By Pam Marshalla
Q: I recently read an article that indicated bite blocks could be made from dental impression compound. Have you heard of this or tried doing it? Do you have any suggestions on how this could be accomplished, the efficacy of doing it, and the material that would suit the job best? I have not used this method myself, but James Dworkin wrote about it in 1991. Dworkin came out of the Darley, Aaronson, and Brown school of thought on motor…
By Pam Marshalla
Q: One of my high school students has a tense upper lip, which interferes with correct productions of P, B, and M, although she can produce labials in structured tasks. She also chews with her mouth open and makes smacking sounds. The resting position of her mouth often reveals her teeth, and her tense upper lip is noticeable. How can I improve her articulation as well as her looks and eating habits? Your client needs a program of orofacial myology…
By Pam Marshalla
Q: My client has no incisors and an underbite, and she distorts both S and Z. These errors sound like a lateral lisp, however when I use your straw testing method, there is no airflow coming out the sides, only the front. My colleague tells me that this is a lateral lisp. But how can it be if the air doesn’t come out the sides? Your colleague is wrong: If the airstream is not coming out the sides (as tested…
By Pam Marshalla
Q: Why does an oral habit like thumb sucking effect the oral structures in some children but not others? I have seen kids who suck their thumbs who have no dental problems, and I have seen kids who suck their thumbs who have terrible open bites. As I understand things, any oral habit can affect oral structures depending upon the following three factors–– Frequency –– How often the client engages in the habit. Once per day? Ten times per day?…
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: I have two girls with Down syndrome who grind their teeth on a regular basis. They are the same age and function at about the same level. What strategies would you use to help with this area? This is a tough question. We have no widely accepted strategies to eliminate tooth grinding other than the dental guard recommended by dentists. But my thinking has always been that if you can pinpoint the cause, then you can design a solution…
By Pam Marshalla
Q: I have a 3-year-old whose front teeth had to be pulled due to decay. He likely won’t have those teeth again for 2-4 years. Do I wait to treat S? This depends upon what you are trying to accomplish… First, if you are trying to bring stridency into the client’s phonological system, and are stimulating S to do that, I would do it now. In fact, I would stimulate for all the strident phonemes right away –– S, Z,…
By Pam Marshalla
Q: Do you have any thoughts on thumb sucking as a way to move facial bones? One of my four-year-old clients is a frequent thumb sucker. A professional on my team wants to encourage the habit to move this child’s facial bones as part of her craniosacral therapy. The therapist says that the child’s thumbsucking is “a pathological compensation for a structural anomaly.” Now the staff thinks that this child’s thumb sucking is okay. What do you have to say about…
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: My client has an anterior open bite, a very strong thumbsucking habit, and a frontal lisp of S and Z. My first impression is to wait to work on speech until after the teeth are firmly in place and the sucking habit is eliminated. Do you agree with this? Yes. In regard to the teeth, it is my opinion that it does no good to work on the sibilants until the “anterior dental barrier” (consisting of the front teeth)…
