Oral Motor Archives - Page 13 of 16 - Marshalla Speech & Language

Tag: Oral Motor

Oral-Motor is Not a Trivial Topic

By Pam Marshalla

Q: I am going to evaluate a 15-year-old male with an orofacial-myofunctional disorder. He will get braces soon. What general oromotor exercises do you recommend to get us jump-started? What materials should I order? Your question is far too general for me to answer. There are no “oral-motor exercises” I can give you to get you “jump-started.” The study of oral motor is deep and complex, and it contains many levels of understanding and direction. Your questions suggest that you…

Frontal Lisp Turns Into Lateral Lisp

By Pam Marshalla

Q: My client had a frontal lisp, but when I taught him to keep his tongue behind his teeth, he switched it to a lateral lisp. Have you seen this? What should I do? I am going to answer this question as if you already have taken my class on the lisps, or you have read my book Frontal Lisp, Lateral Lisp… I think it is somewhat common for a child with a frontal lisp to switch to a lateral lisp…

Handling Oral Hypersensitivity the Easy Way

By Pam Marshalla

Q: I have a six-year-old male client with severe apraxia who lacks many phonemes. I am trying to cue him for place and manner at the mouth, but he is very resistant to my touch. For example, I want to hold his nose to teach him how to make his sounds come out his mouth, but he won’t let me. Any suggestions? Let me answer this in terms of what is the easiest ways to handle oral-tactile hypersensitivity: The easiest…

R, Gag, and Tonsils

By Pam Marshalla

Q: One of my second graders is making no progress on R. On closer inspection, I noticed his tonsils are huge. He also can put the Nuk brush way back on his tongue with no gag reflex. Is his lack of gag and large tonsils related to his slow progress? Lack of a gag reflex can indicate poor oral-tactile sensitivity and awareness, meaning that the client has a very high threshold of sensitivity and may have difficulty perceiving what is…

Oral Motor Activities and Seizures

By Pam Marshalla

Q: Could you give me specifics on what to avoid when doing oral motor work with children who have seizures? Of course, stopping treatment during the seizure and giving recovery time is essential. Anything else? In regard to seizures and oral-motor activities: Stop treatment activities during seizures Avoid treatment activities that seem to cause seizures Allow the recovery time that the child needs to re-focus and process Avoid treatment activities that cause or contribute to fatigue

Bad Tongue, Better Speech

By Pam Marshalla

Q: I have worked with a 4-year-old for two years who had a frenectomy about 3 months ago. His speech is quite intelligible now, but he still has heart-shaped tongue, he cannot dissociate his tongue movements from his jaw movements, and he cannot sweep his tongue around lips to clean himself. He stabilizes his tongue with his teeth and can barely extend it beyond lower lip even after surgery. Since speech is good would you still see him for therapy?…

Frontal Lisp, Missing Teeth, and Thumbsucking

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)…

R and Orthodontia (Palatal Expander)

By Pam Marshalla

Q: Can I work on R with my client who has a palatal expander? My experience has taught me the following: Typical braces, palatal expanders, and the like should not interfere much with the sound quality of R and we can go ahead and begin treatment. However… Oral appliances can interfere with our work on R and other phonemes if there is oral pain in association with them. Wait a few weeks until the pain subsides or is managed appropriately….

Sippy Cups and Lisps

By Pam Marshalla

Q: Do you believe that early frequent use of sippy cups can contribute to, establish, or perpetuate a frontal lisp in children? I find it hard to believe that a sippy cup would cause a frontal lisp pattern in an otherwise normal child. I suspect it can happen, but we don’t have real evidence for this. These are the types of questions that I wish young doctoral students would begin to focus on in their research. We need answers to…

The Big Picture: Articulation, Orofacial Myology, Swallowing, Motor Speech

By Pam Marshalla

Q: I have heard that we should avoid the topic of tongue-thrust therapy (orofacial myofunctional therapy). I’d like to hear your thoughts on this. In my experience, problems in articulation, orofacial myology, feeding, dysphagia, and motor speech disorders are all the same thing manifested in somewhat different ways and to various degrees. All of these therapies are about facilitating new oral movements and/or fixing incorrect oral movements. I have spent my entire career (since 1975) studying the research, clinical practices,…