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 received a referral for a 15-month-old diagnosed by a private SLP with apraxia. The child has excellent receptive language and produces 10-15 words. I was told that the child was an “automatic qualifier” coming in with the diagnosis of apraxia. I have huge reservations with this and do not feel as if the diagnosis was made appropriately in just in one session and not over time. There are no indications of motor difficulties elsewhere. Am I out in…
By Pam Marshalla
Q: My 2-year-old daughter has to get her four front teeth extracted because of decay. The doctor told me that there could be speech disorders. She doesn’t speak as much as other kids of her age and she started walking a little late. After these teeth are extracted I am worried that she is going to stop trying to talk and become even more timid. What can I do? You have two things going on that have different impacts on…
By Pam Marshalla
Q: Do you know if chewing tools are effective in correcting open mouth posture in a 2-year-old? Is there any research on this? The question reveals that you are assuming too much one-to-one correspondence between methods of oral stimulation and results. Chewy tools are designed to facilitate up-and-down jaw movements, and to increase the amount of time a client keeps his jaw in the “up” position. That is all they will do. To assume that chewing on a chewy tool or…
By Pam Marshalla
Q: Would you work on a lateral lisp in a 3-year-old? How? Most therapists would not treat a lateral lisp in a 3-year-old, but one could, and some do. Use the “Long T Method” and make it playful. Hold one end of a straw in front of the central teeth and have the child make a T. The airstream should go into the straw and amplify. Now make it “longer” — aspirate it. It won’t sound like “S” but it…
By Pam Marshalla
Q: Do you have any tips for promoting good /r/ and /l/ in toddlers? Not to correct the phonemes directly, but to set the child up for future success by doing certain oral activities? Most would agree that we do not have to correct R and L in toddlers, but the idea that we can set them on the right development path is right on. This is what I do to set a child on the right developmental path for…
By Pam Marshalla
Q: I just started working with toddlers and preschool children and my colleague says that you can’t do an oral-peripheral exam on these little guys. What do you say? Do you do it and if so how? An examination of the oral mechanism’s structure certainly can be done on little kids. Come on people! Let’s get creative! I do oral exams on all clients regardless of age. With infants I just poke around in there and prop the mouth open…
By Pam Marshalla
Q: My client had a xyanotic episode at 4-days of age. She had no verbal language until about 24 months. She is now 33 months and is talking quite a bit with delay. But what is throwing me for a loop is that she has changed “mommy” from “Mee-mee” to “Mah-mee” and now to “Hah-mee.” She also substitutes H for other M words. I’ve never seen this. Can you explain it? I don’t have all the info I would need…
By Pam Marshalla
Q: Have you ever seen a child add final consonants to words that don’t need them? My 3-year-old male client adds T to the end of everything. I have seen this with a few kids who used a few different phonemes: T and S mostly. I usually consider it overgeneralization of their new knowledge about final consonants, and I don’t worry about it. I do not believe that I ever had to do anything about it, and I just let…
By Pam Marshalla
Q: My client can produce only the schwa––“Uh.” He is 3-years-old and pretty smart. But he cannot imitate any consonants or vowels at all. What can I do? This is what I would be thinking about––– Teach him to prolong the sound he has––the schwa. And teach him to tolerate your hands on his jaw. Once he can prolong his schwa and tolerate your hands, move his jaw up-and-down while he is vocalizing. If he can prolong his sound while you…
