By Pam Marshalla
Q: My male client is age 6. He has average intelligence, CP, and cleft palate. He was pre-mature and is non-verbal. He has been using an iPad with communication app “Words for Life” very successfully. He drools, can’t blow, barely moves his mouth, etc. He makes random vocalizations. Any ideas? This child represents some of the most severe we see. This is severe apraxia and dysarthria, with cleft palate thrown in just to make it interesting. Let us state bluntly…
By Pam Marshalla
Q: Could you advise where to find the best droppers for the dropper technique that you use for habituating the swallow and reducing drooling? I buy my droppers (pipettes) at Sally Beauty Supply, which I believe is a national chain, but you can really get them anywhere. The droppers look like the ones in the image to the right, but any plastic dropper would probably work. Your local pharmacy may carry them, or you can buy multi-packs on Amazon.com 🙂
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 want to get your feedback on my experience with speech apps. I am a seasoned professional and I work the old fashioned way –– with toys, games, books, drawing, coloring, etc.. But I have grad student interns who work with me and I always have them show me what they do in therapy with their iPads. At first I was excited (and envious), but then I noticed the kids were engaged with and pressing the screens, but they…
By Pam Marshalla
Q: My client has low tone and many deviant phonological processes. Is this common? Does this mean he has dysarthria? How should my treatment look different from traditional articulation or phonological therapy? Yes! If the child has hypotonia then this is dysarthria. Whenever you have muscle tone problems of a global nature, then dysarthria is the diagnosis. Dysarthria is a speech movement problem that is the result of muscle tone disturbance. (See definitions below) It is common for children with…
By Pam Marshalla
Q: My friend’s daughter has a tongue thrust (the tongue pushes forward after the swallow). The orthodontist gave her one technique–– holding gum on the roof of her mouth while she swallows. Do you have any other ideas for tongue thrust techniques for a very typically developing 2nd grader? First a few words about the general nature of this question: Asking someone for ideas about teaching a correct swallow is like asking someone for techniques to fix an articulation error. …
By Pam Marshalla
Q: I am working with a child 2;6 who substitutes /n/ or /m/ for many other consonants. We have worked with words she says often, and she can make the correct sounds in words with a model, but talking on her own she just sounds like she is whining. Two-year-olds can be so variable, and what looks like something very severe can turn out to be nothing. She simply may be jargoning, and her jargon happens to sound like whining. …
By Pam Marshalla
Q: My client has a cross bite and his jaw lateralizes to the right causing overall speech imprecision. I am holding his jaw in place with standard jaw stabilization I learned for feeding therapy, but it’s not working. His jaw slips back out of position as soon as I remove my hand. That kind of “hands on” jaw stabilization procedure is good for feeding therapy, but is not effective for speech for the very reason you mentioned–– because as soon…
By Pam Marshalla
Q: What do you do for drooling? Do I need to be a swallowing expert to do it? I see drooling as a three-fold problem–– The child doesn’t swallow often enough. The child doesn’t swallow well enough. (He doesn’t evacuate completely). The child isn’t aware when saliva is building up in his mouth, on his lips, etc. (He doesn’t notice it or doesn’t care about it). So my therapy addresses all three of these issues–– I teach them to swallow…
By Pam Marshalla
This opinion paper was originally posted as a downloadable PDF on my website, authored in November, 2012. Download the original PDF here. *** “Marshalla Eye Dropper Technique” For Drooling Elimination November 2012, Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Application This simple process is to be done in conjunction with a good program to facilitate improved oral-motor and feeding skills. It can be employed even if child is on medication or has had surgery to reduce or eliminate drooling. This method is…
