By Pam Marshalla
Q: I work in the Early Intervention setting and increasingly encounter late talking children (frequently boys) who prefer a frontal tongue posture. What’s the correction? In my experience, this problem does not need to be fixed in a two-year-old boy who is delayed in SL. First, tongue protrusion is normal in two-year-olds. Second, the child is late in talking and therefore should be using the pattern of a one-year-old. The only thing I would do over the next year is…
By Pam Marshalla
Q: I am seeing a child who substitutes K for T. He can click his tongue, can touch the alveolar ridge adequately with his tongue, and he understands the tongue placement for T. But he is not able to raise his tongue tip to the alveolar ridge during his attempt to articulate T. He has good phonemic discrimination, too. The lingua-alveolar consonants emerge when the jaw begins to move up-and-down, not when the tongue moves. So begin by teaching the…
By Pam Marshalla
Q: My 12-year-old client is bright but has a lateral lisp. He has a gap between his side teeth. How can I tell if the dental gap is causing the lateral lisp, and how should I precede? I stuck cotton between the side teeth but it didn’t help. The dental problem may have contributed to the lisp, OR the lisp may have contributed to the dental problem. This is a chicken-and-egg situation that usually has no clear answer. But it doesn’t…
By Pam Marshalla
Q: I am working with a 5 year old boy who is unable to lingua-alveolar consonants except an occasional N in isolation and occasionally in the initial position of syllables. I am able to get the tongue placement for /t/ and /d/ but as soon as he tries to say the sound, he makes the /k/ or /g/. Any suggestions would be most appreciated! The anterior consonants T, D, N, L, S, Z come in because the jaw begins to…
By Pam Marshalla
Q: My client lets air come out the side of his mouth when he makes Th. It’s not a big deal, but it is noticeable and distracting. This could be classified as a minor lateral lisp. The client is lacking the firm push of the side of his tongue against his side teeth that would prevent the airstream from staying midline. I would use a straw. Place one end of the straw outside the central incisors and tell him the…
By Pam Marshalla
Q: What is the secret for vocalic R? I have students who can produce prevocalic R very well yet when it comes to Ar, Or, and Ir, and so forth, they flounder. Any tips for this? The key to mastery of vocalic R first is to realize that tongue position for prevocalic R and postvocalic R are exactly the same. The difference is in the transitions movements. Transitions Movements When we produce a prevocalic R at the beginning of a…
By Pam Marshalla
Q: I currently have a female client age 2;5 who cannot lateralize or elevate her tongue. Would you have any suggestions for me? When a client has the type of limited tongue movement you describe, I think we have to follow Charlie Van Riper’s most basic advice, which is to get the tongue to move in any and all new directions. He called it “vivifying” tongue movement. To vivify means to enlighten or animate. This means that at first we…
By Pam Marshalla
Q: Our SLPAs see artic kids for 5-7 minute every day. Some of the kids with frontal lisps also have reverse swallow patterns (tongue thrust swallow, infantile suckle-swallow patterns). Should the SLPAs work on this too? Will these kids fix their lisps without it? Yours is the question I hope the 21st century will answer! I personally do not think that SLPs or SLPAs who are not trained in teaching the correct swallow have any business working on it with…
By Pam Marshalla
Q: My client is having trouble with L. When he makes his L it sounds as though he is forming some type of constriction in the far back of his mouth. It almost sounds like a glottal stop, but it is not that far back. He can hear the error but cannot change it. This has been called a “Retroflex L”. It means that the client is lifting the back of his tongue instead of the tip of his tongue…
By Pam Marshalla
Q: My client keeps lifting the tip of his tongue when I want him to lift the back for K and G. How can I get him to stop doing this? The simplest way is to use an inhibition technique. Hold down the tip with a tongue depressor and tell him to lift the back instead. I also might use some tactile stimulation in the form of gentle brushing to help him understand the difference between the back of the…
