By Pam Marshalla
Q: I have a fourth grade student who has trouble with the vowelized “L” sound. She can produce final “L” when paired with a high front vowel but not when paired with a low back vowel. Do you have any suggestions for helping her learn how to lower the back of her tongue in order to produce these sounds correctly? Your client can say /l/, but just does not know how to transition from every vowel position to the /l/…
By Pam Marshalla
Q: Do you have a resource for understanding pain in the jaw? I get severe headaches and facial pain from it. Team Approach: Temporomandibular joint (TMJ) pain can be a serious issue and needs to be evaluated by a team of professionals who know the TMJ. The team should include at least a physician, a dentist/orthodontist, and a professional who understands TMJ movement. Sometimes that third person is a physical or occupational therapist, a myofunctional therapist, or a speech-language pathologist….
By Pam Marshalla
Q: Do you have any suggestions for how to elicit the /k/ and /g/? Pre-speech Vocalization Use the velar raspberry because it is the infant’s precursor to /k/ and /g/. If the child can make a velar raspberry, he is articulating in the back and only needs to refine the sound. Practice the raspberry long and short, loud and soft, big and tiny. Shape it into /k/ if the raspberry is voiceless. Shape it into /g/ if the raspberry is…
By Pam Marshalla
Q: I am working with a 2 year old who is exhibiting labial, alveolar and velar assimilation. For example, gog for dog, pup for cup, pomb for comb, and bum for gum. He produces all of the phonemes correctly in isolation and in syllables. Receptive language skills are age appropriate. Where do I start to correct this? I’ve been with him for 6 weeks. I am discovering through my reading that assimilation usually resolves around 3 years of age. His…
By Pam Marshalla
Q: Can you tell me how your books “Becoming Verbal with Childhood Apraxia” and “Apraxia Uncovered, The Seven Stages of Phoneme Development ” are different? Which one should I read first? Think of Becoming Verbal with Childhood Apraxia as Part 1. It is about how to get kids more vocal, verbal, communicative, imitative and interactive, and how to get them to play with the sounds they make. Read it first. Think of Apraxia Uncovered, The Seven Stages of Phoneme Development as Part…
By Pam Marshalla
Q: I have a five-year-old child with cerebral palsy, developmental delay, severe apraxic and dysarthria. Jaw control is limited, she drools, and the tongue retracts when feeding. I am told by her speech reports she needs oral motor work 3 times to 5 times a day. Might you have any suggestions on what I could do? She is in school speech three times per week for 30-minutes and she does see a PROMPT therapist. My experience has taught me that…
By Pam Marshalla
Q: How does a “tongue tie” interfere with speech development? In my experience, a “tongue tie” (a restricting lingua frenulum) can influence speech in certain ways depending upon the severity of tip restriction. The more the restriction, the more the influence on tongue tip movement. The restricting lingua frenulum can bring about an inability to elevate the tongue-tip to the alveolus. As such the English lingua-alveolar phonemes /t/, /d/, /n/ and /l/ must be produced with elevation of the tongue…
By Pam Marshalla
Q: Is there a website or document that describes the problem of pronouncing R’s as W’s? My friend’s 7-year-old daughter has this speech problem and she is now having reading difficulties. I feel the school has not diagnosed this because both parents are from Puerto Rico and the teachers probably think it’s an accent. I recognize the problem because my brother had it, and it was also not diagnosed because my parents are German and everyone just assumed it was…
By Pam Marshalla
Q: I work with a first grade student with multiple articulation errors. He inserts /t/ after /s/ and /sh/ words. For example he says “stay” for “say” and “shtirt” for “shirt.” We’ve slowed the production down to the point of an actual pause between the /s/ and the proceeding vowel and he is 100% accurate. But how do we speed up the motor movement while keeping the production accurate? I have found that the insertion of /t/ before or after…
By Pam Marshalla
Q: What can we do to make the back of the tongue elevate for /k/ and /g/? We can use the Tongue Retraction Response (TRR) as follows: Tactile stimulation down the midline of the tongue from anterior to posterior causes the entire tongue to retract back and up toward the velum. The response occurs about half-way down the tongue, and is elicited after the Tongue Bowl Response (TBR) and before the Tongue Gag Response (TGR). I also have called the…
