By Pam Marshalla
Q: My male client is age 6. He has average intelligence, CP, and cleft palate. He was pre-mature and is non-verbal. He has been using an iPad with communication app “Words for Life” very successfully. He drools, can’t blow, barely moves his mouth, etc. He makes random vocalizations. Any ideas? This child represents some of the most severe we see. This is severe apraxia and dysarthria, with cleft palate thrown in just to make it interesting. Let us state bluntly…
By Pam Marshalla
Q: Could you advise where to find the best droppers for the dropper technique that you use for habituating the swallow and reducing drooling? I buy my droppers (pipettes) at Sally Beauty Supply, which I believe is a national chain, but you can really get them anywhere. The droppers look like the ones in the image to the right, but any plastic dropper would probably work. Your local pharmacy may carry them, or you can buy multi-packs on Amazon.com 🙂
By Pam Marshalla
Q: I have a new referral for a 4-year-old client who has had several cleft repairs and prior therapy. Per his last report his only speech error is a lisp but I also saw in his mom’s referral info that he has some feeding problems and is sensitive to certain food temperatures and consistencies. Could his atypical sensory and chewing issues be factors in his interdental error pattern? Do you have suggestions for evaluating and treating this child? His mom…
By Pam Marshalla
Q: “Do you think feeding problems cause speech problems? My professor says no.” I believe you’re approaching the question from the wrong direction. My experience is that feeding problems do not cause speech problems, and speech problems do not cause feeding problems, because — My experience is that both feeding and speech problems are the result of mouth movement problems. This is easy to understand if you step away from our field and consider other movement skills.
By Pam Marshalla
Q: My elementary-age client injured her tongue-tip. It has been a few weeks post the accident and her speech is moderately distorted and she still complains of pain. Her doctor says she is just trying to get attention. Do you have experience with this? I have worked with a few patients who had injury to the tongue-tip. In my experience it can take up to a year to fully recover from it. If some of the nerves were damaged,…
By Pam Marshalla
Q: My 6-year-old male client drools has language and cognitive problems but no articulation problems, but he drools a lot. I know of your dropper technique. Should I use the dropper with him or just tell him to swallow every 90 seconds? As I am sure you know, a technique is just a technique. Therapy is all about finding out if a certain technique works for a certain client. Therefore in regard to this specific technique, if he can swallow on…
By Pam Marshalla
Q: I have a 9-year-old male client with Asperger’s who sucks him thumb. I read your book How to Stop Thumbsucking and have had success with other children, but not this one. Advice? I have never faced this but I think this all boils down to what makes sense for him. It seems that the only things that get through to these clients are the things they can plug into their own logic. If you can figure out what makes…
By Pam Marshalla
Q: My client has no fricatives/affricates. I have been working of F for about three months, and he is just not getting it. This is how I work: If I cannot get one particular phoneme when a client has none in the class, I revert back to stimulating the class or distinctive feature. Instead of teaching one particular phoneme in the class or with the feature, stimulate for them all. That way the client learns to recognize the similarities between…
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
Q: What do you do for drooling? Do I need to be a swallowing expert to do it? I see drooling as a three-fold problem–– The child doesn’t swallow often enough. The child doesn’t swallow well enough. (He doesn’t evacuate completely). The child isn’t aware when saliva is building up in his mouth, on his lips, etc. (He doesn’t notice it or doesn’t care about it). So my therapy addresses all three of these issues–– I teach them to swallow…
