Evaluation Archives - Page 6 of 8 - Marshalla Speech & Language

Tag: Evaluation

Therapy is On-Going Diagnosis

By Pam Marshalla

Q: Many SLPs write to me with questions about sibilants that are distorted––inter-dental, frontal, whistled, palatal, lateral, and so forth. I have given lots of advice about these errors, but sometimes I can’t. Why? Sometimes I can give no advice for fixing errors on the sibilants because the errors are distorted in such refined ways that there is no way to determine what exactly is going on without seeing and hearing the error myself. If you have taken classes of…

Differentiating “Articulation,” “Oral Motor,” and “Phonology”

By Pam Marshalla

Q: I still cannot seem to explain to colleagues the difference between articulation, oral motor, and phonology. Can you help me one more time? This is the line of thinking I use. It may help you explain these ideas to others–– Movements are used to make phonemes. Phonemes are used to make syllables. Syllables are used to make words. Words are used to make phrases. Phrases are used to make sentences. Sentences are used to make paragraphs. Words, phrases, sentences,…

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…

Frequency of Therapy

By Pam Marshalla

Q: How often do you see your clients? I always set once per week as my “must have” level. That is unless they are only on consult, follow-up, or the later stages of carryover. Over 35 years, I have found that once per week is sufficient for most kids, both the easy kids and the low functioning ones. Easy kids can do perfectly well with once per week, and low functioning clients do not move fast enough to warrant more…

Apraxia and Dysarthria and Real Oral Motor Therapy

By Pam Marshalla

Q: Would you agree with the following statement: Children with apraxia will respond to structured production of increasingly difficult syllable shapes, while children with dysarthria need supplementing with oral motor exercises to address muscle weakness. Before I answer your question, let me say a few things about “muscle weakness” and dysarthria because many SLPs––including professors of articulation and phonology––do not seem to understand this area very well. The muscle weakness seen in dysarthria can have many different causes, and the…

Labeling Toddlers with Apraxia or Autism

By Pam Marshalla

Q: My son is 2 years and 2 months, and he jargons mostly. His therapists can’t seem to figure out if this is apraxia or autism. Why is this? It can be very difficulty to determine if a child has autism or apraxia when they are under three years of age. This is because so many of the problems overlap. Both disorders cause the child to be non-verbal or minimally so. Both cause much refusal to follow directions and answer…

How Long to Fix a Lateral Lisp?

By Pam Marshalla

Q: How long should it take to establish midline airstream when a client has a lateral lisp? This depends upon what you are talking about. Are you trying to figure out how long it should take you to obtain the client’s first midline sibilant, or to finish the entire program? To be very honest, an SLP with no specific training on how to treat a lateral lisp may NEVER figure out how to get a correct set of midline sibilant…

Phonological Policies

By Pam Marshalla

Q: My school district has been suggesting that we work on stopping before s-clusters, and I thought that would be a mistake leading to lots of frustration for both the SLPs and the students. Do you have any comments? I think that whenever we set policy –– “my district has been suggesting that we work on stopping before s-clusters” –– we are forgetting the individual child. There is no hierarchy or policy that should “work.” What “works” is what works…

When “Ate” sounds like “Hate”

By Pam Marshalla

Q: When my 4-year-old client says a word that begins with a vowel, he adds /h/ before it –– “Ate” sounds like “Hate.” What are your thoughts? Let me answer this according to four different scenarios –– 1. Client generally uses no frication at all: If the client was not yet using any fricatives or affricates, and the extra appearances of H were just a fluke, then I would stimulate all eleven sounds for a while till the whole set…

Need for Differential Diagnosis

By Pam Marshalla

Q: I have a six-year-old male client that has phonological and articulation problems. What should I target first in therapy? Therapy always is based on the differential diagnosis. It is impossible to answer that question without information about the client’s entire phonological and articulation repertoire. Selection of therapy targets will be very different depending upon many factors. One makes decisions about therapy based upon a complete overview of what is going on. If you read through this blog, you will…