By Pam Marshalla
Q: Is there an age constraint for starting self-awareness techniques for carryover? My son is 6 years old. Carryover ideas should start right from the first day of therapy, no matter the client’s age. That means that you are planning for and thinking about and stimulating for carryover from the first day, and you are dropping in ideas here and there. For example, let’s say your child is learning to keep his tongue in his mouth. He can work on…
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…
By Pam Marshalla
Q: What is your opinion about push-in vs. pull-out therapy? Is anyone doing research on this? As far as I know, no one is doing research on in-class versus pull-out therapy for articulation. I cannot address this question as it concerns language. In my opinion, in-class stimulation is good for the following: Building general vocabulary and concepts Establishing general communication routines Encouraging basic syntactic structures Stimulating phonological awareness Engaging in articulation carryover activities Teaching elocution Teaching early-developing phonemes—P, B, M…
By Pam Marshalla
Q: My 4-year-old son has a frontal lisp. The school is refusing services and says he will outgrow it. Is this true in all cases? No one that I know of is researching this area any more and there are big questions like this one that are going un-answered. There seem to be two types of frontal lisps. The first is an immature speech pattern that will go away with time––by 7-9 years of age. The second is the result…
By Pam Marshalla
Q: Do I understand your advice? […] When working on producing the ‘hissing” sounds, my focus should be on the airflow and not the correct sound production. For example, the client can’t say Ch but is able to get a lot of airflow on her attempt when probed. So I should reward her when she says Ts instead. Is this correct? My experience and research on normal development demonstrates that children learn MANNER before they learn PLACE features. Thus, stridency…
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. …
By Pam Marshalla
Q: I am working with a child 2;6 who substitutes /n/ or /m/ for many other consonants. We have worked with words she says often, and she can make the correct sounds in words with a model, but talking on her own she just sounds like she is whining. Two-year-olds can be so variable, and what looks like something very severe can turn out to be nothing. She simply may be jargoning, and her jargon happens to sound like whining. …
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…
By Pam Marshalla
Q: I am an SLP and cannot figure out how to remediate my own 20-month-old daughter’s speech problem. She is very expressive, has unlimited vocabulary, is speaking in 4-word sentences, and has above average articulation. She recently developed a cold which is now gone but as a result she is now producing L in place of N in all word positions. She is saying “Lo for “no” and “Bel” for “Ben.” She had this correct before. How should I correct…
By Pam Marshalla
Q: My two-year-old client uses words inconsistently. For example, he only uses “more” when he wants food, and he only says “mama” once or twice a day. Two-year-olds are notoriously inconsistent about everything they do. They go to bed right away one night, and scream bloody murder about it for two hours the next. You ask them if they want a cookie, they say cookie and take it one minute, and the next they won’t even look up at you. …
