Answers & Advice Blog - Page 28 of 52 - Marshalla Speech & Language

Need for Differential Diagnosis

By Pam Marshalla

Q: I have a six-year-old male client that has phonological and articulation problems. What should I target first in therapy? Therapy always is based on the differential diagnosis. It is impossible to answer that question without information about the client’s entire phonological and articulation repertoire. Selection of therapy targets will be very different depending upon many factors. One makes decisions about therapy based upon a complete overview of what is going on. If you read through this blog, you will…

Sliding Jaw on /R/

By Pam Marshalla

Q: I have an elementary client who figured out how to say R all by herself, but she shifts her jaw to one side to accomplish it. I have tried to get her to stop lateralizing the jaw, but then she can’t produce R. Should I worry about this? I would not try to take her away from what she has achieved on her own. She is proud of it! Instead, let her keep producing the R with the jaw…

Verbal, Augmentative, and Cognition

By Pam Marshalla

Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…

Chinese /r/ and /l/ Problems

By Pam Marshalla

Q: I have an adult Chinese student with /r/ and /l/ problems. She produces these phonemes with additional sounds I cannot describe in words. Can you give me any tips in correcting them? I think your best method for correcting this would be to have her say the sounds enough times that you will be able to imitate them exactly. Then model for her what she is doing and help her hear what she is doing wrong. And then help…

Long Distance R Therapy

By Pam Marshalla

Q: My adult daughter needs help with her R. Is this something you can do with her by way of this Blog? Therapy to remediate an incorrect R is like voice training: It cannot be done on paper or in a QA format like this. Your daughter needs to find a live therapist with whom she can work, either together in an office or via live on-line video chatting. Either should work okay if the therapist knows what he/she is…

Inappropriate Prolongation of R

By Pam Marshalla

Q: My student can do R in all words and in all positions, but he prolongs it. Do I need to teach him NOT to do this? I would teach it to him if it did not go away by itself within a reasonable period of time. I am not sure what that reasonable period of time is, but I would be willing to give him 6 months to a year to straighten this out. I probably would give him…

How to Teach Proper Oral-Nasal Resonance Balance

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. *** How to Teach Proper Oral-Nasal Resonance Balance I receive weekly questions from therapists struggling with how to decrease hypernasality in clients who have adequate velo-pharyngeal structure. I am not an expert in this area, but I would like to share what I do to help clients become less nasal. These clients generally can achieve oral sound, but they…

Carryover Techniques for Speech-Language Therapy

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. *** Carryover Techniques The term carryover refers to a client’s ability to take an individual speech skill learned in the therapy room and to apply it broadly in all speaking situations. The following is an outline of the techniques presented in: Marshalla, P. (2010) Carryover Techniques in Articulation and Phonological Therapy. Mill Creek, WA: Marshalla Speech and Language. www.pammarshalla.com…

Starting Position for Speech Movement

By Pam Marshalla

Q: I am working on my master’s thesis on a topic related to the basis of articulation and the neutral/starting positions. I would like to expand my research beyond the linguistics domain into the neighboring fields of speed physiology and therapy. I read your notes “The Roles of Oral Rest Posture and Neutral Position in Articulation” and would like to cite it. Have you published it anywhere? Perhaps you have mentioned starting position in your other publications? I am currently…

Inappropriate Prolongation of R

By Pam Marshalla