By Pam Marshalla
A professor wrote me several years ago. She said she taught articulation and phonology, she had tenure, she did research in phonology, she supervised students, and she had published many articles. She said that she could not “see” the oral-motor problems I was talking about in my writing. She wanted to know what I had to say about that. I wrote back and said that she could not “see” the OM problems I was talking about because she could not…
By Pam Marshalla
Q: I am working with a two-year-old who uses a guttural back sound for initial T in words. He can say initial D correctly. Do I need to be worried about this T? Yes and no. When I work with kids under three years of age, I do not concern myself with how they produce individual phonemes within individual words. So I don’t find it important that the child can say “two” with a correct T, for example. But I…
By Pam Marshalla
Q: I have been told not to attend your seminars because you teach methods that have not been tested. I am new to the profession and am confused. Why do you feel it is appropriate to use and to teach methods that have never been tested? The simplest way I can answer this question (answered before here) is to quote another writing duo: “Clinicians’ imaginations conjure up exercises, techniques, procedures, and approaches, which are first tried on a few patients,…
By Pam Marshalla
Q: My 7-year-old male client has a lateral lisp. I have been trying to use T and Ts, but he just can’t get it. He still lateralizes his /s/ and /z/. He can produce /str/ appropriately but I just can’t get S alone. I wish I could generalize it to /s/ and /z/. Let’s ignore the cluster “Str” for the moment. I think it is too complex to work with and, as you have said, he cannot generalize. Let’s assume…
By Pam Marshalla
Q: In your workshop on the lisps and R, you said that we now have numbers to define jaw stability. Can you share them here? Yes! I would love to! As we all know, the mouth can move in a range that far exceeds that necessary for correct speech articulation, therefore it has to have mechanisms to hold its moving parts in place. This process is called oral stability. Oral stability consists of three parts: jaw stability, lip stability, and…
By Pam Marshalla
Q: I struggle with a student who can say the R sound correctly in the prevocalic position but not unless I correct her. I say, “What’s a wabbit?” and then she corrects herself. She has been in therapy for a few months. Should I film her? And what else can I do to help her? If the R sounds correct, you are doing fine! She is on her way. Filming is always a great idea to help clue kids in…
By Pam Marshalla
Q: Do SLP’s need a background in orofacial myofunctional therapy? I am not a certified orofacial myologist, but I have taken many seminars on the topic. I attend their conventions periodically, and I read and have written for the IAOM Journal. I have found that concepts from orofacial myofunctional therapy have been very useful to me as another way to gain a broad perspective of oral movements. Throughout my career I have combined concepts from orofacial myology, feeding development and therapy, and…
By Pam Marshalla
Q: My client is having trouble with L. When he makes his L it sounds as though he is forming some type of constriction in the far back of his mouth. It almost sounds like a glottal stop, but it is not that far back. He can hear the error but cannot change it. This has been called a “Retroflex L”. It means that the client is lifting the back of his tongue instead of the tip of his tongue…
By Pam Marshalla
Q: Can a child have both dysarthria and apraxia? From my perspective, yes. I see apraxia as a problem in the perception of speech movements. This is an input problem. I see dysarthria as a problem in the control (execution) of movement. This is an output problem. I believe that children can have one, or the other, or both. Also see: Differentiating Between Apraxia and Dysarthria (summary) and Apraxia and Dysarthria and Real Oral Motor Therapy (detail)
By Pam Marshalla
Q: Can phonemes like R and S be taught to adults? I have received an unusual number of questions recently about the effectiveness of articulation therapy with adults. Where is this notion that articulation therapy cannot be done with adults coming from? Articulation therapy is EASIER with adults because they can understand what you are talking about and they usually are highly motivated to change. The only time this is not the case is when the adult client has a significant…
