By Pam Marshalla
Q: I have a relative who does not have any movement of her top lip. She cannot blow a horn and has difficult with straw sucking. Her 4-year-old son also was born with this lack of movement with his upper lip. What could this be? It sounds like it could be Mobious Syndrome (Alternative spellings: Mobius, Moebius). Mobious Syndrome has many characteristics, including partial facial and lip paralysis. Speech can be bad if the paralysis is wide spread in the…
By Pam Marshalla
Q: I use your “butterfly position” on many school age kids and most of them are able to understand it and follow directions. However, many of the preschoolers have a hard time understanding “biting the sides of their tongues.” Do you have a different way of approaching preschoolers when you want to stabilize the back of their tongues? I also have found that many preschoolers have a hard time understanding how to make the butterfly position. And children with lower…
By Pam Marshalla
Q: I have a preschool student who produces vocalic /r/ with more of a [ng] phoneme. If I address it, what can I do? There are always several ways to attack a question about articulation therapy. Let me offer two basic ideas to try: Normal Path of Development You could teach the client to substitute w/r instead if she can do a /w/ correctly without nasality. Teach her to say “Rabbit” as “Wabbit” and so forth. That puts her development…
By Pam Marshalla
Q: What do you recommend to encourage carryover of articulation skills in an older child with a frontal lisp? Note: I am writing a book entitled Carryover Techniques in Articulation and Phonological Therapy which will elaborate on this answer in great detail. [EDIT: Book released 2010]. My book Frontal Lisp, Lateral Lisp has a full chapter on carryover techniques for the lisps including: Auditory Acceptance – The process a client goes through to accept the way his new sound sounds. Determination…
By Pam Marshalla
Q: I am a worried mom that is looking for some help. My son is 23 months. He’s been in speech therapy for about 2-1/2 months. We go twice a month for 30 minutes. He says no words and his sounds are limited. I suspect an oral motor disorder from the start, but the SLP is still just considering that as the problem. He has no difficulty eating, drinking or nursing. But he drools quite a bit, cannot use a…
By Pam Marshalla
Q: My 3-year-old son drools a lot. He had his tonsils and adenoids taken out recently. How can I get him to stop drooling? Kids drool a lot during the birth-to-three time frame. It’s very hard to say if this is a problem or not at this point, unless he has other significant developmental delays. Kids who drool too much do not swallow often enough. They also don’t keep their mouth closed when they shouldn’t have it open. Your child…
By Pam Marshalla
Q: I was interested in gaining some additional information on elocution as you discussed in a recent seminar. “Elocution” refers to diction, pronunciation, and enunciation. “Elocution is the proper and graceful management of the voice, the countenance, and gesture in speaking” – Marcus Tullius Cicero, 106 – 43 BC Elocution is about speaking a little louder, speaking up, speaking out, holding the head up while speaking, looking others in the eye, using polite language, and engaging the listener. Elocution also…
By Pam Marshalla
Q: My client with a lateral lisp can produce /s/ in words but does not carry over to conversation. Are there strategies you would recommend? You are expecting him to skip from words to conversation. It rarely happens that quickly. Help him build through the traditional sequence- words, phrases, sentences, paragraphs, and conversation. You are helping him gradually take control of his expressive speech. Be patient! This can take up to a year. Make sure your practice material is void…
By Pam Marshalla
Q: My client produces a /t/ at the same time he says /p/. And he produces /d/ at the same time he says /b/. How can I prevent the tongue from elevating during /p/ and /b/? You need to inhibit tongue tip elevation. It might be done like this: Place a tongue depressor into the mouth, straight in from the front at midline, so that the blade sits on top of the front of the tongue. With the tongue depressor…
By Pam Marshalla
Q: I have a student with a restricting lingua frenulum that limits his tongue mobility and impacts his speech intelligibility. What do you write in the referral letter to the physician? Write a letter that explains how the restricting lingua frenulum is impacting as many of the following six areas as you can: speech, oral rest, preparation for swallow, the swallow, health, and social appearance. The letter is sent in the hopes that the primary physician will refer the client…
