Tag: Becoming Verbal

Low Cognition and SLP: Therapy vs. Babysitting and School Culture

By Pam Marshalla

Q: I am very frustrated working in the public school. I am forced to see very low functioning children 2-4 times per week, and even with this much therapy they are not progressing in vocabulary, phonemes, nothing. Am I doing something wrong? Let me be very blunt here. Warning! Those of you who don’t know me need to be warned that I do not speak with political correctness. I find it to be an imposition on our freedom of speech…

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Inconsistent Toddler Talk

By Pam Marshalla

Q: My two-year-old client uses words inconsistently. For example, he only uses “more” when he wants food, and he only says “mama” once or twice a day. Two-year-olds are notoriously inconsistent about everything they do. They go to bed right away one night, and scream bloody murder about it for two hours the next.  You ask them if they want a cookie, they say cookie and take it one minute, and the next they won’t even look up at you. …

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Getting a Two-Year-Old to Talk

By Pam Marshalla

Q: I have a two-year-old client who only says “Mmmm” and “Ahhh.” He won’t do anything for me. How can I get him to talk? First, I would like to refer you to my book called Becoming Verbal with Childhood Apraxia.  I am not trying to sell you a book, but I wrote it precisely for this type of case. It will help you understand how to help little kids become more vocal, verbal, interactive, communicative, and imitative.  It discusses…

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Drilling on Correct Words

By Pam Marshalla

Q: In your presentation called Improving Intelligibility in Apraxia and Dysarthria you mentioned that it is important to practice phonemes that they can do, rather than phonemes they can’t do.  Why is that?   That’s a good question!  Van Riper and other old-time SLPs said that about 75% of every therapy session should be a rehearsal of things the child can do correctly, and about 25% should be material that is new, unfamiliar, and challenging.  Most SLPs today spend most…

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Drilling Two-Year-Olds?

By Pam Marshalla

Q: My two-year-old son has dysarthria. We have been practicing his target words 100 times every day at home, but when he goes to speech sessions, his SLP only has him practice his words a few times. Can you comment on this? I don’t think she is working him hard enough. Drill has its place, but he is only 2 years old! You are giving him more practice than just about any toddler could handle. You do not want him…

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Pierre Robin Syndrome

By Pam Marshalla

Q: My two-year-old son has Pierre Robin Syndrome and cleft palate. He had oral surgery at 6-days of age, and again at 9 months. He makes a few sounds like “Eh-eh-eh,” “Mmmmm,” “Baba,” and “Papapa.” There has been little if any vocal play until just recently.  Receptive skills are good and he signs many words. Can the syndrome be a cause for his delay? I need suggestions. Yes, the syndrome is most assuredly the cause of the delay. Surgeries and…

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Verbal, Augmentative, and Cognition

By Pam Marshalla

Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point.  What I know and what I…

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Advice for Pierre-Robin Syndrome

By Pam Marshalla

Q: Can you give our family advice about stimulating speech, language, and feeding in a 14-month old girl with Pierre-Robin Syndrome? She is making some sounds and is pretty smart. We have read your book Becoming Verbal with Childhood Apraxia and it has helped us understand about stimulating sound and word productions. Although she continues to be fed through a G-tube, she now is eating many different foods orally. Let me just make some straightforward statements about how I would…

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Encouraging a “Real” Voice Instead of a Whisper

By Pam Marshalla

Q: My preschool client uses a whisper instead of a “real voice” when he talks. We are using PECS with him, and he can build sentences up to 5 words. Do you have suggestions for developing his voice? First, he needs to be seen by a physician – an ENT – to determine if there is a medical reason for his lack of voice: nodules, polyps, paralysis, malformation, etc.. You need this so you know what you are working with….

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