Dysphagia Archives - Marshalla Speech & Language

Tag: Dysphagia

Does an SLP Need a Background in Orofacial Myology?

By Pam Marshalla

Q: Do SLP’s need a background in orofacial myofunctional therapy? I am not a certified orofacial myologist, but I have taken many seminars on the topic. I attend their conventions periodically, and I read and have written for the IAOM Journal. I have found that concepts from orofacial myofunctional therapy have been very useful to me as another way to gain a broad perspective of oral movements. Throughout my career I have combined concepts from orofacial myology, feeding development and therapy, and…

My Heros in the SLP Profession

By Pam Marshalla

Q: I heard you say that Van Riper was your greatest hero of all time in the profession, but then you said you had others that you didn’t mention. Who else do you admire in the field? What an interesting question! Okay, here are the people that have been the most influential to me, presented in categories that are the most important to my work. Articulation The one-and-only Charles Van Riper wins this top place of honor because he is…

The Roots of Oral-Motor Therapy: A Personal View

By Pam Marshalla

This opinion paper was originally posted as a downloadable PDF on my website, authored in March, 2011, and revised in April, 2011. Download the original PDF here. *** The Roots of Oral-Motor Therapy: A Personal View By Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Time The 1970’s was a time when SLP’s begin to work in multidisciplinary and transdisciplinary teams with OT’s, PT’s and other professionals. For the first time, SLP’s and motor specialists were sharing their thoughts and ideas regarding therapy with…

The Tools of Articulation Training

By Pam Marshalla

Q: I am confused over the term NS-OME (Non Speech Oral Motor Exercises). Some people are saying that we cannot use things like toothettes, bite sticks, whistles, or straws in therapy. I use many things like this in therapy. Shouldn’t we do whatever we can to help our clients learn to make speech sounds? Your question is a good one. Yes, we are supposed to use whatever we can to help our clients learn to produce speech sounds. Van Riper…

Tongue Bowl Reflex (History and Definitions)

By Pam Marshalla

Q: I have been reading some of your material, and I am wondering if you can tell me where the term “Tongue Bowl Reflex” comes from? I made up the term Tongue Bowl Reflex and Tongue Bowl Response. In the 1970’s, the term “tongue bowl” was floating around among therapists who were involved in feeding, dysphagia, and oral-motor. I knew that the tongue bowl was a reflex from various readings I was doing, and I realized that no one had…

Lip Trainer

By Pam Marshalla

Q: Do you know anything about the Lip Trainer? Do you think it has any uses in articulation therapy? I have not used a Lip Trainer, however, it looks just like another version of the Lip Gym, which I have used to increase action of the orbicularis oris (OO). These types of devices can be used to facilitate action of the OO. Two basic methods of muscle stimulation are employed: Stretching and Resistance. Stretching A muscle is stretched to activate…

The Big Picture: Articulation, Orofacial Myology, Swallowing, Motor Speech

By Pam Marshalla

Q: I have heard that we should avoid the topic of tongue-thrust therapy (orofacial myofunctional therapy). I’d like to hear your thoughts on this. In my experience, problems in articulation, orofacial myology, feeding, dysphagia, and motor speech disorders are all the same thing manifested in somewhat different ways and to various degrees. All of these therapies are about facilitating new oral movements and/or fixing incorrect oral movements. I have spent my entire career (since 1975) studying the research, clinical practices,…

Feeding Therapy Techniques

By Pam Marshalla

Q: I am seeing a 4-year-old boy with cerebral palsy. He is pocketing food and liquids on his weaker right side. Choking occurs at home, although we have not seen it at school. What can I do to help? I have had no dysphagia training at all. A feeding problem in a child with cerebral palsy can be a serious issue because the child is in danger of aspiration. I do not give out this type of advice as a…

Stimulating Lip Movement

By Pam Marshalla

Q: What can I do from a muscle-based perspective to engage the upper lip? There have been many methods of stimulating lip movement in the articulation, motor speech, oral motor, feeding, dysphagia, and orofacial myofunctional literature. The following sources are my favorite ones for activities to facilitate lip mobility. [Presented alphabetically] Dworkin, J. P. (1991). Motor speech disorders: A treatment guide. St. Louis: Mosby. Garliner, D. (1981) Myofunctional therapy. Coral Gables: Institute for Myofunctional Therapy. Marshalla, P. J. (1992). Oral…

Oral Motor Treatment and Non-Speech Oral Motor Exercises (NSOME)

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…