Answers & Advice Blog - Page 51 of 52 - Marshalla Speech & Language

Vowels, Diphthongs, Choppiness, Low Intelligibility

By Pam Marshalla

Q: My twin clients have been in therapy for a long time and now can produce all the consonants except /r/ and /s/ in clusters. However, vowels sounds are still inconsistent and their speech is choppy and “staccato-like.” Intelligibility is low. First, kids learn vowels best in isolation, not embedded in the middle of words. Second, choppy and staccato-like rhythm pattern usually is related to diphthongs that are not fully developed. Listen carefully to the diphthongs. You can use the…

Oral Motor Goals in IEPs

By Pam Marshalla

Q: How should we write IEP goals for oral-motor? The answer I always give is: DON’T. Our goals are not to improve jaw, lip or tongue function. Our goals are to improve speech. Write SPEECH goals. Oral-motor techniques are just that: TECHNIQUES. Oral-motor techniques are used to help us achieve the speech goals we have set. For example, let’s say that we are working with a child who has no back sounds – no [k] or [g]. Our therapy techniques…

Diagnosing Toddler with Apraxia?

By Pam Marshalla

Q: One doctor says my two-year-old daughter has apraxia and another does not believe so. Can you tell me what is going on here? I am afraid that you have entered the “apraxia twilight zone.” The subject of apraxia in children is a controversial and confusing one. First, some professionals insist that apraxia in children does not exist. Others insist it does. Since we have no formal way to diagnose the problem medically (e.g, no CAT scan) the diagnosis is…

Again: What Does Oral Motor Therapy Have To Do With Speech?

By Pam Marshalla

Q: What does oral motor therapy have to do with speech? I want to take another run at this question because it arises so often. Consider: Phonemes emerge when a child’s oral-motor control is immature. Think about [b], [d] and [g]. These early voiced stops emerge when a child is about 6 months of age. That means that the oral movements used during their production are primitive. These primitive movements refine over time. From an oral-motor perspective, we can say…

“Popping” and Other Techniques to Teach Voicelessness

By Pam Marshalla

Q: I was at your Improving Intelligibility workshop this winter. On your handout, in regard to teaching voicelessness, you write: “Teach popping with p, t, k.” I did not write anything down and as I look back over the material I have no idea what “popping” is or how to teach it. Help! Ah yes, “Popping” is a term I made up. Let me explain… When children first learn [p], [t] and [k], they do so with productions that are…

How to Correct a Nasal R

By Pam Marshalla

Q: In your book, Successful R Therapy (pg 62), I read about how to help a client with hypernasality on R. That helped a lot. But I need help with the actual teaching part. How do I get the student to say the R without the nasal sound? Your client first needs to discover that sound comes out his nose and mouth differentially, and he needs to control this as he makes R. Use a flexible tube about 18 inches long and…

Why Teach Tip R vs. Back R?

By Pam Marshalla

Q: It seems that children have an easier time understanding the Tip R. However, I know therapists that teach the Back R and seem to like it. Which method do you have more success with and why? In my book, Successful R Therapy, I state that the Tip R is much easier. It is easier to see, describe and understand. And it requires a more primitive movement pattern. Simply curling the tip up and back is something that babies do while vocalizing. I…

Computer Software Recommendations?

By Pam Marshalla

Q: Do you have any computer software recommendations for a student with verbal apraxia? I am not your resource for this kind of information. Find a therapist in your area who has expertise in computer hardware and software. Most school districts and children’s hospitals have at least one person on staff whose job it is to keep up with these products. Also talk to the software companies that sell the equipment. They have salespeople who will teach you all about…

How to Define Oral-Motor Therapy (Especially for Naysayers)

By Pam Marshalla

Q: What is oral motor therapy? How do you define it and what is its purpose? This is the definition I use: Oral-motor therapy (OMT) is the process of facilitating improved jaw, lip and tongue function. Oral-motor techniques can be used in any of the following therapies: articulation, phonology, dysphagia, feeding, orofacial myology, and occupational or physical therapy. You can discover the importance of speech movements by engaging in a simple procedure. Count aloud from one to ten. Did anything move?…

Apraxia and Attention

By Pam Marshalla

Q: My six-year-old daughter has oral and verbal apraxia and developmental coordination disorder. She has a difficult time keeping up her levels of concentration throughout the school day. One teacher tells me that Hannah needs to “attend” and that she is concerned about Hannah’s “attention deficit.” Do you know of any resources that would help explain how her diagnosis affects her ability to focus? Probably the best place to begin is The Out-of-Sync Child and succeeding books (The Out-of-Sync Child…