Tag: Jaw

Down Syndrome: Keeping The Tongue Inside

By Pam Marshalla

Q: How can I get my client with Down syndrome (DS) to keep her tongue inside the mouth during speech? A client with Down syndrome has low tone, dysarthria, and lack of oral stability. The oral mechanism is supposed to be stabilized in a certain way during speech.  The jaw should move up-and-down in a very small restricted range that is high, and the tongue should anchor its movements in the back against the back lateral teeth or palate. Children…

The Schwa… Then What?

By Pam Marshalla

Q: My client can produce only the schwa––“Uh.” He is 3-years-old and pretty smart. But he cannot imitate any consonants or vowels at all. What can I do? This is what I would be thinking about––– Teach him to prolong the sound he has––the schwa. And teach him to tolerate your hands on his jaw. Once he can prolong his schwa and tolerate your hands, move his jaw up-and-down while he is vocalizing. If he can prolong his sound while you…

Stabilizing the Jaw: Best Method for Articulation Therapy

By Pam Marshalla

Q: My client has a cross bite and his jaw lateralizes to the right causing overall speech imprecision. I am holding his jaw in place with standard jaw stabilization I learned for feeding therapy, but it’s not working. His jaw slips back out of position as soon as I remove my hand. That kind of “hands on” jaw stabilization procedure is good for feeding therapy, but is not effective for speech for the very reason you mentioned–– because as soon…

Tongue Stability

By Pam Marshalla

Q: How do you stimulate for tongue stability at the back-lateral margins when a child is too young to understand what you are talking about? That is a great question.  The position of tongue stability is the same as Long E, as in the word “bee.” So with the little guys, I don’t try to explain it. I just over work Long E for a very long time.  These are the types of things I do: Overwork the diminutives: kitty,…

Low Tone and Mild Artic

By Pam Marshalla

Q: My teen client has low tone, mild articulation problems, problems with intelligibility, and imprecision of articulation (interdental lingua-alveolars, F/Th, and distorted R). He has a slack jaw and forward tongue posture at rest. His tongue appears flaccid. Cognitive skills are okay. I went to your class called 21st Century Articulation Therapy and am trying to figure out which methods to use to address low tone in speech. Also what should I do about the tongue thrust? In terms of…

Tapping the Tongue to Stimulate the Lingua-alveolars––T, D, N, L

By Pam Marshalla

Q: My client backs every lingua-alveolar phoneme. He can do a rudimentary L once in a while, but he substitutes k/t, g/d, and ng/n all the time. What can I do? You probably are trying to get your client to elevate the tongue-tip to learn T, D, N, and L. This is to assume that the child can be taught to produce these sounds in the adult form. You have to revert back to teaching your client how to produce…

Outgrow jaw instability?

By Pam Marshalla

Q: My four-year-old client has apraxia and jaw instability. The mom wants to know if jaw stability will improve on its own. There is no way to know that. Certainly jaw stability improves with time, but it may not improve in this child without help. He is developing oral motor patterns that may stay with him until he receives therapy to change them. He should have jaw stability by now, so the question is, why doesn’t he? Whatever is preventing…

Getting the Mouth to Open

By Pam Marshalla

Q: I have a preschool client who talks with his mouth closed. He can imitate me when I model an open mouth posture, but he always closes it when he says a word. I know that he is struggling with motor planning, but I just don’t know where to go from here. Any advice? This client can open his mouth, meaning that the mechanics are good. He also can imitate the posture, meaning that he has control over this movement….

What is Oral Stability?

By Pam Marshalla

Q: You use the phrase “lack of stability” in relation to oral motor function. What do you mean by “stability”? I will have a full chapter on oral stability in my next book to be called The Marshalla Guide to 21st Century Articulation Therapy. Until then, the following is something I wrote in an article for the Oral Motor Institute: Stabilize Oral Movements To stabilize is “to make or become stable” (Jewell & Abate, 2001, p. 1656) or “not likely to change”…

The Jay Leno Effect

By Pam Marshalla

Jay Leno's profile

Q: Does your explanation of techniques to address jaw and tongue stability pertain to clients with the Jay Leno phenomenon? Does the E technique help those kids with lisps related to this facial structure? Techniques to address oral movement are for oral movement problems. As you have noted, Jay Leno has an oral structural problem, too. Structure and function are addressed differently together. I have never worked with Leno, so my analysis of his situation is cursory and speculative, of…