How to Handle Therapy Archives - Page 7 of 10

Tag: How to Handle Therapy

Oral-Motor is Not a Trivial Topic

By Pam Marshalla

Q: I am going to evaluate a 15-year-old male with an orofacial-myofunctional disorder. He will get braces soon. What general oromotor exercises do you recommend to get us jump-started? What materials should I order? Your question is far too general for me to answer. There are no “oral-motor exercises” I can give you to get you “jump-started.” The study of oral motor is deep and complex, and it contains many levels of understanding and direction. Your questions suggest that you…

Banned from Pam Marshalla’s Seminars

By Pam Marshalla

Q: I am a CFY and my supervisor will not let me attend your seminars because she says that you teach oral-motor techniques for which there is no proof. I need help with the lateral lisp and the distorted R. What can I tell her to convince her to let me go? First of all, what right does your supervisor have to determine which continuing education seminars you can and cannot attend? Why are you giving her this power over…

Normative Data and Enrollment

By Pam Marshalla

Q: It seems that every SLP has a different opinion on phoneme development and the age at which sounds should be treated. For example, some SLP’s work on R at age 6 while others wait until clients are age 7 or 8. What is your opinion on sound development? I have been re-studying the developmental articulation norms for the past two years in preparation for my next book, and I have to admit the data is all over the place….

Picking on Young Therapists

By Pam Marshalla

Q: I have been a little put off by your comments about the beliefs of young therapists. As I am sure you realize, everyone starts out as a “young therapist” at one time. Your comments do little to support your new peers in the field. I realize that what you say might accurately portray some “young therapists.” Would you also agree that this is not always the case? It is a challenge for new therapists to establish trust with a…

The Cycles Approach to Therapy

By Pam Marshalla

Q: Can you explain the “cycles approach”? To work in cycles means to work only one week at a time on target phonemes or phonological processes. Therapy progresses through the weeks regardless of whether the client masters the target. For example, the client may have trouble maintaining /s/ in the clusters Sp, St, Sk, Sm, Sn, Sl, Sw, Str, Spr, and so forth. Using cycles, therapy would address one cluster per week. For more information, read the original authors. Look…

Prosody Goals

By Pam Marshalla

Q: I’m wondering what kind of goals you would write for targeting prosody. How do I make it measurable? Prosody entails projection, rate, rhythm, stress, pause, pitch, intonation, and cadence. I would write separate goals for each area impacted. In terms of measuring success before and after, I would take measures where possible. For example, I might count the number of words the client speaks per minute and compare that to the old norms. Where measures like that are not…

Giving a Prognosis to Parents

By Pam Marshalla

Q: What do you say to parents who want to know how much longer speech therapy will continue? I have been seeing an 8-year-old boy for two years for auditory processing, and for both receptive and expressive language skills. He is making good progress but could honestly be in therapy for a few more years. It sounds like this client may never have “normal” speech and language, and he could use help for as long as he can get it….

Quick Dismissal on /r/

By Pam Marshalla

Q: I saw a client with /r/ problems and dismissed him after he could produce /r/ with reminders on picture-naming tasks. I saw him again a year later and his /r/ had deteriorated. Should this have happened? Should I put him back in therapy, or do you think that this will take care of itself? What I have done with these kids is the following: You let him go too quickly. Never dismiss a client until the process of articulation…

Sharing Ideas and Evidence-Based Practice (EBP)

By Pam Marshalla

Q: I received the email you sent regarding collecting suggestions for carryover that you intend to compile in a book. It is surprising to me that you find it reasonable to pass on non-evidence based ideas submitted by therapists. I don’t think this meets a best practice standards at all. Will you measure the merit of these ideas? I’m curious to know how you propose to demonstrate efficacy. What you seem to propose is to collect and disseminate ideas that…

What is Evidence-Based Practice (EBP)?

By Pam Marshalla

The term Evidence-Based Practice (EBP) has been giving practicing SLP’s a lot of trouble recently. This is because some professionals have mistakenly assumed that an evidence-based practice requires that practicing therapists restrict their methods to only those that have been researched in a laboratory. This is a false interpretation of the EBP. The EBP actually integrates information from three sources: LAB, CLINIC, and CLIENT. Let’s review four references that explain this: 1. According to Carol Dollaghan (The handbook for evidence-based…