By Pam Marshalla
Q: My 4-year-old client has learned L with his tongue-tip down. Should I let him continue this pattern, or should I teach him to make a tip-up L? In my opinion, you always want the tongue-tip to be elevated when it is supposed to be on T, D, N, and L. You want your client to be developing oral movement patterns that will help him succeed all the way through to mature speech. So you are teaching him things today…
By Pam Marshalla
Q: What do you recommend to begin doing reading on tongue thrust? In terms of textbooks, I would recommend either of the following. The chapters about what to do in therapy for tongue thrust are basically the same in both of these books: Hanson, M. L., & Barrett, R. H. (1988) Fundamentals of orofacial myology. Springfield: Charles C. Thomas. Hanson, M. L., & Mason, R. M. (2003) Orofacial Myology: International Perspectives. Springfield: Charles C. Thomas.
By Pam Marshalla
Q: My client has a cross bite and his jaw lateralizes to the right causing overall speech imprecision. I am holding his jaw in place with standard jaw stabilization I learned for feeding therapy, but it’s not working. His jaw slips back out of position as soon as I remove my hand. That kind of “hands on” jaw stabilization procedure is good for feeding therapy, but is not effective for speech for the very reason you mentioned–– because as soon…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in November, 2012. Download the original PDF here. *** “Marshalla Eye Dropper Technique” For Drooling Elimination November 2012, Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Application This simple process is to be done in conjunction with a good program to facilitate improved oral-motor and feeding skills. It can be employed even if child is on medication or has had surgery to reduce or eliminate drooling. This method is…
By Pam Marshalla
Q: I have a new referral from a dentist for a client with a “gummy smile.” Haven’t seen him yet. What do you think this means? I would assume that the term “gummy smile” means that the upper lip is retracted and the upper gums are exposed. Assuming that this is the case, the client needs to learn normal oral rest posture. Normal oral rest consists of the lips resting gently together, the teeth resting a few millimeters apart, and…
By Pam Marshalla
Q: How do you get a tongue-tip to curl up and back toward the velum for the retroflex R? I have been using cream cheese, but it does not stick to the palate well, and I have been pushing the tongue back, but the child just doesn’t get what I want him to do. First, using food on the palate is an old-time popular method to stimulate tongue movement, but I never use food. You have to analyze the stimulus. …
By Pam Marshalla
Q: Are there any exercises one can give to extend the tongue frenum instead of having the client get a frenectomy? Are these exercises are proven scientifically? From long ago, therapists have said that “tongue exercises” could stretch the frenum, but I have never seen anyone spell out what those exercises would be, nor have I seen any data that would prove that any certain exercises do help. My own personal experience is this: Clients tend to move their tongues…
By Pam Marshalla
Q: I have a number of clients whose L doesn’t sound right. The tongue-tip is lifting to the alveolar ridge, but the sound is muffled and just a little distorted. Do you have any suggestions? The tongue-tip probably is elevating without the full tongue thinning enough. Try this: Have the client say La-La-La with the jaw lower. Lowering the jaw usually thins the tongue. Have him say Ah first, and have him keep saying Ah while he says L. Make…
By Pam Marshalla
In case you have never seen one, I found these photos of restricting lingua frenums in infants online.
By Pam Marshalla
Q: Do you have any suggestions on how to get a child to place his tongue on “The Spot” (the alveolar ridge)? We tried placing cream cheese as a placement cue but no result. You are on the right track in using tactile stimulation. I call this “Marking the Target” of articulation. But your stimulus is too weak. Cream cheese is barely perceptible in the mouth because it is too smooth, and it adapts quickly to body temperature. You want…
