Answers & Advice Blog - Page 41 of 52 - Marshalla Speech & Language

Cerebral Palsy and Intelligibility

By Pam Marshalla

Q: My 12-year-old grandson has cerebral palsy. He understands everything at age level but he is very hard to understand. He is getting very little speech help. How can we help him at home? Expressive speech is divided into Consonants, Vowels, Syllables, and Intonation Patterns. Most SLP’s focus on Consonants. I would suggest that you focus on Vowels, Syllables and Inflection instead. In other words, have your grandson practice important words, and instead of focusing on getting the consonants correct,…

“Sharp” or “Whistling” /s/

By Pam Marshalla

Q: I have a student who has been in therapy for /s/ for a while now and, although he is able to produce the /s/ sound, his mom thinks it is now too sharp and unnatural. Do you have any advise for this? When we are talking about refining an /s/ like you describe, this all auditory work combined with subtle tongue, lip, and perhaps jaw changes. This is the essence of articulation refinement for all phonemes for all clients….

Exercise Routines

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 as if it was an exercise routine; I teach oral-motor techniques to facilitate sound production. Therefore, none of my books will give you that type of information. I do no measures of number of trials, or number of seconds, etc.. Instead I teach how to facilitate a movement to achieve…

Sharing Ideas and Evidence-Based Practice (EBP)

By Pam Marshalla

Q: I received the email you sent regarding collecting suggestions for carryover that you intend to compile in a book. It is surprising to me that you find it reasonable to pass on non-evidence based ideas submitted by therapists. I don’t think this meets a best practice standards at all. Will you measure the merit of these ideas? I’m curious to know how you propose to demonstrate efficacy. What you seem to propose is to collect and disseminate ideas that…

What is Evidence-Based Practice (EBP)?

By Pam Marshalla

The term Evidence-Based Practice (EBP) has been giving practicing SLP’s a lot of trouble recently. This is because some professionals have mistakenly assumed that an evidence-based practice requires that practicing therapists restrict their methods to only those that have been researched in a laboratory. This is a false interpretation of the EBP. The EBP actually integrates information from three sources: LAB, CLINIC, and CLIENT. Let’s review four references that explain this: 1. According to Carol Dollaghan (The handbook for evidence-based…

Articulation Procedure Basics

By Pam Marshalla

Q: When a child can produce his new sound correctly, do we go for the next level – syllabic level – in the same session? Don’t we have to dedicate a whole session for one goal to be sure that we have achieved the desired result? I always do as much as possible in every session I have with my clients. I try to work on phoneme, syllable, word, phrase, sentence, paragraph, and conversation all in the same session if…

Motivating /r/ Therapy

By Pam Marshalla

Q: I’m working on /r/ with a 4th grade boy that simply does not care about his speech. The parents are upset about his refusals and are blaming me for it! Help! A Few Ideas for the Client Let him opt out for now. Tell him he does not have to fix this now, and that he can do it later. Make it matter-of-fact and no big deal. Some kids will stay in therapy when they know they can get…

Postvocalic /r/

By Pam Marshalla

Q: My client has an initial position /r/. But I’m having a difficult time getting it in final position. How can I get this final /r/? Use his initial /r/ to teach the final /r/. I do it like this: Select a word that starts with /r/ that he can say well, like “rock”. And select a word that ends in /r/ that he cannot say, like “car.” Have the client say them in sequence: “Car-Rock.” The trick is to…

Toddlers and the Frontal Lisp

By Pam Marshalla

Q: Can you correct a frontal lisp in a toddler? We can help a child with a frontal lisp beginning at two years of age, however, most SLP’s hold off until these kids are 7, 8, or 9 years of age because of developmental norms. In a private practice, one can see these clients at any age, however one usually counsels the parents that the child does not really need therapy until later because the error is considered “normal” until…

Definition of Apraxia

By Pam Marshalla

Q: Does apraxia affect classroom learning? Strictly speaking, “apraxia” is a motor speech disorder. Therefore, it only effects the production of speech. But many of these children also have other problems- in comprehension, vocabulary, question comprehension, etc. To me, that means that the child has apraxia AND something else. The apraxia should only effect the expression of speech. That is a “purest” view. And you will read and hear of other views. This is my favorite definition of apraxia. Apraxia…