By Pam Marshalla
Q: In a few of your blogs you mention that sometimes we have to teach a client to suppress his gag reflex. Why would you need to suppress the gag, and how does one go about doing it? The gag needs to be suppressed only if it is interfering with oral motor learning for speech and/or feeding. Severe Cases In the most severe of these cases, excessive gagging causes children to be unwilling to move and explore with the mouth. …
By Pam Marshalla
Q: What is the purpose of stimulating the Tongue Bowl Reflex (TBR)? Isn’t a reflex passive movement? What are we trying to achieve when using a reflex like this? I have chosen to answer your question with material from my next book, The Marshalla Guide to 21st Century Articulation Therapy. The following is abstracted from my chapter called “The Speech Reflexes: Stimulating Automatic Speech Movements”: Theory Reflexes are considered the first movements in the process of human movement development. Speech…
By Pam Marshalla
Q: I just heard the term “velar raspberry.” I feel silly, but I don’t know what it is or why I should be concerned about it. Raspberries are grossly-fricated sounds that babies begin to produce between 4-6 months of age. You know the sound one makes when one sticks the tongue between the lips and blows? That is a raspberry. It is a sound children use to express derision– mockery, scorn, distain, ridicule, and contempt. Raspberries emerge before babbling does,…
By Pam Marshalla
Q: In your class on apraxia, I listened while you described the difference between an “oral-motor technique” (OMT) and a “non-speech oral-motor exercise” (NS-OME). I understood what you were saying at the time, but when I got home and looked at my notes, I found that I didn’t quite get it. Can you give an example to explain this to me? The OMT and the NS-OME are two completely different concepts. The difference between them has to do with the…
By Pam Marshalla
Q: I have a preschooler with an open mouth posture and forward tongue carriage. What homework for parents would you suggest? Should the Mom remind her to keep her mouth closed during play? Treatment and homework activities depend completely upon the cause of the problem. She keeps her mouth open too much of the time. Why? The answer to that question guides your assignment of any activities, whether they are performed in the therapy room or at home. There can…
By Pam Marshalla
Q: I am a special education advocate and I would like to discuss oral motor exercises with someone. An SLP at a district I’m working with stated, “There is no evidence that oral motor exercises are helpful for speech.” Is that true? This area is a mess. Professionals who bash oral-motor generally can be accused of the following: They don’t know what the term “evidence-based practice” really means. They are confusing the concepts of “evidence-based practice” with the concept of…
By Pam Marshalla
Q: How do you teach L for a client who cannot do it at all? These are the types of things I do in whatever order fits the needs of the client: Primitive Movement Teach a primitive L that is made with jaw movement. Have the client stick out his tongue-tip so that it sits between the teeth, and then have him move the jaw up-and-down. This is going to sound and look like the way a baby “lolls” –…
By Pam Marshalla
Q: I was very excited to get your test, the MOST. Can you explain the scoring system to me? We had to design the Marshalla Oral Sensorimotor Test (MOST) so that therapists who had no prior information about oral-motor assessment could administer and score it. Original Design I originally designed a 7-point scoring system, with one score for Pass, and six different scores for Fail. The seven-point scoring system was designed to reveal subtle differences in oral motor skill between one…
By Pam Marshalla
Q: Do you know anything about the Lip Trainer? Do you think it has any uses in articulation therapy? I have not used a Lip Trainer, however, it looks just like another version of the Lip Gym, which I have used to increase action of the orbicularis oris (OO). These types of devices can be used to facilitate action of the OO. Two basic methods of muscle stimulation are employed: Stretching and Resistance. Stretching A muscle is stretched to activate…
By Pam Marshalla
Q: I have a client in grade five who has a frontal lisp. She can make a good /s/, but her jaw slides forward when we do word and sentence drills, and when we engage in conversation. The speech work, especially conversation, seems too fast to allow for her to get her jaw in the right position to keep the tongue in. Suggestions? Your client already can do a correct /s/ with a good jaw position, but she is not…
