By Pam Marshalla
Q: I am seeing a 5-year-old male with interdental S, T, D, N, and L. He can say every sound correctly when reminded to keep back teeth together. Do I address all sounds at once or just S first? Should I still do cornerstone approach since he is stimulable or just work on drill and carryover? As you know, each child is different. This is the process of trial and error. You will have to figure out what works best…
By Pam Marshalla
Q: My student has very uncoordinated oral movements and severely unintelligible speech. He is unable to elevate his tongue-tip, and therefore does not produce any alveolars. His S and Z are very frontal––like Th––and he reduces S-blends. How do I teach alveolars, and do I concentrate on S-blends or correct production of S and Z? Your client requires a whole semester class on how the body works, and how that plays into speech movement development. Questions like yours are the…
By Pam Marshalla
Q: I have an elementary client who figured out how to say R all by herself, but she shifts her jaw to one side to accomplish it. I have tried to get her to stop lateralizing the jaw, but then she can’t produce R. Should I worry about this? I would not try to take her away from what she has achieved on her own. She is proud of it! Instead, let her keep producing the R with the jaw…
By Pam Marshalla
Q: I am working on my master’s thesis on a topic related to the basis of articulation and the neutral/starting positions. I would like to expand my research beyond the linguistics domain into the neighboring fields of speed physiology and therapy. I read your notes “The Roles of Oral Rest Posture and Neutral Position in Articulation” and would like to cite it. Have you published it anywhere? Perhaps you have mentioned starting position in your other publications? I am currently…
By Pam Marshalla
Q: I have a third-grader who has a frontal lisp on /s/ and /z/. He has an underbite and produces these sounds with his tongue contacting the inside of his upper teeth. Should I discontinue therapy until he is seen by an orthodontist or is there something I should be doing in the meantime to help him compensate for his jaw and tongue positioning? I am really not sure if he’s capable of a more retracted tongue position or if…
By Pam Marshalla
Q: I have heard you say that jaw sliding to the left or right can cause one type of lateral lisp. I have also heard you say that this type of jaw instability is seen in children with dysarthria. Are you saying that a lateral lisp is a form of dysarthria? Excellent question! No. I am not saying that a lateral lisp is a form of dysarthria. I am saying that clients with expressive speech deficit often have problems in…
By Pam Marshalla
Q: I am a professor and clinical supervisor in a prestigious university program. I do not see jaw or tongue movement problems in the articulation and phonology clients I supervise. Are you saying that someone like me does not have good observation skills? No. I am not saying that you have poor observations skills. I am saying that you have not been trained to see what is happening right in front of you. Consider this: An SLP must go through…
By Pam Marshalla
Q: How do you teach L for a client who cannot do it at all? These are the types of things I do in whatever order fits the needs of the client: Primitive Movement Teach a primitive L that is made with jaw movement. Have the client stick out his tongue-tip so that it sits between the teeth, and then have him move the jaw up-and-down. This is going to sound and look like the way a baby “lolls” –…
By Pam Marshalla
Q: I have a client in grade five who has a frontal lisp. She can make a good /s/, but her jaw slides forward when we do word and sentence drills, and when we engage in conversation. The speech work, especially conversation, seems too fast to allow for her to get her jaw in the right position to keep the tongue in. Suggestions? Your client already can do a correct /s/ with a good jaw position, but she is not…
By Pam Marshalla
Q: My client had a frontal lisp, but when I taught him to keep his tongue behind his teeth, he switched it to a lateral lisp. Have you seen this? What should I do? I am going to answer this question as if you already have taken my class on the lisps, or you have read my book Frontal Lisp, Lateral Lisp… I think it is somewhat common for a child with a frontal lisp to switch to a lateral lisp…
