Evaluation Archives - Page 5 of 8 - Marshalla Speech & Language

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Language Therapy with a Blind Child

By Pam Marshalla

Q: I just was assigned a three-year-old child who is blind and who has no expressive language. I have never worked with a child like this before. I am looking for general guidance. I am not an expert on working with blind children, but I have some experience and these are my thoughts–– Blindness effects language development in certain ways mostly by limiting the child’s experiences and related vocabulary and concepts. How does he develop concepts of size and space…

Epenthesis

By Pam Marshalla

Q: I am so happy to have found your website and blog. I shared the post you made about not stressing out over kids putting extra schwas at the ends of syllables (epenthesis) with all my coworkers at our speech clinic and they loved that advice. I can’t tell you how many goals have been written in this clinic to avoid that process and I feel relieved that I can spend less time worrying about it and more time worrying…

Denying Lisp Services in the Schools

By Pam Marshalla

Q: My friend’s daughter has a lateral lisp and has been denied services in her school because “it does not affect her ability to learn the curriculum.” I was alarmed and upset by this. Is it possible that certain school districts do not treat this? What is your stance on this? Unfortunately there now are many school districts that hold this policy. Frankly, it makes me sick. If I were a parent I would be screaming about this. Sometimes a…

Familial Lateral Lisp

By Pam Marshalla

Q: Should a lateral lisp be treated for a three-year-old when it is present in the speech of a parent? Maybe it will not be outgrown? I always treat lateral lisp as early as possible because I do not believe that it is ever outgrown. The lateral lisp is a deviant sound, not a delayed sound. Therefore more time will not necessarily make it go away. If anything, the lateral lisp seems to get more habituated as the child gets…

Drilling on Correct Words

By Pam Marshalla

Q: In your presentation called Improving Intelligibility in Apraxia and Dysarthria you mentioned that it is important to practice phonemes that they can do, rather than phonemes they can’t do. Why is that? That’s a good question! Van Riper and other old-time SLPs said that about 75% of every therapy session should be a rehearsal of things the child can do correctly, and about 25% should be material that is new, unfamiliar, and challenging. Most SLPs today spend most…

When to Begin R Therapy

By Pam Marshalla

Q: While I understand that every case is different, as a general rule, at what age do you consider it appropriate to target R when it is the only error? I have taught R to one- and two-year old children, so I know it is possible to do very young. However each therapist must address this question relative to his or her employment situation. Therapists in private practice often see these kids at 4 and 5 years of age. Therapists…

Convincing Parents Who Deny Lisp Therapy

By Pam Marshalla

Q: I am aware that a lateral lisp is not considered a developmental error and that it probably will not be outgrown. But I have had parents decline therapy for their six-year-olds saying that they don’t hear it, or telling me that the child does it only when his is excited. Do you have any advice for educating parents about this type of speech error and helping convey the importance of therapy? Most SLPs are not trained in counseling parents…

Maturation as a Therapy Strategy

By Pam Marshalla

Q: Do you think that physical maturation alone can be all that a particular client may need to help his speech improve? Yes, clearly some children outgrow their speech problems. But the only way to know this is to let time pass without therapy. I sometimes recommend that a child go 6-12 months with no therapy to see what happens. I make sure the parents know that I am doing this and why. Often the parents and I alone, or…

Lateral Lisp and Young Kids

By Pam Marshalla

Q: How young do you see children with a lateral lisps? Most SLPs leave the lateral lisp alone until age 6-8. However, I and many other therapists address it earlier with children 4 and 5 years of age. I work on the following with younger kids– I make sure that T and D are midline and not lateral. If they are lateral, I straighten them out. I use a straw for this– They produce T into the straw held outside…

Recommendations for Polymicrogyria

By Pam Marshalla

Q: My client is a five-year-old with polymicrogyria. He drools severely, eats only purees, basically is non-verbal, and has a non-verbal IQ of about 85. He is labeled as apraxic. Can you give me advice on how to proceed? I had not heard of this disorder, so I Googled it and found quite a bit under “polymicrogyria ” and “children with polymicrogyria.” Apparently it is a developmental malformation of the human brain characterized by an excessive number of small convolutions on the…