Answers & Advice Blog - Page 27 of 52 - Marshalla Speech & Language

Oral-Motor/Artic Client

By Pam Marshalla

Q: My student has very uncoordinated oral movements and severely unintelligible speech. He is unable to elevate his tongue-tip, and therefore does not produce any alveolars. His S and Z are very frontal––like Th––and he reduces S-blends. How do I teach alveolars, and do I concentrate on S-blends or correct production of S and Z? Your client requires a whole semester class on how the body works, and how that plays into speech movement development. Questions like yours are the…

The Long T (again)

By Pam Marshalla

Q: I bought your book Frontal Lisp, Lateral Lisp recently and am trying your “Long T Method.” My client can do T but not Ts. Is there still hope that I can use the Long T method or should I skip to something else? I only tried an aspirated T during one session so far. Patience! One session is not enough to know if a method will work or not. Also, you seem to be trying to get him to…

Work the Lateral Lisp Slowly

By Pam Marshalla

Q: I have had success with your “Long T Method” for teaching S and Z with my adolescent lateral lisper, but he continues to break down in reading and in conversation, he can do Sh and Zh on words, but he can’t do Ch or J at all. Where do I go from here? Can I expect braces to help improve his speech? Braces will not help. This is not a tooth problem. It is a tongue movement problem. You…

The Tools of Articulation Training

By Pam Marshalla

Q: I am confused over the term NS-OME (Non Speech Oral Motor Exercises). Some people are saying that we cannot use things like toothettes, bite sticks, whistles, or straws in therapy. I use many things like this in therapy. Shouldn’t we do whatever we can to help our clients learn to make speech sounds? Your question is a good one. Yes, we are supposed to use whatever we can to help our clients learn to produce speech sounds. Van Riper…

Phonological Policies

By Pam Marshalla

Q: My school district has been suggesting that we work on stopping before s-clusters, and I thought that would be a mistake leading to lots of frustration for both the SLPs and the students. Do you have any comments? I think that whenever we set policy –– “my district has been suggesting that we work on stopping before s-clusters” –– we are forgetting the individual child. There is no hierarchy or policy that should “work.” What “works” is what works…

When “Ate” sounds like “Hate”

By Pam Marshalla

Q: When my 4-year-old client says a word that begins with a vowel, he adds /h/ before it –– “Ate” sounds like “Hate.” What are your thoughts? Let me answer this according to four different scenarios –– 1. Client generally uses no frication at all: If the client was not yet using any fricatives or affricates, and the extra appearances of H were just a fluke, then I would stimulate all eleven sounds for a while till the whole set…

Emerging Lateral Lisp in 12-Month-Old

By Pam Marshalla

Q: I am an SLP and my 12-month-old daughter is developing a lateral lisp on her first words! Help!!! I believe this to be one of the worst positions in which an SLP can find him- or herself. We can teach midline sibilants to very young children, even toddlers, if we approach the acquisition of frication/stridency the way an infant does. I would do these three things now –– 1. Teach her to make a lingua-labial raspberry. Put the tongue…

What Evidence-Based Practice (EBP) Really Means

By Pam Marshalla

This opinion paper was originally posted as a downloadable PDF on my website, authored in mid- 2011. Download the original PDF here. *** What Evidence-Based Practice (EBP) Really Means Q: It is surprising to me that you find it reasonable to pass on non-evidence based ideas. I don’t think this meets a best practice standard at all. I’m curious to know how you demonstrate efficacy this way. The term “Evidence-Based Practice” has been bandied about and distorted. EBP does not mean that we only…

Stopping Stopping (Organizing the “Hissing Sounds”)

By Pam Marshalla

Q: In my therapy with kids who have the stopping process, I typically start with S-clusters and S in the postvocalic position. It seems they develop the idea of “fricative-ness” more easily this way and, from there, they more easily go on to prevocalic S. I find that starting with prevocalic S often leads to a lot of frustration because they learn “sock” as “stock,” and so forth. Can you comment on this? First, we have such a mess in…

Prioritizing the Frontal Lisp and Cluster Reduction

By Pam Marshalla

Q: My client is beginning to use S-blends, but she does so with an interdental lisp. Do I treat the phonological process first and let her lisp, or treat the lisp first and then the process? Or should I do both concurrently? I am worried about reinforcing the lisp. I would work on the phonology first to stimulate the use of the phoneme within the language. Then I would address place of articulation. That’s the way I would organize it…