By Pam Marshalla
I was recently reminded of a client I worked with decades ago who taught me a very important lesson about therapy when I was a young therapist. I wanted to share his story. David David was 6;0 and non-verbal. He was a big clunky kid with fine and gross motor problems who was basically untestable, and everyone thought he had very low IQ. I was using Bliss Symbols with him (it was 1976) to develop a home-made communication board (before…
By Pam Marshalla
I recently attended a seminar on apraxia taught by David Hammer, SLP. It was fabulous and I highly recommend it to all my readers! David uses a combination of verbal cues, object cues, and gestural cues together in his work with apraxic children. He bases this speech training on the theory that children with apraxia need a multisensory approach that focuses on phoneme sequencing. The verbal cues he uses are names and phrases that describe the outstanding place, manner, and…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in September, 2011. Download the original PDF here. *** Making Speech Targets Salient Classic Auditory Training Tools for Amplifying Speech By Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Making Speech Targets Salient One of the most important things we do in articulation therapy is to make speech units stand out so the client can focus on them. Our most important tool for making speech units salient is our own…
By Pam Marshalla
Q: I am a SLP graduate student looking for some evidence-based practice to implement for a client diagnosed with childhood apraxia of speech. I watched the YouTube videos of your hand cues for placement, and I think they would work great. I was wondering if you had any research to support these cues, or if you obtained research elsewhere to support them. A therapist doesn’t look for an evidence-based practice: A therapist creates one. The EBP is formed when a…
By Pam Marshalla
Q: Do you have any suggestions for slowing the rate of speech in an elementary school child? Rate is all about the number of syllables produced per unit of time. Therefore focus on syllables. This is what I do. I call it “Pencil Talking”–– The child and I each hold a pencil with a good eraser. We engage in general conversation, or we talk about speech. We tap our erasers on the table to mark each syllable as we talk….
By Pam Marshalla
Q: How do you teach L for a client who cannot do it at all? These are the types of things I do in whatever order fits the needs of the client: Primitive Movement Teach a primitive L that is made with jaw movement. Have the client stick out his tongue-tip so that it sits between the teeth, and then have him move the jaw up-and-down. This is going to sound and look like the way a baby “lolls” –…
By Pam Marshalla
Q: I have a six-year-old male client with severe apraxia who lacks many phonemes. I am trying to cue him for place and manner at the mouth, but he is very resistant to my touch. For example, I want to hold his nose to teach him how to make his sounds come out his mouth, but he won’t let me. Any suggestions? Let me answer this in terms of what is the easiest ways to handle oral-tactile hypersensitivity: The easiest…
By Pam Marshalla
Q: My son is 9 years old and has been diagnosed with autism and apraxia. He is non verbal and low-to-medium functioning. We are trying to determine the best methodology to help him talk more. I read a lot about your Apraxia experience but nothing about your experience with Autism. Since my son has Autism as well I was hoping if you could give me your expert opinion on what to do as I am trying to determine what is…
By Pam Marshalla
Q: We have a 7-year-old son who has a diagnosis of moderate autism. About a year ago it was suggested that he has apraxia as well. He is completely nonverbal. We have read Becoming Verbal with Childhood Apraxia. Using some of your suggestions, he now imitates about four sounds. It is so frustrating because as soon as we get him to imitate a sound, he loses mastery of an old one – one step forward, one step back. He attends…
