By Pam Marshalla
Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…
By Pam Marshalla
Q: I serve a female client with Down syndrome in school. She is bright and has done quite well in articulation therapy, but she cannot produce CH due to a severe underbite. This is her last articulation error. Her inability to say the sound is not due to poor oral control or cognitive issues. She simply cannot make this phoneme correctly because of the occlusal problem, but she is not going to receive orthodontia or oral surgery. The parents have…
By Pam Marshalla
Q: I work at a clinic where my supervisor does not believe in apraxia. She says that all of these children have phonological deficit. What are your thoughts on this? I sympathize with your supervisor in that I too struggled for many years with questions of apraxia–– What is it? How is it diagnosed? How is apraxia different from a severe phonological disorder? The problem we are having is that we have taken the term “apraxia” from the adult neurological…
By Pam Marshalla
Q: I was very excited to get your test, the MOST. Can you explain the scoring system to me? We had to design the Marshalla Oral Sensorimotor Test (MOST) so that therapists who had no prior information about oral-motor assessment could administer and score it. Original Design I originally designed a 7-point scoring system, with one score for Pass, and six different scores for Fail. The seven-point scoring system was designed to reveal subtle differences in oral motor skill between one…
By Pam Marshalla
Q: I still have many high school students that have not corrected articulation errors. How long you continue to try to get these teens to carryover productions into conversation after years of no progress? I would answer your question with a series of questions to ponder about your approach to therapy with these kids. These are the things I would think about: Are you working directly on carryover activities? Are you giving them speech assignments to do outside of therapy?…
By Pam Marshalla
Q: What does an SLP call a distorted /s/ phoneme that whistles, like the gopher in Winnie-the-Pooh? Is it considered a lisp? The term “lisp” has gone through many changes throughout the centuries, and it depends upon whom you read as to what it means. In the 1800’s, some writers used the term “lisp” to refer to any problems with the sibilants. Others used the term to mean any and all speech deficits, including all problems of voice, resonance, prosody,…
By Pam Marshalla
Q: I have worked with a 4-year-old for two years who had a frenectomy about 3 months ago. His speech is quite intelligible now, but he still has heart-shaped tongue, he cannot dissociate his tongue movements from his jaw movements, and he cannot sweep his tongue around lips to clean himself. He stabilizes his tongue with his teeth and can barely extend it beyond lower lip even after surgery. Since speech is good would you still see him for therapy?…
By Pam Marshalla
Q: It seems that every SLP has a different opinion on phoneme development and the age at which sounds should be treated. For example, some SLP’s work on R at age 6 while others wait until clients are age 7 or 8. What is your opinion on sound development? I have been re-studying the developmental articulation norms for the past two years in preparation for my next book, and I have to admit the data is all over the place….
By Pam Marshalla
Q: I need information on evaluating oral-motor skills in school age articulation/phonological cases as well as appropriate oral-motor exercises/goals for educational IEP’s/settings. The only test I know of that will give you a standard score for oral motor skills is my test called the MOST — The Marshalla Oral-Sensorimotor Test. It is available through SuperDuper Publications. The MOST was normed on kids 4;0 – 7;11. It will give you individual scores for jaw, lips, tongue, velum, respiration, phonation, and oscillating oral movements….
By Pam Marshalla
Q: I am an SLP in the schools. Often I am asked to address writing as a language goal. What are your thoughts regarding writing as a language goal? Grrrrrr! We are not “Writing-Language Pathologists,” or “Reading-Language Pathologists,” or “Literacy-Language Pathologists.” We are SPEECH-language pathologists! I hope I was not unclear in this response.
