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

Tag: Evaluation

Prosody Goals

By Pam Marshalla

Q: I’m wondering what kind of goals you would write for targeting prosody. How do I make it measurable? Prosody entails projection, rate, rhythm, stress, pause, pitch, intonation, and cadence. I would write separate goals for each area impacted. In terms of measuring success before and after, I would take measures where possible. For example, I might count the number of words the client speaks per minute and compare that to the old norms. Where measures like that are not…

Giving a Prognosis to Parents

By Pam Marshalla

Q: What do you say to parents who want to know how much longer speech therapy will continue? I have been seeing an 8-year-old boy for two years for auditory processing, and for both receptive and expressive language skills. He is making good progress but could honestly be in therapy for a few more years. It sounds like this client may never have “normal” speech and language, and he could use help for as long as he can get it….

Quick Dismissal on /r/

By Pam Marshalla

Q: I saw a client with /r/ problems and dismissed him after he could produce /r/ with reminders on picture-naming tasks. I saw him again a year later and his /r/ had deteriorated. Should this have happened? Should I put him back in therapy, or do you think that this will take care of itself? What I have done with these kids is the following: You let him go too quickly. Never dismiss a client until the process of articulation…

Age for Frontal Lisp Therapy

By Pam Marshalla

Q: Age what age should a child with an isolated Frontal Lisp be seen for therapy? When to see a child with a frontal lisp is a controversial thing. We CAN help a child like this from the age of two and older. But most SLP’s still hold off until they are older. Most school districts do not let a child like this enter therapy until age 7, 8, or 9 years of age. In a private practice, one can…

Big Tongue

By Pam Marshalla

Q: How can you tell if a client’s tongue is too big? Usually a tongue that looks too big actually is a tongue that is low in tone. These clients usually have an unstable jaw and an unstable tongue. I.e., the jaw is low and the tongue is low and forward. The client also may have upper respiratory problems that are forcing him to keep the mouth open and carry the tongue forward in order to create a bigger oro-pharyngeal…

Fear in Labeling Motor Speech Disorders

By Pam Marshalla

Q: This seems perhaps silly, but I have to admit that I am afraid of labeling a client with apraxia or dysarthria. Perhaps it is because I took no formal class on motor speech disorders while I was in college, and I have had to piece information together myself. Can you advise me? I too was afraid of motor speech for years. In fact people asked me to speak about it for some 20 years before I felt brave enough…

Speech Therapy Exit Criteria

By Pam Marshalla

Q: I have heard you say that although most school districts seem to have excellent entrance criteria for therapy, they tend to have very poor exit criteria. Could you speak to this in regard to a client’s willingness to participate and in regard to cognitive level? Because I have been in private practice for 25 years, I have not had to agree with anyone on exit criteria, and therefore I have taken it on a case-by-case basis. In all honesty,…

Writing Oral Motor Goals for Therapy

By Pam Marshalla

Q: What is your opinion about writing goals for oral motor exercises when a client has a functional articulation disorder? My training would suggest that working on oral motor skills is appropriate only when there is a motor speech disorder. When asked how to write OM goals, I say, “Don’t write OM goals!” Oral movement is not your goal. The speech sound production is your goal. Write speech goals. Speech is movement. Whether you are working with clients who have…

Is a Diagnosis of Apraxia Necessary for Therapy?

By Pam Marshalla

Q: Is it necessary to get a diagnosis of apraxia with a young child who does not talk, or can we just proceed with therapy? The answer to that depends upon the rules and regulations of your treatment center or school, and whether or not insurance providers are involved. But in my opinion, as far as the actual therapy is concerned, you do not need a diagnosis to start. Just start. Time in treatment will tell you increasingly more about…

Diagnosing Toddler with Apraxia?

By Pam Marshalla

Q: One doctor says my two-year-old daughter has apraxia and another does not believe so. Can you tell me what is going on here? I am afraid that you have entered the “apraxia twilight zone.” The subject of apraxia in children is a controversial and confusing one. First, some professionals insist that apraxia in children does not exist. Others insist it does. Since we have no formal way to diagnose the problem medically (e.g, no CAT scan) the diagnosis is…