By Pam Marshalla
Q: How do you get a tongue-tip to curl up and back toward the velum for the retroflex R? I have been using cream cheese, but it does not stick to the palate well, and I have been pushing the tongue back, but the child just doesn’t get what I want him to do. First, using food on the palate is an old-time popular method to stimulate tongue movement, but I never use food. You have to analyze the stimulus. …
By Pam Marshalla
Q: Are there any exercises one can give to extend the tongue frenum instead of having the client get a frenectomy? Are these exercises are proven scientifically? From long ago, therapists have said that “tongue exercises” could stretch the frenum, but I have never seen anyone spell out what those exercises would be, nor have I seen any data that would prove that any certain exercises do help. My own personal experience is this: Clients tend to move their tongues…
By Pam Marshalla
Q: How do you stimulate for tongue stability at the back-lateral margins when a child is too young to understand what you are talking about? That is a great question. The position of tongue stability is the same as Long E, as in the word “bee.” So with the little guys, I don’t try to explain it. I just over work Long E for a very long time. These are the types of things I do: Overwork the diminutives: kitty,…
By Pam Marshalla
Q: I have a number of clients whose L doesn’t sound right. The tongue-tip is lifting to the alveolar ridge, but the sound is muffled and just a little distorted. Do you have any suggestions? The tongue-tip probably is elevating without the full tongue thinning enough. Try this: Have the client say La-La-La with the jaw lower. Lowering the jaw usually thins the tongue. Have him say Ah first, and have him keep saying Ah while he says L. Make…
By Pam Marshalla
In case you have never seen one, I found these photos of restricting lingua frenums in infants online.
By Pam Marshalla
Q: I have a client with a lateral lisp, and I have started trying to elicit an S with the tongue tip down. I call a tip-down S a “dipper” and a tip-up S a “tipper.” The dipper position has helped him, but I can’t find any information about the validity of using such an approach. Can you point me in the right direction? I love your terms “tipper” and “dipper.” Excellent shorthand! The tipper and the dipper are allophonic…
By Pam Marshalla
Q: I am working with an 8-year-old client with severe apraxia who only can produce vowels, M and B. I have tried all the strategies in beginning of your book called Apraxia Uncovered. But this has also not yielded much. Do you have any hints for how to physically prompt other consonants? This child has severe cognitive dysfunction, too. The reason that the information in Apraxia Uncovered was not of much help to you is because although your client may…
By Pam Marshalla
Q: Do you have any suggestions on how to get a child to place his tongue on “The Spot” (the alveolar ridge)? We tried placing cream cheese as a placement cue but no result. You are on the right track in using tactile stimulation. I call this “Marking the Target” of articulation. But your stimulus is too weak. Cream cheese is barely perceptible in the mouth because it is too smooth, and it adapts quickly to body temperature. You want…
By Pam Marshalla
Q: I am a graduate student and I am writing a paper on the efficacy of oral motor exercises in children with articulation difficulties. Having attended a seminar of yours, I am wondering if there are researchers you could point me to who have used EBP in their research. Please see the articles we have published on the Oral Motor Institute website. OMI home page List of published articles
By Pam Marshalla
Q: My client has been in therapy for a long time for many error phonemes, and now we are working on the sibilants. He is doing them well now, but he tends to pull his right cheek to the side. It sounds correct but looks funny. Does the facial position matter if it sounds okay? If it sounds correct, I would not worry about that cheek pulling to the side until he is well on his way toward establishing the…
