Category: Oral Motor

Question re: Eyedropper Technique and Drooling

By Pam Marshalla

Q: I am using your eyedropper method for a non-verbal 5-year-old girl in the trainable cognitive level. She also has a neuromuscular disorder. We do it for 15 minutes and then she gets bored. Do you have advice? This is not the type of activity that you do for 15 minutes.  Weave it in-and-out of other SL activities you are doing.  Use the dropper procedure every 90 seconds while she is otherwise engaged.  You want to stimulate her to swallow…

Mobius Syndrome and Articulation Therapy

By Pam Marshalla

Q: What type of articulation therapy should be provided for children with Mobius Syndrome? I have only seen a few children with Mobius Syndrome, and those were seen for diagnosis only. As I understand it, facial paralysis is the main problem and the paralysis can involve some or all of the facial muscles, particularly the upper lip in most cases. The breadth and scope of the paralysis will guide speech involvement.  One client I saw had paralysis only in the…

Tongue Thrust Following the Swallow

By Pam Marshalla

Q: My friend’s daughter has a tongue thrust (the tongue pushes forward after the swallow). The orthodontist gave her one technique–– holding gum on the roof of her mouth while she swallows. Do you have any other ideas for tongue thrust techniques for a very typically developing 2nd grader? First a few words about the general nature of this question:  Asking someone for ideas about teaching a correct swallow is like asking someone for techniques to fix an articulation error. …

Tongue-Tip on L

By Pam Marshalla

Q: My 4-year-old client has learned L with his tongue-tip down. Should I let him continue this pattern, or should I teach him to make a tip-up L? In my opinion, you always want the tongue-tip to be elevated when it is supposed to be on T, D, N, and L.  You want your client to be developing oral movement patterns that will help him succeed all the way through to mature speech.  So you are teaching him things today…

Tongue Thrust References

By Pam Marshalla

Q: What do you recommend to begin doing reading on tongue thrust? In terms of textbooks, I would recommend either of the following.  The chapters about what to do in therapy for tongue thrust are basically the same in both of these books: Hanson, M. L., & Barrett, R. H. (1988) Fundamentals of orofacial myology. Springfield: Charles C. Thomas. Hanson, M. L., & Mason, R. M. (2003) Orofacial Myology: International Perspectives. Springfield: Charles C. Thomas.

Stabilizing the Jaw: Best Method for Articulation Therapy

By Pam Marshalla

Q: My client has a cross bite and his jaw lateralizes to the right causing overall speech imprecision. I am holding his jaw in place with standard jaw stabilization I learned for feeding therapy, but it’s not working. His jaw slips back out of position as soon as I remove my hand. That kind of “hands on” jaw stabilization procedure is good for feeding therapy, but is not effective for speech for the very reason you mentioned–– because as soon…

Essence Elements of Drooling Elimination

By Pam Marshalla

Q: What do you do for drooling? Do I need to be a swallowing expert to do it? I see drooling as a three-fold problem–– The child doesn’t swallow often enough. The child doesn’t swallow well enough. (He doesn’t evacuate completely). The child isn’t aware when saliva is building up in his mouth, on his lips, etc. (He doesn’t notice it or doesn’t care about it). So my therapy addresses all three of these issues–– I teach them to swallow…

“Marshalla Eye Dropper Technique” For Drooling Elimination

By Pam Marshalla

This opinion paper was originally posted as a downloadable PDF on my website, authored in November, 2012. Download the original PDF here. *** “Marshalla Eye Dropper Technique” For Drooling Elimination November 2012, Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Application This simple process is to be done in conjunction with a good program to facilitate improved oral-motor and feeding skills. It can be employed even if child is on medication or has had surgery to reduce or eliminate drooling. This method is…

“Gummy Smile”

By Pam Marshalla

Q: I have a new referral from a dentist for a client with a “gummy smile.” Haven’t seen him yet. What do you think this means? I would assume that the term “gummy smile” means that the upper lip is retracted and the upper gums are exposed.  Assuming that this is the case, the client needs to learn normal oral rest posture.  Normal oral rest consists of the lips resting gently together, the teeth resting a few millimeters apart, and…

Trill-to-R

By Pam Marshalla

Q: I have tried “everything” to teach R to this one client and he has gotten nowhere. Then one day he learns a Spanish trilled /r/, and WHAM! He gets an American R right away. Can you explain this? Van Riper wrote about this as one method for teaching the retroflex R:  “Have the child imitate you as you trill the tongue-tip. Then use this trill to precede the vowel E”  (Van Riper, Speech Correction, 1947, p. 142). Think of…