By Pam Marshalla
Q: Do you know of any good books about remediating speech (not language) in children with Down syndrome? My client is 12 years old and I think it is time to concentrate more on intelligibility after years of language work. I answered this question through a personal exchange with the SLP, however I thought I would say a few things about the topic here on my blog. Always remember that with Down syndrome you always have dysarthria and that means that…
By Pam Marshalla
Q: My client had a xyanotic episode at 4-days of age. She had no verbal language until about 24 months. She is now 33 months and is talking quite a bit with delay. But what is throwing me for a loop is that she has changed “mommy” from “Mee-mee” to “Mah-mee” and now to “Hah-mee.” She also substitutes H for other M words. I’ve never seen this. Can you explain it? I don’t have all the info I would need…
By Pam Marshalla
Q: Have you ever seen a child add final consonants to words that don’t need them? My 3-year-old male client adds T to the end of everything. I have seen this with a few kids who used a few different phonemes: T and S mostly. I usually consider it overgeneralization of their new knowledge about final consonants, and I don’t worry about it. I do not believe that I ever had to do anything about it, and I just let…
By Pam Marshalla
Q: I am very frustrated working in the public school. I am forced to see very low functioning children 2-4 times per week, and even with this much therapy they are not progressing in vocabulary, phonemes, nothing. Am I doing something wrong? Let me be very blunt here. Warning! Those of you who don’t know me need to be warned that I do not speak with political correctness. I find it to be an imposition on our freedom of speech…
By Pam Marshalla
Q: My client can produce only the schwa––“Uh.” He is 3-years-old and pretty smart. But he cannot imitate any consonants or vowels at all. What can I do? This is what I would be thinking about––– Teach him to prolong the sound he has––the schwa. And teach him to tolerate your hands on his jaw. Once he can prolong his schwa and tolerate your hands, move his jaw up-and-down while he is vocalizing. If he can prolong his sound while you…
By Pam Marshalla
Q: My 4-year-old son has a frontal lisp. The school is refusing services and says he will outgrow it. Is this true in all cases? No one that I know of is researching this area any more and there are big questions like this one that are going un-answered. There seem to be two types of frontal lisps. The first is an immature speech pattern that will go away with time––by 7-9 years of age. The second is the result…
By Pam Marshalla
Q: Do I understand your advice? […] When working on producing the ‘hissing” sounds, my focus should be on the airflow and not the correct sound production. For example, the client can’t say Ch but is able to get a lot of airflow on her attempt when probed. So I should reward her when she says Ts instead. Is this correct? My experience and research on normal development demonstrates that children learn MANNER before they learn PLACE features. Thus, stridency…
By Pam Marshalla
Q: I am working with a child 2;6 who substitutes /n/ or /m/ for many other consonants. We have worked with words she says often, and she can make the correct sounds in words with a model, but talking on her own she just sounds like she is whining. Two-year-olds can be so variable, and what looks like something very severe can turn out to be nothing. She simply may be jargoning, and her jargon happens to sound like whining. …
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: I am an SLP and cannot figure out how to remediate my own 20-month-old daughter’s speech problem. She is very expressive, has unlimited vocabulary, is speaking in 4-word sentences, and has above average articulation. She recently developed a cold which is now gone but as a result she is now producing L in place of N in all word positions. She is saying “Lo for “no” and “Bel” for “Ben.” She had this correct before. How should I correct…
