Jaw Archives - Page 4 of 5 - Marshalla Speech & Language

Tag: Jaw

Tongue Suctioning vs. Tongue-tip Elevation

By Pam Marshalla

Q: What is the difference between lingual-palatal suction and tongue-tip elevation? I have a student with cerebral palsy who can do suctioning but not tip elevation. Can you tell me why? There is a significant difference between lingua-palatal suctioning and tongue-tip elevation. To understand these subtle differences in tongue movement means to have studied feeding development (ala Morris and Klein, 2000). Tongue-tip elevation is accomplished by elevating the tongue-tip actively upward to the alveolar ridge. It requires the tongue to be functioning…

Bad Tongue, Better Speech

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?…

The Big Picture: Articulation, Orofacial Myology, Swallowing, Motor Speech

By Pam Marshalla

Q: I have heard that we should avoid the topic of tongue-thrust therapy (orofacial myofunctional therapy). I’d like to hear your thoughts on this. In my experience, problems in articulation, orofacial myology, feeding, dysphagia, and motor speech disorders are all the same thing manifested in somewhat different ways and to various degrees. All of these therapies are about facilitating new oral movements and/or fixing incorrect oral movements. I have spent my entire career (since 1975) studying the research, clinical practices,…

Jaw Position and Lateral Lisp

By Pam Marshalla

Q: I have a student with a lateral lisp whose does not have proper jaw alignment. The jaw at rest and during speech is moved over to the right. My thoughts are that the misalignment of the jaw is causing lateralization of the sibilants. Is this correct? What are your thoughts? You are right. The jaw has to be in a stable midline position to produce a correct midline sibilant. I divide lateral lisps into several categories according to whether…

Eliciting Gross /t/ and /d/

By Pam Marshalla

Q: My client in second grade cannot make /t/ or /d/ at all. I have tried all kinds of things to activate the tongue tip, but he still persists on saying /k/ and /g/. How can I elicit /t/ and /d/? Since you have tried so many techniques to facilitate refined tongue-tip elevation that haven’t worked, I would revert to a more infantile way to elicit these anterior consonants. This is the way babies learn to make a /d/: They…

Attaining and Maintaining Intelligibility with Dysarthria

By Pam Marshalla

Q: I have a ten-year-old client who is very hard to understand, although he has no specific phoneme errors. We’ve started doing a pacing board which is helpful. I know that oral-motor exercises are taboo these days, but I feel in some way I have to address motor weakness. The greatest and most effective technique for dysarthria is EXAGGERATION of speech. This is spoken of in virtually all books on traditional articulation therapy and more modern texts on motor speech…

Oral Stability and the Frontal Lisp

By Pam Marshalla

I receive weekly questions about the severe frontal lisp. The questions always are about how to keep the tongue inside the mouth for speech. We are talking here about the client who has: Interdental tongue placement on all the sibilants: S, Z, Sh, Zh, Ch, J Interdental tongue placement on all the lingua-alveolar sounds: T, D, N, L Open mouth resting posture Reverse swallow (infantile suckle-swallow, tongue-thrust swallow) From a motor perspective, the severe frontal lisp with interdental tongue placement…

The Roles of Oral Rest Posture and Neutral Position in Articulation Therapy

By Pam Marshalla

Q: How do oral rest and the neutral position impact articulation? Should we be concerned about these subjects in clients with an articulation/phonological deficit? So very many of our clients have problems with oral rest posture and the neutral position that I get at least one email per week from all over the world from SLP’s trying to figure out what to do about it. I will have a chapter devoted to this topic in my next book to be…

Jaw Stabilization for the Lateral Lisp

By Pam Marshalla

Q: I am working with a first grader who completely shifts his jaw to the left when he produces lateralized “Sh” and “Ch”. I am trying to work on his jaw, but it requires me to firmly give manual jaw stabilization even in isolation. Is it possible to change this strong habit of lateralizing the jaw? You are on the right track, but you are going about it in a less-than-optimum way. When we use manual jaw stabilization like you…

Jaw Pain

By Pam Marshalla

Q: Do you have a resource for understanding pain in the jaw? I get severe headaches and facial pain from it. Team Approach: Temporomandibular joint (TMJ) pain can be a serious issue and needs to be evaluated by a team of professionals who know the TMJ. The team should include at least a physician, a dentist/orthodontist, and a professional who understands TMJ movement. Sometimes that third person is a physical or occupational therapist, a myofunctional therapist, or a speech-language pathologist….