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: Can you recommend any good references for feeding therapy? The absolute must-read best resource on feeding therapy is–– Morris, S. E., & Klein, M. D. (2000, 1987). Pre-Feeding Skills: A Comprehensive Resource for Mealtime Development. Austin: Pro-Ed. Also, Talk Tools International puts on good feeding seminars.
By Pam Marshalla
Q: I attended a workshop of yours and recall the recommendation to have the student brush the sides of the tongue to elicit the R sound. I can’t find the method in your handout. Where is it? It is SOOOOOOOO critically important to understand the PURPOSE of a method! One does not brush the sides of the tongue to elicit R and I would NEVER recommend that. Instead one brushes the sides of the tongue to AWAKEN the tactile system there. …
By Pam Marshalla
Q: Where can I find out about oral-motor therapy? The best place to begin learning about oral motor techniques is from reading what has been written in books and online. Search online under oral-motor. May I recommend the following beginning points–– This blog’s oral-motor category The articles posted at the Oral Motor Institute website The resources made by Talk Tools International Debra Beckman’s Resources SpeechLanguageFeeding.com
By Pam Marshalla
Q: My male client is six and he has had phonological therapy for three years with another therapist. He was switched to me because he was going nowhere, and now he is going nowhere with me. I think he needs a motor approach but I have no idea how to begin. Can you guide me? Yours is a very common dilemma: You have tried basic phonological therapy that is auditory/cognitive/linguistic in nature and found that your client is not doing…
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 client has no back sounds, and he substitutes Sh and Ch for S. I cannot get a good S out of him. I have tried straws and the Ts technique you talk about, but he always makes a Sh or Ch. What do you think I should try next? I think you should try putting more attention on his tongue-tip to stimulate S and Z. The following excerpt about improving awareness and control of the tongue-tip is from…
By Pam Marshalla
Q: My 10-year-old student with a profound hearing loss and a recent cochlear implant cannot produce any back sounds. We have tried all of the elicitation techniques (tongue depressors, lying on back, gargling) which usually result in her using a glottal plosive instead. Do you have any other suggestions? I am not sure what you mean by “all of the elicitation techniques.” You mention using a tongue depressor, but you do not say HOW you used it. It’s all about…
By Pam Marshalla
Q: My 6-year-old male client keeps his lips in a perpetual smile that is interfering with intelligibility when he speaks. He appears to have low muscle tone. He also has great difficulty producing multisyllabic words. I am wondering where to begin? Your client has lip retraction associated with mild dysarthria. How do I know he has dysarthria? Because he has speech distortion related to neuromuscular disturbance. That is the very definition of dysarthria. I have written the following about lip…
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…
