By Pam Marshalla
Q: My client has an anterior open bite, a very strong thumbsucking habit, and a frontal lisp of S and Z. My first impression is to wait to work on speech until after the teeth are firmly in place and the sucking habit is eliminated. Do you agree with this? Yes. In regard to the teeth, it is my opinion that it does no good to work on the sibilants until the “anterior dental barrier” (consisting of the front teeth)…
By Pam Marshalla
Q: Is it normal for child 4;6 to mouth everything, including toys, walls, and doorknobs? If this isn’t normal, do you have any ideas how to eliminate this problem? I need ideas for mom to try at home. This always is a difficult topic. This is how I think about it… Mouthing this much in a four-year-old definitely is not normal. The client is over-doing it for some reason. Oral craving due to significant limitations in the ability to process…
By Pam Marshalla
Q: I am looking for something to assist us with a student who stimulates by licking everything in sight. Are there any strategies for decreasing this behavior? It interferes with his attending during class. I have worked so little with kids on the autism spectrum that I do not know how to answer this. I have never had to extinguish a behavior like this. I can say this however: I would not consider this an oral-motor problem. This is a…
By Pam Marshalla
Q: I have a 7-year-old boy who has a habit of biting on pencils, shirt collars, hair, his baseball glove, and so forth. He has no speech problems. Others are noticing it and commenting. The boy is not aware of it and says it “tastes good.” What do you think? There does not seem to be a heightened anxiety or fatigue factor. In light of your oral motor practice, what program should be followed? If a client like this came…
By Pam Marshalla
Q: How do you teach young children to keep their mouths closed? I am working with a 28-month-old with an open mouth resting posture. He also sucks his thumb and uses a sippy cup. This question is a huge one that requires a lot of background. I will be writing a full chapter on this in my next book, called 21st Century Articulation Therapy to be published in 2012. Let me write a few main ideas here: Medical We always have…
By Pam Marshalla
Q: I am working with an eight-year-old boy who has a lateral lisp as well as orthodontic problems and oral habits. He has severe lip-licking and nail-biting habits, and he has a narrow palate that will need expansion. I am thinking that he may do better in therapy once the palatal expander is removed. What are your thoughts? One could approach this problem from many angles, but this would be my basic line of thinking: A lateral lisp is a…
By Pam Marshalla
Q: Jessica is 26 months old and has a diagnosis of autism/PDD. She has started to respond to discrete trial instruction, however she presents with constant mouthing, licking, and biting her fingers. We have tried numerous things – chewing tubes, cold stimulation, vibration to the mouth, pressure, sweet, sour, salty, ignoring, and so forth. But the behaviors are increasing. Parents report constant licking and gnawing at furniture, books, and other household objects. Any suggestions you can give that might help…
By Pam Marshalla
Q: Our son is 28 months old and just starting to talk. He may be apraxic and he sucks a pacifier all day and night. He seems to be very bright. What is your opinion about the pacifier? I have seen otherwise normally-developing two-year-olds who do not talk at all become completely verbal within a few weeks after their pacifier is tossed out. I always recommend elimination of the pacifier in cases of speech delay, except in those rare cases…
