By Pam Marshalla
Q: I have been teaching R using your L-to-R sliding and tapping methods. However the further back my client tries to pull his tongue-tip the more it pulls to his left. He cannot keep it at midline past the middle of his palate, and he is not able to get a good R. I have not encountered this, but these are the methods I would use to address it– Have him use his finger, or another tool, and trace down…
By Pam Marshalla
Q: How do you teach a child to blow his nose? This has worked for me a few times- Teach them to pant in-and-out though the mouth. Then teach them how to sniff in and out through the nose. Once they can get the air moving in and out through the nose, teach them to push breathe more deeply with each sniff in and out. Gradually put more emphasis on the outgoing air. Gradually make the outward sniff a blow…
By Pam Marshalla
Q: My client has cerebral palsy. His articulation is really good but he is dysfluent. Can you help me? I am sorry, but I am completely unqualified to answer any questions about fluency.
By Pam Marshalla
Q: I recently read an article that indicated bite blocks could be made from dental impression compound. Have you heard of this or tried doing it? Do you have any suggestions on how this could be accomplished, the efficacy of doing it, and the material that would suit the job best? I have not used this method myself, but James Dworkin wrote about it in 1991. Dworkin came out of the Darley, Aaronson, and Brown school of thought on motor…
By Pam Marshalla
Q: My client is a five-year-old with polymicrogyria. He drools severely, eats only purees, basically is non-verbal, and has a non-verbal IQ of about 85. He is labeled as apraxic. Can you give me advice on how to proceed? I had not heard of this disorder, so I Googled it and found quite a bit under “polymicrogyria ” and “children with polymicrogyria.” Apparently it is a developmental malformation of the human brain characterized by an excessive number of small convolutions on the…
By Pam Marshalla
Q: Many SLPs write to me with questions about sibilants that are distorted––inter-dental, frontal, whistled, palatal, lateral, and so forth. I have given lots of advice about these errors, but sometimes I can’t. Why? Sometimes I can give no advice for fixing errors on the sibilants because the errors are distorted in such refined ways that there is no way to determine what exactly is going on without seeing and hearing the error myself. If you have taken classes of…
By Pam Marshalla
Q: When I try to use a tongue depressor or any other tool in my client’s mouth, he backs off right away and says, “It hurts.” He does this even before I use the tool to touch his mouth or do anything. I don’t think he’s hypersensitive. I think he’s refusing just to refuse. He is four-years-old and I am trying to elicit a K and a G. I think you are right. A little guy like that may use…
By Pam Marshalla
Q: I attended your R seminar and have been having great success. However, I do not know what to do with R-Blends. I can’t seem to get Tr, Dr, and so forth. That is a great question, and represents a topic I never seem to get to in my seminars. I also did not describe it very well in my R book, so here is the best way I have been able to describe what I do to date ––…
By Pam Marshalla
I recently attended a seminar on apraxia taught by David Hammer, SLP. It was fabulous and I highly recommend it to all my readers! David uses a combination of verbal cues, object cues, and gestural cues together in his work with apraxic children. He bases this speech training on the theory that children with apraxia need a multisensory approach that focuses on phoneme sequencing. The verbal cues he uses are names and phrases that describe the outstanding place, manner, and…
By Pam Marshalla
Q: My teen client has low tone, mild articulation problems, problems with intelligibility, and imprecision of articulation (interdental lingua-alveolars, F/Th, and distorted R). He has a slack jaw and forward tongue posture at rest. His tongue appears flaccid. Cognitive skills are okay. I went to your class called 21st Century Articulation Therapy and am trying to figure out which methods to use to address low tone in speech. Also what should I do about the tongue thrust? In terms of…
