By Pam Marshalla
Q: My client and I speak both Spanish and English. He devoices D to make T. I don’t know how to help him. Here are the things I usually do–– Teach him about “Voice-on” and “Voice-off” in a different context. I usually start with “Ah” and “H”. Have him hold his neck at the larynx to feel the vibration of voice on the vowel and the absence of voice on H. Repeat this with the fricative cognates: S and Z,…
By Pam Marshalla
Q: I work in a school and I have an autistic student 4;0 with limited verbalizations. She also sees a private therapist who keeps telling the parents that my methodology isn’t right, and that is why the girl isn’t making progress. She says that apraxia therapy has to be done a certain way. The child actually is making progress but limited, and the parents are saying that the progress is due to the child’s own development and not because of…
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
I receive many requests from adults who are seeking help for their minor articulation problems. They find me on the web and write to me asking what they should do. (Sometimes I worry these folks are secret “anti-oral-motor people” writing to catch me doing unethical therapy via email so they can shut me down somehow… That’s the paranoid side of me. But usually I believe that these are honest people who genuinely are seeking advice.) The following is a typical question…
By Pam Marshalla
Q: Do you like the “Moving Across Syllables” program? My supervisor says it works. All methods work for the right client at the right time. All you can do is try and see. If it works for him, it works. If not, perhaps it will work later on, or perhaps you need to find a different plan for him. The old-timers called this “trial-and-error.” Trial-and-error is not old-fashioned or out-of-step with modern therapy. It is the basis of what we do every…
By Pam Marshalla
Q: Sometimes parents fight and argue with me when I mention dismissing their child who no longer needs speech services. Where in the ASHA guidelines does it say that it is unethical to provide services for an individual who does not need it? This is in ASHA’s Code of Ethics although it’s phrased funny and therefore somewhat buried… It is letter I under Principle of Ethics 1 – Rules of Ethics. The important part of the guideline here is where it…
By Pam Marshalla
Q: I work with a 6th grade student who has myotonic dystrophy. This is my 5th year working with this student. We have been working on P, B, and M for all of that time. At this time he can say these sounds correctly much of the time in therapy but has a horrible time with carry-over and self monitoring. He refuses to use video or voice recording or a mirror to help with this. Any thoughts on how I…
By Pam Marshalla
Q: I am an SLP and a mother with a four-year-old boy who has a frontal lisp. Do you think I should work with him, and if so, what simple things could I do at home? I always tell parents we do not have to work on a frontal lisp in a preschool child, but we usually do anyway because the parents want it. I find that the absolute key to remediation of the frontal lisp has three essential parts:…
By Pam Marshalla
Q: My client misarticulates all the lingua-alveolar consonants–– T, D, N, L, S, Z. Can you give me some advice for how to fix them? Designing methods to “fix” a phoneme all depends upon what is wrong with it. Therefore in order to recommend methods to address these lingua-alveolars, one would need to know–– Are they completely absent from the client’s repertoire? Are they backed? Are they lateralized? Are they interdentalized? Are they nasalized? Is there a lack of plosiveness…
By Pam Marshalla
Q: My 5-year-old son has average intelligence but speaks in 3-5 word utterances. He had hearing problems earlier. The SLP at school wants to put him into a group. Can he be affected by the modeling of the other students who also have poor articulation? Isn’t a 1-to-1 setting better? I work in private practice because I always prefer the 1:1 situation, but a group can be useful for many reasons. Group work can be more motivating and fun. Language…
