By Pam Marshalla
Q: I work in the Early Intervention setting and increasingly encounter late talking children (frequently boys) who prefer a frontal tongue posture. What’s the correction? In my experience, this problem does not need to be fixed in a two-year-old boy who is delayed in SL. First, tongue protrusion is normal in two-year-olds. Second, the child is late in talking and therefore should be using the pattern of a one-year-old. The only thing I would do over the next year is…
By Pam Marshalla
Q: My toddler-age clients sometimes fuss and cry, even scream. I know this is normal behavior for a little kid, but I am a young therapist with no children of my own yet, and I simply do not know how to handle it. Do you have advice for me? Sometimes it is the language we use that causes stubborn and uncooperative behavior. Changing our language can improve some of these situations. Let me illustrate with a story. 🙂 I was…
By Pam Marshalla
Q: I currently have a female client age 2;5 who cannot lateralize or elevate her tongue. Would you have any suggestions for me? When a client has the type of limited tongue movement you describe, I think we have to follow Charlie Van Riper’s most basic advice, which is to get the tongue to move in any and all new directions. He called it “vivifying” tongue movement. To vivify means to enlighten or animate. This means that at first we…
By Pam Marshalla
Q: Do you have any advice for helping preschoolers begin to use two-word combinations? The best way I ever have found to stimulate two-word combinations is to model them melodically following the basic research done on Melodic Intonation Therapy (see resources below) — this research was done with adults, but people have applied it to kids ever since it first came out. I use a two-tone high-low melodic pattern. Model the first word on the high tone, and the second…
By Pam Marshalla
Q: I am working with toddlers for the first time after a 10-year career with elementary school children. They are different! Can you guide me? This is what I would tell a graduate student–– With a toddler, the most important thing to change from therapy with older children is that you have to STOP trying to get him to do what you want him to, and you have to START doing what he is doing. In other words, stop saying,…
By Pam Marshalla
Q: My four-year-old client substitutes E for final Er, as in teachee/teacher. Have you seen this before? Should I be extra worried about it? To me this is just another minor problem with R.  Nothing special just not very common — kids screw up R in more ways than are imaginable! The kids I have seen like this correct their errors easily. Most of their families thought the error was very cute and were sad to see it go!
By Pam Marshalla
Q: A pediatrician recommended that a 4-year-old child receive speech therapy for R distortion. When do you recommend starting therapy for R? In my seminars I always say that a preschool child CAN be helped with R, but most therapists don’t feel it is necessary that young. School-based therapists almost never see these kids that young, but therapists in private practice often do. Therapists in private practice do so not because they feel it is absolutely necessary but because the…
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 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…
