When to see a child with a frontal lisp is a controversial thing. We CAN help a child like this from the age of two and older. But most SLP’s still hold off until they are older. Most school districts do not let a child like this enter therapy until age 7, 8, or 9 years of age. In a private practice, one can…
By Pam Marshalla
Q: How can you tell if a client’s tongue is too big? Usually a tongue that looks too big actually is a tongue that is low in tone. These clients usually have an unstable jaw and an unstable tongue. I.e., the jaw is low and the tongue is low and forward. The client also may have upper respiratory problems that are forcing him to keep the mouth open and carry the tongue forward in order to create a bigger oro-pharyngeal…
By Pam Marshalla
Q: Can you explain how to follow sanitary procedures when using hands or objects in the mouth? SLPs need to follow sanitary procedures at all times when touching a client with the hands or other objects in, on, or around the mouth. The following summarizes the basics of: (1) Scrubbing and gloving, (2) Handling objects in sanitary ways, and (3) Sanitizing objects for re-use.* 1. Scrubbing and Gloving Procedure: Adhere to the following procedure at all times when touching a…
By Pam Marshalla
Q: I have several students that have distorted /r/’s and short lingua frenums. I am having trouble and would like some advice. We cannot teach what I call a “Tip R” (the Retroflex R) with a short lingua frenum, but we can teach a “Back R.” However, the Back R is more difficult to do for most students. I would continue with the Back R with an emphasis on the Butterfly Position as described in my book Successful R Therapy, but…
By Pam Marshalla
Q: I have one student who makes /r/ in her nose. It is very nasal. Advice? Your client should be able to do the following because he is only hypernasal on one sound. That means that he is not structurally hypernasal (velo-pharyngeal insufficiency), nor does he have a motor speech disorder that causes him to be functionally hypernasal all the time. He simply has a habit of directing sound out the nose instead of the mouth when he says /r/….
