By Pam Marshalla
Q: Is it wise to talk to a preschool child with childhood apraxia about their disorder? I never tell little kids that they have a disorder. I let them know that they are speaking very well, that they are still learning, and that I am thrilled that they are speaking as well as they are. Often I imitate back to the child what he said and how he said it, then I model for him how to say it better….
By Pam Marshalla
Q: Our son is three and was non-verbal. Our SLP seems really good at helping him learn to talk. But he is very hard to understand. What can we do? The essence of speech therapy for little children is to learn about words and sounds. We need to focus on both when working with young children. Many of today’s younger therapists put all their focus on building vocabulary, and they spend very little time focused on the actual production of…
By Pam Marshalla
Q: Is it necessary to get a diagnosis of apraxia with a young child who does not talk, or can we just proceed with therapy? The answer to that depends upon the rules and regulations of your treatment center or school, and whether or not insurance providers are involved. But in my opinion, as far as the actual therapy is concerned, you do not need a diagnosis to start. Just start. Time in treatment will tell you increasingly more about…
By Pam Marshalla
Q: I was listening to your audio tape called Apraxia Uncovered and heard you say that voice-activated toys are great for getting children to vocalize. Where can I find these? I know of no speech company that is selling these toys now, but I searched online and found many for sale at various venues. Some are overpriced, but if you take the time to look around online, I am sure you will find at least one at a reasonable price….
By Pam Marshalla
Q: What do you tell parents when they ask what caused their child’s articulation disorder? First I draw whatever conclusions I can from the child’s medical and physical history. For example, I explain how the child’s errors might be related to his positive history of ear infections, oral injury, structural deficit, neuromuscular disorder, sensorimotor dysfunction, and so forth. Second, I draw conclusions from information I have about the client’s cognitive level. For example if the client is four-years-old, but he…
By Pam Marshalla
Q: Do you have any techniques for teaching Sh for a client who can do a correct S? There are several easy things that usually work well if the client already can do an S. Use a Sequence: Have him make an S, and then slide into a whispered (voiceless) Y. Then have him do the same thing with the lips rounded. The sound of Sh often will be heard during the transition between the two sounds if the client…
By Pam Marshalla
Q: What can I do from a muscle-based perspective to engage the upper lip? There have been many methods of stimulating lip movement in the articulation, motor speech, oral motor, feeding, dysphagia, and orofacial myofunctional literature. The following sources are my favorite ones for activities to facilitate lip mobility. [Presented alphabetically] Dworkin, J. P. (1991). Motor speech disorders: A treatment guide. St. Louis: Mosby. Garliner, D. (1981) Myofunctional therapy. Coral Gables: Institute for Myofunctional Therapy. Marshalla, P. J. (1992). Oral…
By Pam Marshalla
Q: I have heard you say that you have a real problem with Evidence-Based Practice (EBP). Why would you be opposed to something that so clearly will help and protect our clients? I am not against using EBP. I am for EBP. However, I am concerned about several recent results of the EBP philosophy. I am especially opposed to three new ideas: I am against throwing out everything we have learned through a century of trial-and-error speech-language therapy just because we…
By Pam Marshalla
Once again I shall take a run at the question of what oral motor treatment is, and what are the differences between oral motor treatment and non-speech oral-motor exercises. This answer ensued from an email dialogue I was having with someone very concerned that SLP’s have begun to use non-speech oral-motor exercises INSTEAD of methods to facilitate sound and word productions. I tried to explain how this is wrong. ALL methods to improve speech are “oral” techniques, and they are…
By Pam Marshalla
Q: My 12-year-old son cannot say R, however I am not so sure if that is the only problem. Many people do not understand him, a great crisis for him as he starts junior high this fall. He talks very fast. We tried a home program, but I really don’t know what I’m doing. Help! Your letter points directly to the articulation crisis occurring in this country: Many SLP’s are graduating from universities with absolutely no idea how to fix…
