Tag: Tools for Therapy

Getting the Tongue-Tip to Curl Up and Back

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. …

Marking Place of Articulation

By Pam Marshalla

Q: Do you have any suggestions on how to get a child to place his tongue on “The Spot” (the alveolar ridge)? We tried placing cream cheese as a placement cue but no result. You are on the right track in using tactile stimulation.  I call this “Marking the Target” of articulation.  But your stimulus is too weak.  Cream cheese is barely perceptible in the mouth because it is too smooth, and it adapts quickly to body temperature.  You want…

Putty Bite Blocks

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…

What does blowing have to do with speech?

By Pam Marshalla

Q: At what age should a child be able to blow bubbles or a horn? My two-year-old client, who I suspect has apraxia, cannot blow and he is very hard to understand. We have no data on when children should be able to blow bubbles or a horn.  However, I have been observing the blowing skills of young children for 40 years.  I have observed scores of children trying to blow out their birthday candles and my experiences can be summarized…

Substituting N for L

By Pam Marshalla

Q: My 5-year-old client substitutes N for L. I cannot seem to help him make the sound oral and not nasal. These are the types of things I would try… Use a Vowel Have her open her mouth wide and say “Ah.” Then have her prolong “Ah” for 5 seconds or more. Then have her continue to say “Ah” while she lifts and lowers her tongue-tip up to the alveolar ridge about 5 times. Tell her, “Don’t try to say…

Making Speech Targets Salient – Classic Auditory Training – Tools for Amplifying Speech

By Pam Marshalla

This opinion paper was originally posted as a downloadable PDF on my website, authored in September, 2011. Download the original PDF here. *** Making Speech Targets Salient Classic Auditory Training Tools for Amplifying Speech By Pam Marshalla, MA, CCC-SLP Speech-Language Pathologist Making Speech Targets Salient One of the most important things we do in articulation therapy is to make speech units stand out so the client can focus on them. Our most important tool for making speech units salient is our own…

Fixing an Inhaled S

By Pam Marshalla

Q: My client inhales on S. I have tried using a straw and a cotton ball to teach him about airflow. He does fine with these, but he doesn’t transfer the skill to S. Help! Your client probably continues to inhale on S because he “thinks” he is trying to say S. He has an auditory/motor memory for his own S that he is continuing to access. You have to help him learn to block access to this memory. Here…

The Tools of Articulation Training

By Pam Marshalla

Q: I am confused over the term NS-OME (Non Speech Oral Motor Exercises). Some people are saying that we cannot use things like toothettes, bite sticks, whistles, or straws in therapy. I use many things like this in therapy. Shouldn’t we do whatever we can to help our clients learn to make speech sounds? Your question is a good one.  Yes, we are supposed to use whatever we can to help our clients learn to produce speech sounds.  Van Riper…

How to Teach Proper Oral-Nasal Resonance Balance

By Pam Marshalla

This opinion paper was originally posted as a downloadable PDF on my website, authored in mid- 2011. Download the original PDF here. *** How to Teach Proper Oral-Nasal Resonance Balance I receive weekly questions from therapists struggling with how to decrease hypernasality in clients who have adequate velo-pharyngeal structure. I am not an expert in this area, but I would like to share what I do to help clients become less nasal. These clients generally can achieve oral sound, but they…

Sanitizing the Tools of Articulation Therapy

By Pam Marshalla

Q: We are wondering about hygiene and the use of tools in articulation therapy. What are the practices you use to keep your multiple-use tools sanitary from client to client? Guidelines Adhere to the following sanitary guidelines when handling objects that are used in, on, or around the mouth: Wood, paper, cardboard, sponge, cotton, leather, or hemp objects should be used once and then discarded. Dental floss also should be used once and then discarded. Plastic, rubber, vinyl, metal, and…