By Pam Marshalla
Q: I have a nine-year-old client who inhales as she tries to say R. I have never seen this before. Do you know how to address this? There is a very simple old-time solution for this using a straw, a few sheets of tissue paper, and a few small cotton balls: Teach About Exhalation Place a cotton ball on the table and give the child the straw to hold at her mouth. Have the child blow through the straw at…
By Pam Marshalla
Q: At what age should my school speech therapist begin working on my son’s “R” sound? Would you address it before “S,” “Z,” and “Th”? When do you address these errors? Do missing teeth affect the decision making in this process at all? Yours is a very simple yet complicated question. First, these are what we call “later-developing sounds.” When a child has errors on these sounds, most SLP’s in the public schools wait until the kids are 7, 8,…
By Pam Marshalla
Q: I am a CFY and my supervisor will not let me attend your seminars because she says that you teach oral-motor techniques for which there is no proof. I need help with the lateral lisp and the distorted R. What can I tell her to convince her to let me go? First of all, what right does your supervisor have to determine which continuing education seminars you can and cannot attend? Why are you giving her this power over…
By Pam Marshalla
Q: One of my second graders is making no progress on R. On closer inspection, I noticed his tonsils are huge. He also can put the Nuk brush way back on his tongue with no gag reflex. Is his lack of gag and large tonsils related to his slow progress? Lack of a gag reflex can indicate poor oral-tactile sensitivity and awareness, meaning that the client has a very high threshold of sensitivity and may have difficulty perceiving what is…
By Pam Marshalla
Q: My adolescent client can produce a postvocalic R, but it is effortful and sounds fluttery like a trill. I am afraid that it is a habit now. Help! If I hear any other junk on an R, I simply refocus on the correct acoustic quality by training R from scratch. Teach him to get the correct sound. A trill or flutter on R is not the correct sound in standard North American English.
By Pam Marshalla
Q: My 12-year-old client can produce an R, but he hesitates on either side of it. For example, he says, “I’m [slight pause] ready.” This pause is for a fraction of a second. Do you have any thoughts or suggestions? This is an example of one of the limitless number of ways clients can mess up a perfectly good R. Your client can produce R, therefore his problem is not with R at this point. His problem is in the…
By Pam Marshalla
Q: How do you teach an R? I just don’t get it! Some kids get it right away and other cannot seem to bunch up the back of their tongues no matter what I do. It sounds like you are always teaching what I call a “Back R.” Teaching a Back R is much more than teaching the client to bunch up the back of the tongue. The “Back R” position is attained by spreading, elevating, and retracting the back…
By Pam Marshalla
Q: Can I work on R with my client who has a palatal expander? My experience has taught me the following: Typical braces, palatal expanders, and the like should not interfere much with the sound quality of R and we can go ahead and begin treatment. However… Oral appliances can interfere with our work on R and other phonemes if there is oral pain in association with them. Wait a few weeks until the pain subsides or is managed appropriately….
By Pam Marshalla
Q: It seems that every SLP has a different opinion on phoneme development and the age at which sounds should be treated. For example, some SLP’s work on R at age 6 while others wait until clients are age 7 or 8. What is your opinion on sound development? I have been re-studying the developmental articulation norms for the past two years in preparation for my next book, and I have to admit the data is all over the place….
By Pam Marshalla
Q: What do you think of Speech Buddies? I have a set of Speech Buddies here that the creators sent to me for comment. They are a beautiful set of articulation tools. Speech Buddies are part of our return to the “phonetic placement technique” as described by Van Riper. He wrote the following: “For centuries, speech correctionists have used diagrams, applicators, and instruments to ensure appropriate tongue, jaw, and lip placement. [These] phonetic placement methods are indispensable tools in the speech…
