Oral Motor Archives - Page 3 of 23 - Marshalla Speech & Language

Category: Oral Motor

Strength vs. Motor Patterns — The Nitty Gritty

By Pam Marshalla

Q: I was at the IAOM convention in the fall of 2013, and I heard you speak on oral stability. You used your hands to describe the difference between oral strength and oral movement patterns. Can you post it here? I would like to share it with my colleagues and I can’t remember what you said. This is probably the best way I have discovered to describe the difference between movement patterns and strength of movement. Hand Movement vs. Hand…

Jaw Sliding

By Pam Marshalla

Q: Could you talk about young kids with articulation disorders who demonstrate significant jaw sliding? What causes this when there is no neuromuscular problems? Jaw sliding left and right pulls the tongue laterally away from its alignment with the palate. This causes articulation of the tongue to the palate to be off and this distorts sound quality. Treatment is to stabilize the jaw at midline. There is no telling why these things occur. All movements are asymmetrical to a certain…

Incisor Grinding

By Pam Marshalla

Q: Do you have any treatment for incisor grinding? I wrote about this recently regarding clients who are lower-functioning, but in general — Changing any oral habit is a matter of engaging in the following points: Identify the problem. Help the client become aware of the problem: What can he do to track how often he does this? Get more info about it: E.g., what does the orthodontist/dental say about it and what methods do they recommend. Identifying specifics about…

Finishing Up R Therapy

By Pam Marshalla

Q: My client adds E after all vocalic Rs. Example: She says “deer” as “Deer-ee”. Is this an oral-motor problem? What can I do? If your client has a correct R in some contexts but not others, then this is no longer about oral motor skill. She already can attain an R position. This is a problem of auditory discrimination. For some reason, she needs the E after the R to make the R correct in the vocalic position. Teach…

Inhibiting Tooth Grinding

By Pam Marshalla

Q: Do you have any treatment for incisor grinding in a client with low cognition? Oral habits are difficult to change when cognition is low. The standard rule of thumb is to recognize that he child is benefitting in some way from the habit. Most people postulate that the grinding relieves boredom and/or it gives tactile stimulation that feels good. Many children with low cognition also have low oral-tactile awareness and discrimination, therefore oral habits feel good. If grinding is…

Large Tongue

By Pam Marshalla

Q: I evaluated a 4;6 male with a 4mm open bite. He used a sippy-cup and pacifier. I advised to eliminate the sippy cup and pacifier, but what was noticeable on oral exam was that he had a really long tongue. Is it possible the tongue is just too large for his oral space? Is there a quantitative way to measure this? I find this to be one of those impossible-to-answer questions. We have no way of knowing clinically if…

Stimulating Tongue-Back Lowering

By Pam Marshalla

Q: My adolescent client speaks while holding his tongue tensed against the roof of his mouth in an “ing” position all the time. He has had years of therapy due to hearing impairment but can not produce a T, D or N at all. Most all of my oral motor experience has been to increase strength/tone. Any suggestions are greatly appreciated. Ahhhhhh…. You have discovered that “oral motor” needs to be much more than simply “strengthening” the mechanism. In fact,…

Resistance to Teach Tongue-Back Elevation

By Pam Marshalla

Q: My student substitutes T/K and D/G. As per suggestions on your website, I am facilitating posterior tongue elevation by using a tongue depressor and having the student push against it with the posterior part of the tongue. I have been able to elicit H but not K or G. Is H the sound you refer to as a velar fricative? I need help with this method. Let me straighten this up first- H is a glottal fricative and not…

Saving the Profession by Wagging the Tongue

By Pam Marshalla

Q: Every week I encounter more statements by SLPs about never doing anything in therapy that has not been proven in research. These statements virtually always concern oral-motor techniques. How do you respond to this? I am so concerned about the limited thinking that has begun to dominate our profession that my heart is bleeding. I am not concerned only with OM. I am concerned about the profession at large. 🙁 Follow me here. Let’s talk about OM and then…

You Never Know What Will Work

By Pam Marshalla

I was recently reminded of a client I worked with decades ago who taught me a very important lesson about therapy when I was a young therapist. I wanted to share his story. David David was 6;0 and non-verbal. He was a big clunky kid with fine and gross motor problems who was basically untestable, and everyone thought he had very low IQ. I was using Bliss Symbols with him (it was 1976) to develop a home-made communication board (before…