By Pam Marshalla
Q: This seems perhaps silly, but I have to admit that I am afraid of labeling a client with apraxia or dysarthria. Perhaps it is because I took no formal class on motor speech disorders while I was in college, and I have had to piece information together myself. Can you advise me? I too was afraid of motor speech for years. In fact people asked me to speak about it for some 20 years before I felt brave enough…
By Pam Marshalla
Q: Can you explain the PROMPT method you mention in your class on apraxia and dysarthria? PROMPT is short for the system called “Prompts for Restructuring Oral Muscular Phonetic Targets” developed by Deborah Hayden. It is a tactile cueing technique for phoneme production. The trainer uses hands-on tactile cues – she touches on and around the client’s mouth – to shape the mouth for speech sound production. On their website, the PROMPT method is described as: “the systematic manipulation of…
By Pam Marshalla
Q: I have an 8-year-old student, in a regular second grade classroom. She can say a few words and carries a diagnosis of apraxia. She is below average in intelligence. The parents are insisting on sign language training only and are refusing other forms of augmentative communication – computer, pictures, etc. She can do up to five signs in sequence with prompting, but verbal speech is not coming along. She is failing further and further behind in academics because of…
By Pam Marshalla
Q: What is your opinion of PROMPT? I have a parent that believes that this is the only method to use with her apraxic child. I have tried to explain there are other methods to try. I am not PROMPT trained because of the time and expense. I also have not been formally trained in PROMPT, but I have seen it in action. It is a very good approach, perhaps one of the best for apraxia. But it is not…
By Pam Marshalla
Q: Your book, Apraxia Uncovered, describes seven stages of vocal development. If my son can only do 80% of Stage One, should I proceed with Stage Two? Or do I wait for him to be able to do 100% of Stage One before moving on to Stage Two, even though he is able to do some of the items already in Stage Two? The stages overlap. Many children learn a little bit of this and that from each stage without…
By Pam Marshalla
Q: How often should a young child (2-4 years of age) with apraxia or dysarthria receive speech-language therapy services? I have a baseline that all my clients with motor speech disorders have to meet. They must attend once per week for one hour at a minimum. Twice per week is very nice. Three times per week is a complete luxury. More than that is unnecessary because these children do not change very fast. Children with motor speech disorders take a…
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: 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
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…
