By Pam Marshalla
Q: My four-year-old client has apraxia and jaw instability. The mom wants to know if jaw stability will improve on its own. There is no way to know that. Certainly jaw stability improves with time, but it may not improve in this child without help. He is developing oral motor patterns that may stay with him until he receives therapy to change them. He should have jaw stability by now, so the question is, why doesn’t he? Whatever is preventing…
By Pam Marshalla
Q: Why does an oral habit like thumb sucking effect the oral structures in some children but not others? I have seen kids who suck their thumbs who have no dental problems, and I have seen kids who suck their thumbs who have terrible open bites. As I understand things, any oral habit can affect oral structures depending upon the following three factors–– Frequency –– How often the client engages in the habit. Once per day? Ten times per day?…
By Pam Marshalla
Q: My 5-year-old client substitutes N for L. I cannot seem to help him make the sound oral and not nasal. These are the types of things I would try… Use a Vowel Have her open her mouth wide and say “Ah.” Then have her prolong “Ah” for 5 seconds or more. Then have her continue to say “Ah” while she lifts and lowers her tongue-tip up to the alveolar ridge about 5 times. Tell her, “Don’t try to say…
By Pam Marshalla
Q: Would you agree with the following statement: Children with apraxia will respond to structured production of increasingly difficult syllable shapes, while children with dysarthria need supplementing with oral motor exercises to address muscle weakness. Before I answer your question, let me say a few things about “muscle weakness” and dysarthria because many SLPs––including professors of articulation and phonology––do not seem to understand this area very well. The muscle weakness seen in dysarthria can have many different causes, and the…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in September, 2011. Download the original PDF here. *** Making Speech Targets Salient Classic Auditory Training Tools for Amplifying Speech By Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Making Speech Targets Salient One of the most important things we do in articulation therapy is to make speech units stand out so the client can focus on them. Our most important tool for making speech units salient is our own…
By Pam Marshalla
Q: My client started with a frontal lisp. Now he is now producing a “Whistling S.” How do I correct this? A whistling S usually is an S that is being made in just the right place that whistling occurs. Simply have your client begin to move his tongue-tip higher or lower, slightly more forward or back, or slightly more to the left or right as he prolongs his S. You are searching for the place that works to alleviate…
By Pam Marshalla
Q: You use the phrase “lack of stability” in relation to oral motor function. What do you mean by “stability”? I will have a full chapter on oral stability in my next book to be called The Marshalla Guide to 21st Century Articulation Therapy. Until then, the following is something I wrote in an article for the Oral Motor Institute: Stabilize Oral Movements To stabilize is “to make or become stable” (Jewell & Abate, 2001, p. 1656) or “not likely to change”…
By Pam Marshalla
Q: I cannot get K or G out of my client although I think I have tried every trick in the book! For example, I have used modeling, auditory bombardment, tactile cueing, using a tongue depressor to hold the tongue-tip down, using a tongue depressor to push the back of the tongue down to create the reflex to get it to pop up, putting sweet taste on the velum to get back of tongue to reach for it, using gravity,…
By Pam Marshalla
Q: Does your explanation of techniques to address jaw and tongue stability pertain to clients with the Jay Leno phenomenon? Does the E technique help those kids with lisps related to this facial structure? Techniques to address oral movement are for oral movement problems. As you have noted, Jay Leno has an oral structural problem, too. Structure and function are addressed differently together. I have never worked with Leno, so my analysis of his situation is cursory and speculative, of…
By Pam Marshalla
Q: My client only produces [+Back] consonants K and G, and he sucks his thumb. His tongue is beginning to move for L. Do you think that the thumb sucking is keeping his tongue retracted? Tongue retraction can have many causes including an oral habit like thumb sucking. It also can be the result of oral-tactile hypersensitivity that is causing the tongue to pull back and high in a perpetual “high guard” position. It also is a problem when oral muscle…
