By Pam Marshalla
Q: My client is having trouble with L. When he makes his L it sounds as though he is forming some type of constriction in the far back of his mouth. It almost sounds like a glottal stop, but it is not that far back. He can hear the error but cannot change it. This has been called a “Retroflex L”. It means that the client is lifting the back of his tongue instead of the tip of his tongue…
By Pam Marshalla
Q: In a few of your blogs you mention that sometimes we have to teach a client to suppress his gag reflex. Why would you need to suppress the gag, and how does one go about doing it? The gag needs to be suppressed only if it is interfering with oral motor learning for speech and/or feeding. Severe Cases In the most severe of these cases, excessive gagging causes children to be unwilling to move and explore with the mouth. …
By Pam Marshalla
Q: One of my second graders is making no progress on R. On closer inspection, I noticed his tonsils are huge. He also can put the Nuk brush way back on his tongue with no gag reflex. Is his lack of gag and large tonsils related to his slow progress? Lack of a gag reflex can indicate poor oral-tactile sensitivity and awareness, meaning that the client has a very high threshold of sensitivity and may have difficulty perceiving what is…
By Pam Marshalla
Q: My colleagues and I are wondering how you go about stimulating elevation of the back of the tongue for [+Back] phonemes? The very best way to facilitate upward elevation of any part of the tongue, including the back, is to apply a bit of pressure downward at the spot you want to elevate, and to ask the client to push up against your pressure. Use a finger, tongue depressor, Nuk massager, or any other appropriate tool. This is the…
By Pam Marshalla
Q: What can we do to make the back of the tongue elevate for /k/ and /g/? We can use the Tongue Retraction Response (TRR) as follows: Tactile stimulation down the midline of the tongue from anterior to posterior causes the entire tongue to retract back and up toward the velum. The response occurs about half-way down the tongue, and is elicited after the Tongue Bowl Response (TBR) and before the Tongue Gag Response (TGR). I also have called the…
