By Pam Marshalla
Q: My two-year-old client uses words inconsistently. For example, he only uses “more” when he wants food, and he only says “mama” once or twice a day. Two-year-olds are notoriously inconsistent about everything they do. They go to bed right away one night, and scream bloody murder about it for two hours the next. You ask them if they want a cookie, they say cookie and take it one minute, and the next they won’t even look up at you. …
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: I am so happy to have found your website and blog. I shared the post you made about not stressing out over kids putting extra schwas at the ends of syllables (epenthesis) with all my coworkers at our speech clinic and they loved that advice. I can’t tell you how many goals have been written in this clinic to avoid that process and I feel relieved that I can spend less time worrying about it and more time worrying…
By Pam Marshalla
Q: Should a lateral lisp be treated for a three-year-old when it is present in the speech of a parent? Maybe it will not be outgrown? I always treat lateral lisp as early as possible because I do not believe that it is ever outgrown. The lateral lisp is a deviant sound, not a delayed sound. Therefore more time will not necessarily make it go away. If anything, the lateral lisp seems to get more habituated as the child gets…
By Pam Marshalla
Q: I am working with an 8-year-old client with severe apraxia who only can produce vowels, M and B. I have tried all the strategies in beginning of your book called Apraxia Uncovered. But this has also not yielded much. Do you have any hints for how to physically prompt other consonants? This child has severe cognitive dysfunction, too. The reason that the information in Apraxia Uncovered was not of much help to you is because although your client may…
By Pam Marshalla
Q: I work with infants and often reference the developmental material you present in Apraxia Uncovered. I have a little fellow with an unrepaired cleft palate. He is doing all the skills prior to raspberries and none after. Should I stimulate the raspberries with him? Are raspberries possible with an unrepaired cleft? How much intraoral pressure is needed for them? I have not worked with babies like this, so I don’t really know the answer to any of your questions. I would…
By Pam Marshalla
Q: My two-year-old son has Pierre Robin Syndrome and cleft palate. He had oral surgery at 6-days of age, and again at 9 months. He makes a few sounds like “Eh-eh-eh,” “Mmmmm,” “Baba,” and “Papapa.” There has been little if any vocal play until just recently. Receptive skills are good and he signs many words. Can the syndrome be a cause for his delay? I need suggestions. Yes, the syndrome is most assuredly the cause of the delay. Surgeries and…
By Pam Marshalla
Q: My client backs every lingua-alveolar phoneme. He can do a rudimentary L once in a while, but he substitutes k/t, g/d, and ng/n all the time. What can I do? You probably are trying to get your client to elevate the tongue-tip to learn T, D, N, and L. This is to assume that the child can be taught to produce these sounds in the adult form. You have to revert back to teaching your client how to produce…
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…
By Pam Marshalla
Q: My school district has been suggesting that we work on stopping before s-clusters, and I thought that would be a mistake leading to lots of frustration for both the SLPs and the students. Do you have any comments? I think that whenever we set policy –– “my district has been suggesting that we work on stopping before s-clusters” –– we are forgetting the individual child. There is no hierarchy or policy that should “work.” What “works” is what works…
