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: I just was assigned a three-year-old child who is blind and who has no expressive language. I have never worked with a child like this before. I am looking for general guidance. I am not an expert on working with blind children, but I have some experience and these are my thoughts–– Blindness effects language development in certain ways mostly by limiting the child’s experiences and related vocabulary and concepts. How does he develop concepts of size and space…
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: My two-year-old son has dysarthria. We have been practicing his target words 100 times every day at home, but when he goes to speech sessions, his SLP only has him practice his words a few times. Can you comment on this? I don’t think she is working him hard enough. Drill has its place, but he is only 2 years old! You are giving him more practice than just about any toddler could handle. You do not want him…
By Pam Marshalla
Q: While I understand that every case is different, as a general rule, at what age do you consider it appropriate to target R when it is the only error? I have taught R to one- and two-year old children, so I know it is possible to do very young. However each therapist must address this question relative to his or her employment situation. Therapists in private practice often see these kids at 4 and 5 years of age. Therapists…
By Pam Marshalla
Q: When I try to use a tongue depressor or any other tool in my client’s mouth, he backs off right away and says, “It hurts.” He does this even before I use the tool to touch his mouth or do anything. I don’t think he’s hypersensitive. I think he’s refusing just to refuse. He is four-years-old and I am trying to elicit a K and a G. I think you are right. A little guy like that may use…
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 son is 2 years and 2 months, and he jargons mostly. His therapists can’t seem to figure out if this is apraxia or autism. Why is this? It can be very difficulty to determine if a child has autism or apraxia when they are under three years of age. This is because so many of the problems overlap. Both disorders cause the child to be non-verbal or minimally so. Both cause much refusal to follow directions and answer…
By Pam Marshalla
Q: I am an SLP and my 12-month-old daughter is developing a lateral lisp on her first words! Help!!! I believe this to be one of the worst positions in which an SLP can find him- or herself. We can teach midline sibilants to very young children, even toddlers, if we approach the acquisition of frication/stridency the way an infant does. I would do these three things now –– 1. Teach her to make a lingua-labial raspberry. Put the tongue…
By Pam Marshalla
Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…
