Category: Oral Motor

Facilitating Tongue-Tip Elevation

By Pam Marshalla

Q: How can I get my client to elevate the tongue-tip instead of the blade to produce lingua-alveolar phonemes? Following my 22 Fundamental Methods of Facilitating Jaw, Lip, and Tongue Movements, I would do one or more of the following: Assist – Lift the tip with a tongue depressor. Associate – Find one phoneme in which the client elevates the tip, and use that phoneme movement to teach the others. Contrast – Contrast tongue-tip elevation with tongue-back elevation. Cue –…

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Jaw Lateralization and the Lateral Lisp

By Pam Marshalla

Q: I have a kindergarten student who slides her jaw side-to-side during conversational speech, resulting in a lateral lisp. I have used a bite block program but it has not helped. She has good jaw strength. She can hold large bite blocks in her teeth bilaterally and speak without dropping them. But her speech isn’t any better. What should I do? This is not a strength problem. I am sure her oral mechanism is strong enough to support speech. This is…

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Feeding Therapy Resources

By Pam Marshalla

Q: I am looking for oral motor exercises that will teach and promote chewing. My client prefers a diet of soft foods that he can form into a bolus with his tongue against the roof of his mouth and swallow whole without moving the food to his molars and cheeks. The best book on the topic is: Morris, S. E., & Klein, M. D. (2000). Pre-feeding skills: A comprehensive resource for mealtime development, 2nd edition. Austin, TX: Therapy Skill Builders (Harcourt…

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Stimulating Lip Movement

By Pam Marshalla

Q: What can I do from a muscle-based perspective to engage the upper lip? There have been many methods of stimulating lip movement in the articulation, motor speech, oral motor, feeding, dysphagia, and orofacial myofunctional literature. The following sources are my favorite ones for activities to facilitate lip mobility. [Presented alphabetically] Dworkin, J. P. (1991). Motor speech disorders: A treatment guide. St. Louis: Mosby. Garliner, D. (1981) Myofunctional therapy. Coral Gables: Institute for Myofunctional Therapy. Marshalla, P. J. (1992). Oral…

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Oral Motor Treatment and Non-Speech Oral Motor Exercises (NSOME)

By Pam Marshalla

Once again I shall take a run at the question of what oral motor treatment is, and what are the differences between oral motor treatment and non-speech oral-motor exercises. This answer ensued from an email dialogue I was having with someone very concerned that SLP’s have begun to use non-speech oral-motor exercises INSTEAD of methods to facilitate sound and word productions. I tried to explain how this is wrong. ALL methods to improve speech are “oral” techniques, and they are…

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Inhibiting Lip Interference During Phoneme Learning

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…

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Autism and Mouthing Behavior

By Pam Marshalla

Q: Jessica is 26 months old and has a diagnosis of autism/PDD. She has started to respond to discrete trial instruction, however she presents with constant mouthing, licking, and biting her fingers. We have tried numerous things – chewing tubes, cold stimulation, vibration to the mouth, pressure, sweet, sour, salty, ignoring, and so forth. But the behaviors are increasing. Parents report constant licking and gnawing at furniture, books, and other household objects. Any suggestions you can give that might help…

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Horn Programs and Articulation Therapy

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…

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The “Butterfly Position” for R Therapy

By Pam Marshalla

Q: You use the term “Butterfly Position” in Successful R Therapy. Is this something new? Did you make this up, or does it come from somewhere else? I made up the term “Butterfly Position” in 1978 during a workshop I was teaching. I have used the term ever since in workshop handouts and books I have written. The “Butterfly Position” refers to the ability to shape the tongue into a position that has a low midline and high sides. This…

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