By Pam Marshalla
I was recently reminded of a client I worked with decades ago who taught me a very important lesson about therapy when I was a young therapist. I wanted to share his story. David David was 6;0 and non-verbal. He was a big clunky kid with fine and gross motor problems who was basically untestable, and everyone thought he had very low IQ. I was using Bliss Symbols with him (it was 1976) to develop a home-made communication board (before…
By Pam Marshalla
Q: My 5-year-old daughter has below average intelligence and she can say Bah, Mah, S, Da, and Nnn, but no real words. She has had speech therapy for two years. Could you suggest an oral appliance that can help her to improve oral muscles and tongue movement awareness? I am going to be very blunt here, and probably more straight forward than I would in a real therapy session in which I would gently lead you toward this idea over…
By Pam Marshalla
Q: My male client is age 6. He has average intelligence, CP, and cleft palate. He was pre-mature and is non-verbal. He has been using an iPad with communication app “Words for Life” very successfully. He drools, can’t blow, barely moves his mouth, etc. He makes random vocalizations. Any ideas? This child represents some of the most severe we see. This is severe apraxia and dysarthria, with cleft palate thrown in just to make it interesting. Let us state bluntly…
By Pam Marshalla
Q: I have a 5-year-old child with PDD, NOS (autism spectrum disorder). Her language comprehension is very good. She makes sounds and she babbles, but she produces no words. She is social and definitely has communicative interest and intent. Based on your experience, would the techniques in your book and CD called Apraxia Uncovered be of potential benefit to my daughter to help her speak words (even though she does not carry a diagnosis of Apraxia, per se). Thank you…
By Pam Marshalla
Q: I have a two-year-old client who only says “Mmmm” and “Ahhh.” He won’t do anything for me. How can I get him to talk? First, I would like to refer you to my book called Becoming Verbal with Childhood Apraxia. I am not trying to sell you a book, but I wrote it precisely for this type of case. It will help you understand how to help little kids become more vocal, verbal, interactive, communicative, and imitative. It discusses…
By Pam Marshalla
Q: My client is a five-year-old with polymicrogyria. He drools severely, eats only purees, basically is non-verbal, and has a non-verbal IQ of about 85. He is labeled as apraxic. Can you give me advice on how to proceed? I had not heard of this disorder, so I Googled it and found quite a bit under “polymicrogyria ” and “children with polymicrogyria.” Apparently it is a developmental malformation of the human brain characterized by an excessive number of small convolutions on the…
By Pam Marshalla
Q: My two-year-old son has Pierre Robin Syndrome and cleft palate. He had oral surgery at 6-days of age, and again at 9 months. He makes a few sounds like “Eh-eh-eh,” “Mmmmm,” “Baba,” and “Papapa.” There has been little if any vocal play until just recently. Receptive skills are good and he signs many words. Can the syndrome be a cause for his delay? I need suggestions. Yes, the syndrome is most assuredly the cause of the delay. Surgeries and…
By Pam Marshalla
Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…
By Pam Marshalla
Q: I have an 8-year-old student, in a regular second grade classroom. She can say a few words and carries a diagnosis of apraxia. She is below average in intelligence. The parents are insisting on sign language training only and are refusing other forms of augmentative communication – computer, pictures, etc. She can do up to five signs in sequence with prompting, but verbal speech is not coming along. She is failing further and further behind in academics because of…
By Pam Marshalla
Q: Our son is three and was non-verbal. Our SLP seems really good at helping him learn to talk. But he is very hard to understand. What can we do? The essence of speech therapy for little children is to learn about words and sounds. We need to focus on both when working with young children. Many of today’s younger therapists put all their focus on building vocabulary, and they spend very little time focused on the actual production of…
