Tongue Archives - Page 10 of 10 - Marshalla Speech & Language

Tag: Tongue

Stimulating the Butterfly Position

By Pam Marshalla

Q: I use your “butterfly position” on many school age kids and most of them are able to understand it and follow directions. However, many of the preschoolers have a hard time understanding “biting the sides of their tongues.” Do you have a different way of approaching preschoolers when you want to stabilize the back of their tongues? I also have found that many preschoolers have a hard time understanding how to make the butterfly position. And children with lower…

Tongue-Tip Interference During /p/ and /b/ Productions

By Pam Marshalla

Q: My client produces a /t/ at the same time he says /p/. And he produces /d/ at the same time he says /b/. How can I prevent the tongue from elevating during /p/ and /b/? You need to inhibit tongue tip elevation. It might be done like this: Place a tongue depressor into the mouth, straight in from the front at midline, so that the blade sits on top of the front of the tongue. With the tongue depressor…

Frenectomy: Sample Physician Referral Letter

By Pam Marshalla

Q: I have a student with a restricting lingua frenulum that limits his tongue mobility and impacts his speech intelligibility. What do you write in the referral letter to the physician? Write a letter that explains how the restricting lingua frenulum is impacting as many of the following six areas as you can: speech, oral rest, preparation for swallow, the swallow, health, and social appearance. The letter is sent in the hopes that the primary physician will refer the client…

Lateral Lisp, Palatal Expander, and Oral Habits

By Pam Marshalla

Q: I am working with an eight-year-old boy who has a lateral lisp as well as orthodontic problems and oral habits. He has severe lip-licking and nail-biting habits, and he has a narrow palate that will need expansion. I am thinking that he may do better in therapy once the palatal expander is removed. What are your thoughts? One could approach this problem from many angles, but this would be my basic line of thinking: A lateral lisp is a…

Facilitating Tongue-Tip Elevation

By Pam Marshalla

Q: How can I get my client to elevate the tongue-tip instead of the blade to produce lingua-alveolar phonemes? Following my 22 Fundamental Methods of Facilitating Jaw, Lip, and Tongue Movements, I would do one or more of the following: Assist – Lift the tip with a tongue depressor. Associate – Find one phoneme in which the client elevates the tip, and use that phoneme movement to teach the others. Contrast – Contrast tongue-tip elevation with tongue-back elevation. Cue –…

Patience and the Lateral Lisp

By Pam Marshalla

Q: I have been working with a 10-year-old girl with a significant lateral lisp that affects all of her sibilant sounds. I have been focusing on establishing /s/ and /z/, but have not been able to progress very far because her ability to achieve the correct tongue position is so inconsistent. I have taught her the “Butterfly Position” to help her lift the side margins of her tongue, and am using the “Long T Method” from Frontal Lisp, Lateral Lisp….

Techniques For “Long E”

By Pam Marshalla

Q: I cannot get my client with Down Syndrome to produce “Long E” (as in the word bee). I have tried using a tongue blade to get his tongue back. Do you have any other suggestions? To produce long E (/i/), the jaw must be high and the tongue must be wide, high, and tense in the back. If you are using a tongue blade to push the tongue back, you have several problems that are working against you. First,…

The “Butterfly Position” for R Therapy

By Pam Marshalla

Q: You use the term “Butterfly Position” in Successful R Therapy. Is this something new? Did you make this up, or does it come from somewhere else? I made up the term “Butterfly Position” in 1978 during a workshop I was teaching. I have used the term ever since in workshop handouts and books I have written. The “Butterfly Position” refers to the ability to shape the tongue into a position that has a low midline and high sides. This…

Tongue Back Elevation

By Pam Marshalla

Q: What can we do to make the back of the tongue elevate for /k/ and /g/? We can use the Tongue Retraction Response (TRR) as follows: Tactile stimulation down the midline of the tongue from anterior to posterior causes the entire tongue to retract back and up toward the velum. The response occurs about half-way down the tongue, and is elicited after the Tongue Bowl Response (TBR) and before the Tongue Gag Response (TGR). I also have called the…