Answers & Advice Blog - Page 45 of 52 - Marshalla Speech & Language

Lateral Lisp, Palatal Expander, and Oral Habits

By Pam Marshalla

Q: I am working with an eight-year-old boy who has a lateral lisp as well as orthodontic problems and oral habits. He has severe lip-licking and nail-biting habits, and he has a narrow palate that will need expansion. I am thinking that he may do better in therapy once the palatal expander is removed. What are your thoughts? One could approach this problem from many angles, but this would be my basic line of thinking: A lateral lisp is a…

Teaching /w/

By Pam Marshalla

Q: I have a three-year-old girl who does not make a /w/ and so far I’ve been unsuccessful at changing that! She can do bilabial sounds /m, b, p/ and can close her lips fine to “kiss” or make fish lips and smack her lips. I’ve been trying to approximate the /w/ by having her combine “oo” and “uh” but she stops the airflow in between so the /w/ is never heard! Are there any airflow tricks I can use…

What to Practice at Home

By Pam Marshalla

Q: When it comes to giving homework in articulation therapy, should the SLP wait until the student masters it in the speech room? I view learning new phonemes as the process of learning new movements. Therefore, I only have kids practice at home what they can do with 100% accuracy with me in the therapy room. I am a very picky and exacting teacher! Rigidity such as this is not critical when the client has a general articulation delay. When…

What is PROMPT?

By Pam Marshalla

Q: Can you explain the PROMPT method you mention in your class on apraxia and dysarthria? PROMPT is short for the system called “Prompts for Restructuring Oral Muscular Phonetic Targets” developed by Deborah Hayden. It is a tactile cueing technique for phoneme production. The trainer uses hands-on tactile cues – she touches on and around the client’s mouth – to shape the mouth for speech sound production. On their website, the PROMPT method is described as: “the systematic manipulation of…

Help Teaching Final Consonants

By Pam Marshalla

Q: Can you give me some ideas about getting my clients to use final consonants? Here are a few ideas. These can be used alone or in combinations together. Auditory Bombardment Read a list of words that all have the same phoneme in the final position: cat, hat, rat, light, boat, kite, meat… Do this while the client is playing quietly at a table task such as drawing or clay. The client’s job is to listen. Amplification Amply your productions…

Parents Limiting Augmentative Communication Systems

By Pam Marshalla

Q: I have an 8-year-old student, in a regular second grade classroom. She can say a few words and carries a diagnosis of apraxia. She is below average in intelligence. The parents are insisting on sign language training only and are refusing other forms of augmentative communication – computer, pictures, etc. She can do up to five signs in sequence with prompting, but verbal speech is not coming along. She is failing further and further behind in academics because of…

Word Lists

By Pam Marshalla

Q: Where do you get the very specific word lists you use for the articulation training you describe for R and the Lisps? You are talking about organizing word lists by vowels when working on phoneme R or the sibilants. I use a variety of dictionaries, thesauruses, and rhyming dictionaries. I also use the popular book called 40,000 Selected Words: Organized by Letter, Sound, Syllable by Valeda Blockcolsky, Joan M. Frazer, and Douglas H. Frazer. I always keep on hand a…

Speech Therapy Exit Criteria

By Pam Marshalla

Q: I have heard you say that although most school districts seem to have excellent entrance criteria for therapy, they tend to have very poor exit criteria. Could you speak to this in regard to a client’s willingness to participate and in regard to cognitive level? Because I have been in private practice for 25 years, I have not had to agree with anyone on exit criteria, and therefore I have taken it on a case-by-case basis. In all honesty,…

Writing Oral Motor Goals for Therapy

By Pam Marshalla

Q: What is your opinion about writing goals for oral motor exercises when a client has a functional articulation disorder? My training would suggest that working on oral motor skills is appropriate only when there is a motor speech disorder. When asked how to write OM goals, I say, “Don’t write OM goals!” Oral movement is not your goal. The speech sound production is your goal. Write speech goals. Speech is movement. Whether you are working with clients who have…

Evidence-Based Practice and Controversy Over My Work

By Pam Marshalla

Q: The lead SLP at my agency will not allow me to attend Pam Marshalla’s workshop on R therapy. She feels that Pam’s book suggests an oral motor approach that is not evidence-based. I think there is some confusion in our profession about the difference between placement techniques and oral motor exercises as a isolated activity. I work for a progressive educational agency that seems to be running scared of any controversial terms. Honestly, the amount of misunderstanding about oral…