By Pam Marshalla
Q: I am working with a 5 year old boy who is unable to lingua-alveolar consonants except an occasional N in isolation and occasionally in the initial position of syllables. I am able to get the tongue placement for /t/ and /d/ but as soon as he tries to say the sound, he makes the /k/ or /g/. Any suggestions would be most appreciated! The anterior consonants T, D, N, L, S, Z come in because the jaw begins to…
By Pam Marshalla
Q: My nearly 3-year-old client makes a substitution for /k/ which comes from the throat. The closest I have found online is to describe it as a uvular stop. Have you heard this substitution before and how would you describe it. Any thoughts on how to treat it? Infants start out by making stops and fricatives all along the vocal track from anterior to posterior — Bi-labial Labial-dental Lingual-labial Lingual-dental Lingual-alveolar Lingual-velar Tracheal Glottal Then they learn to restrict what…
By Pam Marshalla
Q: I am working with a child 4;0 with velar fronting. I have established a somewhat inconsistent K in initial and medial position. How can I get k in final position? If he has K anywhere, he is on his way. At his age I would predict that he will learn it on his own given more time. It is very unusual for a child to get K initial and medial but not final — final usually comes in first — but…
By Pam Marshalla
Q: My client keeps lifting the tip of his tongue when I want him to lift the back for K and G. How can I get him to stop doing this? The simplest way is to use an inhibition technique. Hold down the tip with a tongue depressor and tell him to lift the back instead. I also might use some tactile stimulation in the form of gentle brushing to help him understand the difference between the back of the…
By Pam Marshalla
Q: My student substitutes T/K and D/G. As per suggestions on your website, I am facilitating posterior tongue elevation by using a tongue depressor and having the student push against it with the posterior part of the tongue. I have been able to elicit H but not K or G. Is H the sound you refer to as a velar fricative? I need help with this method. Let me straighten this up first- H is a glottal fricative and not…
By Pam Marshalla
Q: My 10-year-old student with a profound hearing loss and a recent cochlear implant cannot produce any back sounds. We have tried all of the elicitation techniques (tongue depressors, lying on back, gargling) which usually result in her using a glottal plosive instead. Do you have any other suggestions? I am not sure what you mean by “all of the elicitation techniques.” You mention using a tongue depressor, but you do not say HOW you used it. It’s all about…
By Pam Marshalla
Q: What is your opinion about push-in vs. pull-out therapy? Is anyone doing research on this? As far as I know, no one is doing research on in-class versus pull-out therapy for articulation. I cannot address this question as it concerns language. In my opinion, in-class stimulation is good for the following: Building general vocabulary and concepts Establishing general communication routines Encouraging basic syntactic structures Stimulating phonological awareness Engaging in articulation carryover activities Teaching elocution Teaching early-developing phonemes—P, B, M…
By Pam Marshalla
Q: I cannot get K or G out of my client although I think I have tried every trick in the book! For example, I have used modeling, auditory bombardment, tactile cueing, using a tongue depressor to hold the tongue-tip down, using a tongue depressor to push the back of the tongue down to create the reflex to get it to pop up, putting sweet taste on the velum to get back of tongue to reach for it, using gravity,…
By Pam Marshalla
Q: My client only produces [+Back] consonants K and G, and he sucks his thumb. His tongue is beginning to move for L. Do you think that the thumb sucking is keeping his tongue retracted? Tongue retraction can have many causes including an oral habit like thumb sucking. It also can be the result of oral-tactile hypersensitivity that is causing the tongue to pull back and high in a perpetual “high guard” position. It also is a problem when oral muscle…
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…
