By Pam Marshalla
Q: My male client is age 6. He has average intelligence, CP, and cleft palate. He was pre-mature and is non-verbal. He has been using an iPad with communication app “Words for Life” very successfully. He drools, can’t blow, barely moves his mouth, etc. He makes random vocalizations. Any ideas? This child represents some of the most severe we see. This is severe apraxia and dysarthria, with cleft palate thrown in just to make it interesting. Let us state bluntly…
By Pam Marshalla
Q: I have a new referral for a 4-year-old client who has had several cleft repairs and prior therapy. Per his last report his only speech error is a lisp but I also saw in his mom’s referral info that he has some feeding problems and is sensitive to certain food temperatures and consistencies. Could his atypical sensory and chewing issues be factors in his interdental error pattern? Do you have suggestions for evaluating and treating this child? His mom…
By Pam Marshalla
Q: I work with infants and often reference the developmental material you present in Apraxia Uncovered. I have a little fellow with an unrepaired cleft palate. He is doing all the skills prior to raspberries and none after. Should I stimulate the raspberries with him? Are raspberries possible with an unrepaired cleft? How much intraoral pressure is needed for them? I have not worked with babies like this, so I don’t really know the answer to any of your questions. I would…
By Pam Marshalla
Q: I have a 15-months-old client with a repaired cleft palate who drools. Should I be working on the drooling issue? It is normal for a child to drool now and again until age three or so. I would not be concerned about the drooling unless the child was drooling profusely most of the time. If she were drooling most of the time, I would look at her feeding skills. Most children who drool to excess have feeding/swallowing issues as well….
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…
