By Pam Marshalla
Q: My client keeps lifting the tip of his tongue when I want him to lift the back for K and G. How can I get him to stop doing this? The simplest way is to use an inhibition technique. Hold down the tip with a tongue depressor and tell him to lift the back instead. I also might use some tactile stimulation in the form of gentle brushing to help him understand the difference between the back of the…
By Pam Marshalla
Q: Can you help me deal with a situation? I work in the schools. A private SLP accused me in a meeting with parents recently of not using the correct “motor planning methods” with a mutual apraxic child. Do you know what she is talking about? She really embarrassed me. Grrrrrrrrrrrrrrrrr! I regret the competitiveness that some therapists have, and absolutely detest the way some private therapists treat SLPs in the schools. You should not have had to experience that….
By Pam Marshalla
Q: I have a client who uses a velar fricative for the sibilants. I was experimenting with some of your self-assessment exercises in your book Frontal Lisp, Lateral Lisp, and I noticed that as I dropped my jaw to produce /s/, the sound eventually became a velar fricative. Do you think jaw grading or stability exercises will help my client with this? Position of the tongue relative to the palate is directly related to jaw position, height, and stability as…
By Pam Marshalla
Q: My preschool client has no fricatives or affricates. Do you have advice for getting them started? The fricatives and affricates emerge out of the pre-speech raspberries. I would start there. The raspberries are made both with and without voice and in many places of articulation–– bi-labial, lingua-labial, lingua-velar, and nasal snort. I have my clients makes them big and sloppy at first. Then I teach them to make the soft and gentle. When I move on to the fricated…
By Pam Marshalla
Q: Can you give me a short course on stimulating the tongue to move? This is about as short and sweet as it could possibly be–– The first thing to understand about the oral mechanism is that the muscles of the facial structures are contiguous and integral to the skin. This is different from the entire rest of the body where skin and muscles form completely separate structures. This means that tactile stimulation is the most powerful way to “wake…
By Pam Marshalla
Q: I am targeting /f/ in the initial position. My client is able to produce /f/ at the word level; however, he adds a /v/ after the /f/ for every word; i.e., /fvood/ for /food/. I exhausted all techniques in my bag of tricks! I am currently having him whisper words and trying to add voicing back to the word; however, that /v/ keeps popping back up. Do you have any other ideas or advice on how to target this?…
By Pam Marshalla
Q: Do you think that clients really can improve when parents never attend therapy as is common in the public schools? The notion that children only can improve when parents are involved is a modern idea that runs counter to the way therapy has been practiced throughout the past century. In 38 years I rarely have involved parents all the time. I have parents watch parts of therapy when they are around, and I give them encouraging information about how…
By Pam Marshalla
Q: I am working with toddlers for the first time after a 10-year career with elementary school children. They are different! Can you guide me? This is what I would tell a graduate student–– With a toddler, the most important thing to change from therapy with older children is that you have to STOP trying to get him to do what you want him to, and you have to START doing what he is doing. In other words, stop saying,…
By Pam Marshalla
Q: I was at the IAOM convention in the fall of 2013, and I heard you speak on oral stability. You used your hands to describe the difference between oral strength and oral movement patterns. Can you post it here? I would like to share it with my colleagues and I can’t remember what you said. This is probably the best way I have discovered to describe the difference between movement patterns and strength of movement. Hand Movement vs. Hand…
By Pam Marshalla
Q: Could you talk about young kids with articulation disorders who demonstrate significant jaw sliding? What causes this when there is no neuromuscular problems? Jaw sliding left and right pulls the tongue laterally away from its alignment with the palate. This causes articulation of the tongue to the palate to be off and this distorts sound quality. Treatment is to stabilize the jaw at midline. There is no telling why these things occur. All movements are asymmetrical to a certain…
