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: Should a lateral lisp be treated for a three-year-old when it is present in the speech of a parent? Maybe it will not be outgrown? I always treat lateral lisp as early as possible because I do not believe that it is ever outgrown. The lateral lisp is a deviant sound, not a delayed sound. Therefore more time will not necessarily make it go away. If anything, the lateral lisp seems to get more habituated as the child gets…
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: In your presentation called Improving Intelligibility in Apraxia and Dysarthria you mentioned that it is important to practice phonemes that they can do, rather than phonemes they can’t do. Why is that? That’s a good question! Van Riper and other old-time SLPs said that about 75% of every therapy session should be a rehearsal of things the child can do correctly, and about 25% should be material that is new, unfamiliar, and challenging. Most SLPs today spend most…
By Pam Marshalla
Q: My two-year-old son has dysarthria. We have been practicing his target words 100 times every day at home, but when he goes to speech sessions, his SLP only has him practice his words a few times. Can you comment on this? I don’t think she is working him hard enough. Drill has its place, but he is only 2 years old! You are giving him more practice than just about any toddler could handle. You do not want him…
By Pam Marshalla
Q: Do you think that enlarged tonsils and adenoids are related to the lateral lisp? We have no data on this as far as I know. I have seen a few kids where I thought these problems were inter-related. But I would not suspect that all tonsil/adenoid problems cause lateral lisps, or that all lateral lisps are caused by tonsil/adenoid problems. I think you have to determine this for the individual child. We must ask ourselves: Do the tonsil/adenoid problems…
By Pam Marshalla
Q: While I understand that every case is different, as a general rule, at what age do you consider it appropriate to target R when it is the only error? I have taught R to one- and two-year old children, so I know it is possible to do very young. However each therapist must address this question relative to his or her employment situation. Therapists in private practice often see these kids at 4 and 5 years of age. Therapists…
