By Pam Marshalla
Q: I currently have a female client age 2;5 who cannot lateralize or elevate her tongue. Would you have any suggestions for me? When a client has the type of limited tongue movement you describe, I think we have to follow Charlie Van Riper’s most basic advice, which is to get the tongue to move in any and all new directions. He called it “vivifying” tongue movement. To vivify means to enlighten or animate. This means that at first we…
By Pam Marshalla
A professor wrote me several years ago. She said she taught articulation and phonology, she had tenure, she did research in phonology, she supervised students, and she had published many articles. She said that she could not “see” the oral-motor problems I was talking about in my writing. She wanted to know what I had to say about that. I wrote back and said that she could not “see” the OM problems I was talking about because she could not…
By Pam Marshalla
Q: I was at the IAOM convention in the fall of 2013, and I heard you speak on oral stability. You used your hands to describe the difference between oral strength and oral movement patterns. Can you post it here? I would like to share it with my colleagues and I can’t remember what you said. This is probably the best way I have discovered to describe the difference between movement patterns and strength of movement. Hand Movement vs. Hand…
By Pam Marshalla
Q: Every week I encounter more statements by SLPs about never doing anything in therapy that has not been proven in research. These statements virtually always concern oral-motor techniques. How do you respond to this? I am so concerned about the limited thinking that has begun to dominate our profession that my heart is bleeding. I am not concerned only with OM. I am concerned about the profession at large. 🙁 Follow me here. Let’s talk about OM and then…
By Pam Marshalla
Q: My client lowers the jaw too much when he speaks, and he has a frontal lisp. He tends to clench the jaw when I tell him to hold the jaw up. I may have taught him this when using a bite stick to position the jaw. Not sure what to do now. As you have discovered, making a strong crushing bite on a firm object is not what he needs. The term “jaw stability” does not mean “jaw rigidity.”…
By Pam Marshalla
Q: Do you know if chewing tools are effective in correcting open mouth posture in a 2-year-old? Is there any research on this? The question reveals that you are assuming too much one-to-one correspondence between methods of oral stimulation and results. Chewy tools are designed to facilitate up-and-down jaw movements, and to increase the amount of time a client keeps his jaw in the “up” position. That is all they will do. To assume that chewing on a chewy tool or…
By Pam Marshalla
Q: Are there any exercises one can give to extend the tongue frenum instead of having the client get a frenectomy? Are these exercises are proven scientifically? From long ago, therapists have said that “tongue exercises” could stretch the frenum, but I have never seen anyone spell out what those exercises would be, nor have I seen any data that would prove that any certain exercises do help. My own personal experience is this: Clients tend to move their tongues…
By Pam Marshalla
Q: At what age should a child be able to blow bubbles or a horn? My two-year-old client, who I suspect has apraxia, cannot blow and he is very hard to understand. We have no data on when children should be able to blow bubbles or a horn. However, I have been observing the blowing skills of young children for 40 years. I have observed scores of children trying to blow out their birthday candles and my experiences can be summarized…
By Pam Marshalla
Q: Would you agree with the following statement: Children with apraxia will respond to structured production of increasingly difficult syllable shapes, while children with dysarthria need supplementing with oral motor exercises to address muscle weakness. Before I answer your question, let me say a few things about “muscle weakness” and dysarthria because many SLPs––including professors of articulation and phonology––do not seem to understand this area very well. The muscle weakness seen in dysarthria can have many different causes, and the…
By Pam Marshalla
Q: I am confused over the term NS-OME (Non Speech Oral Motor Exercises). Some people are saying that we cannot use things like toothettes, bite sticks, whistles, or straws in therapy. I use many things like this in therapy. Shouldn’t we do whatever we can to help our clients learn to make speech sounds? Your question is a good one. Yes, we are supposed to use whatever we can to help our clients learn to produce speech sounds. Van Riper…
