Answers & Advice Blog - Page 24 of 52 - Marshalla Speech & Language

Down Syndrome and Stuttering: Diagnostic Labels

By Pam Marshalla

Q: I have a student with Down syndrome who stutters. Her private SLP has diagnosed her as having apraxia, and insists that the fluency problem is part of the apraxia. Can this be right? Many therapists assign the label of apraxia to children with Down syndrome, but I believe that this is an incorrect diagnosis. Dysarthria should be the assigned disorder. Please note the following definitions: Dysarthria Dysarthria comprises a group of speech disorders resulting from disturbances in muscular control….

How Long to Fix a Lateral Lisp?

By Pam Marshalla

Q: How long should it take to establish midline airstream when a client has a lateral lisp? This depends upon what you are talking about. Are you trying to figure out how long it should take you to obtain the client’s first midline sibilant, or to finish the entire program? To be very honest, an SLP with no specific training on how to treat a lateral lisp may NEVER figure out how to get a correct set of midline sibilant…

Lateral Lisps in Languages Other than English

By Pam Marshalla

Q: I am an SLP from Greece, and I’ve been working with a five-year-old girl with lateral lisp for four months. She still cannot produce a clear “S”. I am interested in buying your book on this subject, but I’d like to know whether these techniques apply only to English. Also, I have heard some SLPs claim that a lateral lisp cannot always be cured. I have never met a lateral lisp that could not be fixed except in the…

Making Speech Targets Salient – Classic Auditory Training – Tools for Amplifying Speech

By Pam Marshalla

This opinion paper was originally posted as a downloadable PDF on my website, authored in September, 2011. Download the original PDF here. *** Making Speech Targets Salient Classic Auditory Training Tools for Amplifying Speech By Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Making Speech Targets Salient One of the most important things we do in articulation therapy is to make speech units stand out so the client can focus on them. Our most important tool for making speech units salient is our own…

Evidence for Cues

By Pam Marshalla

Q: I am a SLP graduate student looking for some evidence-based practice to implement for a client diagnosed with childhood apraxia of speech. I watched the YouTube videos of your hand cues for placement, and I think they would work great. I was wondering if you had any research to support these cues, or if you obtained research elsewhere to support them. A therapist doesn’t look for an evidence-based practice: A therapist creates one. The EBP is formed when a…

Age of Treatment Onset for Frontal Lisp

By Pam Marshalla

Q: How young will you see a child for an interdental/frontal lisp? Yours is one of the toughest questions to answer because there are different perspectives and different reasons for early treatment. If there is a speech problem only, most therapists in the public schools seem to wait for a child with a frontal lisp to turn 7 years of age and older. However, I meet many school SLPs who see these kids in kindergarten and first grade. Therapists in…

Treating a Whistled S

By Pam Marshalla

Q: My client started with a frontal lisp. Now he is now producing a “Whistling S.” How do I correct this? A whistling S usually is an S that is being made in just the right place that whistling occurs. Simply have your client begin to move his tongue-tip higher or lower, slightly more forward or back, or slightly more to the left or right as he prolongs his S. You are searching for the place that works to alleviate…

Using the Syllable Method for R

By Pam Marshalla

Q: I recently attended your seminar on R therapy. I have a student who can say “growl” but that’s it. Should I use your syllable method? Yes! Use the syllable method! If he can do the word “growl”, then he should be able to say “grah” by taking the end of the word off. Then if he can say, “grah”, he should be able to say “ground”, “grouch”, “grout” and so forth. Just make sure to make the words into…

What is Oral Stability?

By Pam Marshalla

Q: You use the phrase “lack of stability” in relation to oral motor function. What do you mean by “stability”? I will have a full chapter on oral stability in my next book to be called The Marshalla Guide to 21st Century Articulation Therapy. Until then, the following is something I wrote in an article for the Oral Motor Institute: Stabilize Oral Movements To stabilize is “to make or become stable” (Jewell & Abate, 2001, p. 1656) or “not likely to change”…

“Ruh” – Blocking Out The Old Motor Memory

By Pam Marshalla

Q: I attended your conference on Frontal Lisp, Lateral Lisp, and Distorted R a few weeks ago, and I have been trying your methods. Your L-to-R tapping method has WORKED on my toughest clients! They can say “Ruh” but we don’t call it “R”––we call it “The way back L.” On all of your material, you have it typed out as “Ruh.” I am hesitant to write it that way for word practice because then my clients have been reverting…