How to Handle Therapy Archives - Page 3 of 10

Tag: How to Handle Therapy

Low Cognition and SLP: Therapy vs. Babysitting and School Culture

By Pam Marshalla

Q: I am very frustrated working in the public school. I am forced to see very low functioning children 2-4 times per week, and even with this much therapy they are not progressing in vocabulary, phonemes, nothing. Am I doing something wrong? Let me be very blunt here. Warning! Those of you who don’t know me need to be warned that I do not speak with political correctness. I find it to be an imposition on our freedom of speech…

Starting Carryover with Young Kids

By Pam Marshalla

Q: Is there an age constraint for starting self-awareness techniques for carryover? My son is 6 years old. Carryover ideas should start right from the first day of therapy, no matter the client’s age. That means that you are planning for and thinking about and stimulating for carryover from the first day, and you are dropping in ideas here and there. For example, let’s say your child is learning to keep his tongue in his mouth. He can work on…

Push-In vs. Pull-out

By Pam Marshalla

Q: What is your opinion about push-in vs. pull-out therapy? Is anyone doing research on this? As far as I know, no one is doing research on in-class versus pull-out therapy for articulation. I cannot address this question as it concerns language. In my opinion, in-class stimulation is good for the following: Building general vocabulary and concepts Establishing general communication routines Encouraging basic syntactic structures Stimulating phonological awareness Engaging in articulation carryover activities Teaching elocution Teaching early-developing phonemes—P, B, M…

Language Therapy with a Blind Child

By Pam Marshalla

Q: I just was assigned a three-year-old child who is blind and who has no expressive language. I have never worked with a child like this before. I am looking for general guidance. I am not an expert on working with blind children, but I have some experience and these are my thoughts–– Blindness effects language development in certain ways mostly by limiting the child’s experiences and related vocabulary and concepts. How does he develop concepts of size and space…

Big Ideas for Teaching Phonemes

By Pam Marshalla

Q: I have a four-year-old male client whose only consonant is D. He says “telephone” as “Deh-duh-doh.” How do I teach him other phonemes? Therapists use a wide variety of methods to stimulate new phonemes. I have summarized them in an article published by the Oral Motor Institute (Marshalla, 2008). I also have put this information into my newest seminar, titled “21st Century Articulation Therapy.” It also will appear in my next book to be called “The Marshalla Guide to…

Epenthesis

By Pam Marshalla

Q: I am so happy to have found your website and blog. I shared the post you made about not stressing out over kids putting extra schwas at the ends of syllables (epenthesis) with all my coworkers at our speech clinic and they loved that advice. I can’t tell you how many goals have been written in this clinic to avoid that process and I feel relieved that I can spend less time worrying about it and more time worrying…

Denying Lisp Services in the Schools

By Pam Marshalla

Q: My friend’s daughter has a lateral lisp and has been denied services in her school because “it does not affect her ability to learn the curriculum.” I was alarmed and upset by this. Is it possible that certain school districts do not treat this? What is your stance on this? Unfortunately there now are many school districts that hold this policy. Frankly, it makes me sick. If I were a parent I would be screaming about this. Sometimes a…

Drilling on Correct Words

By Pam Marshalla

Q: In your presentation called Improving Intelligibility in Apraxia and Dysarthria you mentioned that it is important to practice phonemes that they can do, rather than phonemes they can’t do. Why is that? That’s a good question! Van Riper and other old-time SLPs said that about 75% of every therapy session should be a rehearsal of things the child can do correctly, and about 25% should be material that is new, unfamiliar, and challenging. Most SLPs today spend most…

Drilling Two-Year-Olds?

By Pam Marshalla

Q: My two-year-old son has dysarthria. We have been practicing his target words 100 times every day at home, but when he goes to speech sessions, his SLP only has him practice his words a few times. Can you comment on this? I don’t think she is working him hard enough. Drill has its place, but he is only 2 years old! You are giving him more practice than just about any toddler could handle. You do not want him…

Convincing Parents Who Deny Lisp Therapy

By Pam Marshalla

Q: I am aware that a lateral lisp is not considered a developmental error and that it probably will not be outgrown. But I have had parents decline therapy for their six-year-olds saying that they don’t hear it, or telling me that the child does it only when his is excited. Do you have any advice for educating parents about this type of speech error and helping convey the importance of therapy? Most SLPs are not trained in counseling parents…