By Pam Marshalla
Q: I have heard you say that jaw sliding to the left or right can cause one type of lateral lisp. I have also heard you say that this type of jaw instability is seen in children with dysarthria. Are you saying that a lateral lisp is a form of dysarthria? Excellent question! No. I am not saying that a lateral lisp is a form of dysarthria. I am saying that clients with expressive speech deficit often have problems in…
By Pam Marshalla
Q: I recently heard the term “pop out words” accredited to you and used to describe words a child may say once but then not repeat. Can you explain this phenomenon to me, why it happens, and why I should be concerned about it. I use the term “pop-out words” to refer to the way children produce a clear word occasionally but who cannot say the word on demand. For example, one essentially non-verbal child called out “Turkey” on Thanksgiving…
By Pam Marshalla
Q: Can you give me ideas about how to help a boy who is making R out his nose? He has no other velopharyngeal problems. This is what I do: Use a tube that stretches from the child’s mouth to his ear. Teach him to listen to the oral sound of several vowels. Then stretch the tube from his nose to his ear. Teach him to hear the nasal sound that emerges when he says M, N, and Ng. Then…
By Pam Marshalla
Q: I have a nine-year-old client who inhales as she tries to say R. I have never seen this before. Do you know how to address this? There is a very simple old-time solution for this using a straw, a few sheets of tissue paper, and a few small cotton balls: Teach About Exhalation Place a cotton ball on the table and give the child the straw to hold at her mouth. Have the child blow through the straw at…
By Pam Marshalla
Q: My son is 2-years and 5-months. His therapist seems frustrated by his stubborn personality and his continual effort to get out of doing his speech cards. I know we can help him more if he would only try. Can you suggest anything? It sounds like the therapist is trying to work with him as though he were four or five years of age. He’s only two and a half! Children this young should balk at doing speech cards. …
By Pam Marshalla
Q: I am now so thoroughly frustrated with the field of speech pathology, I’m tempted to throw in the towel… Or should I say throw in the bite blocks? I think the whole question of oral-motor therapy has gotten totally out of hand, and I no longer know what to believe. In this age, from every corner, we are encouraged to follow the evidence-based practice. In the absence of any hard evidence, I don’t know whether I ought to try…
By Pam Marshalla
Q: Which of your books do you suggest for teaching me the number of repetitions or the amount of seconds for engaging in oral-motor exercises? I do not teach oral-motor techniques exercise routines. I teach oral-motor techniques to facilitate sound production. Therefore none of my books will give you that type of information. In general I do not measure the number of trials, or the number of seconds — I teach techniques to facilitate new movements for phoneme productions. The…
By Pam Marshalla
Q: I am a professor and clinical supervisor in a prestigious university program. I do not see jaw or tongue movement problems in the articulation and phonology clients I supervise. Are you saying that someone like me does not have good observation skills? No. I am not saying that you have poor observations skills. I am saying that you have not been trained to see what is happening right in front of you. Consider this: An SLP must go through…
By Pam Marshalla
Q: The handout from your live class on the lisps has a method called the “Medial Squeeze.” What is it, and what is it for? The Medial Squeeze is a method I developed to get the tongue to widen. The tongue needs to sit wide on the floor of the mouth at rest, it needs to be wide for a normal swallow, and it needs to stay wide during speech movement. Some of our clients squeeze the tongue medially during…
By Pam Marshalla
Q: In a few of your blogs you mention that sometimes we have to teach a client to suppress his gag reflex. Why would you need to suppress the gag, and how does one go about doing it? The gag needs to be suppressed only if it is interfering with oral motor learning for speech and/or feeding. Severe Cases In the most severe of these cases, excessive gagging causes children to be unwilling to move and explore with the mouth. …
