By Pam Marshalla
Q: I am faced with cutting my caseload down considerably due to budget cuts. We will see the more severe kids a max of one time per week, and that’s fine. However, we are being asked to cut the mild kids more, and even eliminate them from our caseloads. Do you have any ideas? Many therapists are facing this today. Here is a brainstorm I had that may get you thinking outside the box. The idea is to use four…
By Pam Marshalla
Q: I attended a workshop of yours and recall the recommendation to have the student brush the sides of the tongue to elicit the R sound. I can’t find the method in your handout. Where is it? It is SOOOOOOOO critically important to understand the PURPOSE of a method! One does not brush the sides of the tongue to elicit R and I would NEVER recommend that. Instead one brushes the sides of the tongue to AWAKEN the tactile system there. …
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 see kids in a school setting. My 3-year-old client has a private SLP who is using kinesio tape on his mouth to help improve lip closure and resting posture. I had not yet heard of this technique but I am intrigued. I would love to know your opinion regarding this method. Some traditional SLPs placed tape on the side of the lips to signal the client that he was moving them instead of his tongue*. You see it…
By Pam Marshalla
Q: I went to your class on R therapy, but I still do not understand how to help a client who can say R in some words but not others. For example, my client can say “board” but not “bird.” Help! This is what I do with kids who have Rs in some words and not others–– I see if I can manipulate a word they can say in such a way that the “er” is teased away from the…
By Pam Marshalla
Q: I have read your R book and have taken 2 classes from you, but I am still struggling with student with persistent R distortions. She has the most success producing vocalic R (car, ear, air, tire) but not “Er” all by itself. This is a very common problem that many SLPs have. How does one obtain an isolated “Er” when the child has it in a vocalic position attached to other vowels? I usually help the client like this–…
By Pam Marshalla
Q: I have tried “everything” to teach R to this one client and he has gotten nowhere. Then one day he learns a Spanish trilled /r/, and WHAM! He gets an American R right away. Can you explain this? Van Riper wrote about this as one method for teaching the retroflex R: “Have the child imitate you as you trill the tongue-tip. Then use this trill to precede the vowel E” (Van Riper, Speech Correction, 1947, p. 142). Think of…
By Pam Marshalla
Q: How do you get a tongue-tip to curl up and back toward the velum for the retroflex R? I have been using cream cheese, but it does not stick to the palate well, and I have been pushing the tongue back, but the child just doesn’t get what I want him to do. First, using food on the palate is an old-time popular method to stimulate tongue movement, but I never use food. You have to analyze the stimulus. …
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: Is the best approach for ankyloglossia to do a back r? If the tongue-tip is tied down, the client will be unable to stretch the tip up and back far enough for a Tip R (retroflex R). You will have no choice but to teach a Back R. But, as you know, the Back R can be much harder for many kids. That’s an excellent reason to have the frenum surgically altered. I always refer a client with a…
