Evaluation Archives - Page 4 of 8 - Marshalla Speech & Language

Tag: Evaluation

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…

Starting Over in Apraxia Research

By Pam Marshalla

Q: I have heard you complain about research in the area of apraxia. Why do you think it is so poor? Think about this: APRAXIA occurs in the ABSENCE of neuromuscular disorder while DYSARTHRIA occurs in the PRESENCE of neuromuscular disorder. Now think about this: ALL the research in speech that has been done on apraxic kids since the beginning of time has been done without any assessment of their muscle tone. Researchers have just been assuming that tone is…

Differentiating Between Apraxia and Dysarthria

By Pam Marshalla

Q: What would to do in an evaluation to differentiate between CAS and dysarthia? Specifically would you rule out muscle weakness? The definitions of apraxia and dysarthria speak for themselves–– APRAXIA is a motor speech disorder that occurs in the ABSENCE of neuromuscular problems. It is a problem in the perception of movement, and therefore it causes problems in planning movement. The result is severe articulation and phonological deficit. DYSARTHRIA is a motor speech disorder that occurs in the PRESENCE…

Low Tone and Speech Therapy

By Pam Marshalla

Q: My client has low tone and many deviant phonological processes. Is this common? Does this mean he has dysarthria? How should my treatment look different from traditional articulation or phonological therapy? Yes! If the child has hypotonia then this is dysarthria. Whenever you have muscle tone problems of a global nature, then dysarthria is the diagnosis. Dysarthria is a speech movement problem that is the result of muscle tone disturbance. (See definitions below) It is common for children with…

Is a Frontal Lisp Outgrown?

By Pam Marshalla

Q: My 4-year-old son has a frontal lisp. The school is refusing services and says he will outgrow it. Is this true in all cases? No one that I know of is researching this area any more and there are big questions like this one that are going un-answered. There seem to be two types of frontal lisps. The first is an immature speech pattern that will go away with time––by 7-9 years of age. The second is the result…

Whining Toddler

By Pam Marshalla

Q: I am working with a child 2;6 who substitutes /n/ or /m/ for many other consonants. We have worked with words she says often, and she can make the correct sounds in words with a model, but talking on her own she just sounds like she is whining. Two-year-olds can be so variable, and what looks like something very severe can turn out to be nothing. She simply may be jargoning, and her jargon happens to sound like whining. …

Let Toddlers Make Toddler Errors

By Pam Marshalla

Q: I am an SLP and cannot figure out how to remediate my own 20-month-old daughter’s speech problem. She is very expressive, has unlimited vocabulary, is speaking in 4-word sentences, and has above average articulation. She recently developed a cold which is now gone but as a result she is now producing L in place of N in all word positions. She is saying “Lo for “no” and “Bel” for “Ben.” She had this correct before. How should I correct…

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. …

Transcribing a Frontal Lisp

By Pam Marshalla

Q: How do you transcribe a frontal lisp? There are many ways to designate a frontal lisp– Some therapists do like to write it as Th/S (using IPA symbols, of course.) Some place a right-facing arrow under the phoneme, to indicate that the tongue is protruding forward. Some draw a circle between a downward-facing caret and an upward-facing caret, indicating the tongue is between the upper and lower teeth. Some simply write D for distorted, but I think that is…

Misdiagnosing Mild Dysarthria as Apraxia

By Pam Marshalla

SLPs often overlook the diagnosis of mild dysarthria. This therapist’s letter perfectly describes such a client. My answer below summarizes the problems and offers links to treatment. Q: I was hoping you could provide some guidance for me with a student I am evaluating. She is 11 years old and has been in speech for R, L, S, Th for several years. I met her for the first time this week when I began her re-evaluation. The SLP who has…