Answers & Advice Blog - Page 35 of 52 - Marshalla Speech & Language

Mumbling

By Pam Marshalla

Q: I have a 4th grade student who has trouble saying multi-syllable words in conversations. Do you have any suggestions for working with a student like him who doesn’t have any specific phoneme errors? Charles Van Riper called these clients “clumsy-mouthed individuals.” In my opinion, this is mild dysarthria. The key to treatment at this level is to teach the client to over-pronounce while he learns to self-monitor. Teach him how to do the following: Speak up Speak out Punch…

Sloppy Speech

By Pam Marshalla

Q: My preschool client can produce all the consonants and vowels, but his speech is somewhat unintelligible at times. I seem to be working on just general enunciation. Is this correct? Should I be doing more? Yes! You are on the right track. Teach him to enunciate. This is the essence of therapy at this level, and it applies to all clients of all ages and ability levels. This is part of what I call “Lessons from the Elocutionists”. Teach…

Bad Tongue, Better Speech

By Pam Marshalla

Q: I have worked with a 4-year-old for two years who had a frenectomy about 3 months ago. His speech is quite intelligible now, but he still has heart-shaped tongue, he cannot dissociate his tongue movements from his jaw movements, and he cannot sweep his tongue around lips to clean himself. He stabilizes his tongue with his teeth and can barely extend it beyond lower lip even after surgery. Since speech is good would you still see him for therapy?…

Trilled R

By Pam Marshalla

Q: My adolescent client can produce a postvocalic R, but it is effortful and sounds fluttery like a trill. I am afraid that it is a habit now. Help! If I hear any other junk on an R, I simply refocus on the correct acoustic quality by training R from scratch. Teach him to get the correct sound. A trill or flutter on R is not the correct sound in standard North American English.

Refining R

By Pam Marshalla

Q: My 12-year-old client can produce an R, but he hesitates on either side of it. For example, he says, “I’m [slight pause] ready.” This pause is for a fraction of a second. Do you have any thoughts or suggestions? This is an example of one of the limitless number of ways clients can mess up a perfectly good R. Your client can produce R, therefore his problem is not with R at this point. His problem is in the…

Frontal Lisp, Missing Teeth, and Thumbsucking

By Pam Marshalla

Q: My client has an anterior open bite, a very strong thumbsucking habit, and a frontal lisp of S and Z. My first impression is to wait to work on speech until after the teeth are firmly in place and the sucking habit is eliminated. Do you agree with this? Yes. In regard to the teeth, it is my opinion that it does no good to work on the sibilants until the “anterior dental barrier” (consisting of the front teeth)…

How To Teach R

By Pam Marshalla

Q: How do you teach an R? I just don’t get it! Some kids get it right away and other cannot seem to bunch up the back of their tongues no matter what I do. It sounds like you are always teaching what I call a “Back R.” Teaching a Back R is much more than teaching the client to bunch up the back of the tongue. The “Back R” position is attained by spreading, elevating, and retracting the back…

R and Orthodontia (Palatal Expander)

By Pam Marshalla

Q: Can I work on R with my client who has a palatal expander? My experience has taught me the following: Typical braces, palatal expanders, and the like should not interfere much with the sound quality of R and we can go ahead and begin treatment. However… Oral appliances can interfere with our work on R and other phonemes if there is oral pain in association with them. Wait a few weeks until the pain subsides or is managed appropriately….

Sippy Cups and Lisps

By Pam Marshalla

Q: Do you believe that early frequent use of sippy cups can contribute to, establish, or perpetuate a frontal lisp in children? I find it hard to believe that a sippy cup would cause a frontal lisp pattern in an otherwise normal child. I suspect it can happen, but we don’t have real evidence for this. These are the types of questions that I wish young doctoral students would begin to focus on in their research. We need answers to…

Apraxia: Classroom Placement and Amount of Therapy

By Pam Marshalla

Q: My beautiful nearly four-year-old son was diagnosed with verbal apraxia around the age of two. There does not seem to be any other developmental issues of concern. Have you found that an alternative schooling program is better for the preschool aged children with apraxia? If so what type of schooling would you suggest? He currently is enrolled in the public school system and only receives one half-hour of speech therapy three days per week there. We also go to…