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: 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…
By Pam Marshalla
Q: My four-year-old client is essentially non-verbal. He can say “momma.” He also babbles a little and says a few vowels. I am a first-year therapist and don’t really know how far he can go. And I don’t know what to tell the parents. We all start out as you are by making guesses from the seat of our pants. There is no way to know where this client will go at this point. What I know and what I…
By Pam Marshalla
Q: I serve a female client with Down syndrome in school. She is bright and has done quite well in articulation therapy, but she cannot produce CH due to a severe underbite. This is her last articulation error. Her inability to say the sound is not due to poor oral control or cognitive issues. She simply cannot make this phoneme correctly because of the occlusal problem, but she is not going to receive orthodontia or oral surgery. The parents have…
By Pam Marshalla
Q: My 5-year-old is in articulation therapy with a speech pathologist for half-hour per week to treat a lateral lisp. Is this intense enough? And what is the best thing for me to do at home to help her practice? One half-hour session per week with homework activities is intense enough for a lateral lisp. That is precisely what I give my clients. Success all depends upon whether or not the therapist knows what he or she is doing. The…
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….
By Pam Marshalla
Q: I have a three-year-old client with apraxia. The mother recently has put the child on a fish oil regiment. I was wondering what your take was on this and if you have had experience with diet modifications. In 33 years as an SLP, I have seen many diet fads come and go – fish oil, whip cream, no potatoes and tomatoes, excess protein, limited protein, vegetarianism, veganism, increased electrolytes, no sugar, no food dyes or additives of any kind,…
By Pam Marshalla
Q: I have an 8-year-old student, in a regular second grade classroom. She can say a few words and carries a diagnosis of apraxia. She is below average in intelligence. The parents are insisting on sign language training only and are refusing other forms of augmentative communication – computer, pictures, etc. She can do up to five signs in sequence with prompting, but verbal speech is not coming along. She is failing further and further behind in academics because of…
By Pam Marshalla
Q: What do you tell parents when they ask what caused their child’s articulation disorder? First I draw whatever conclusions I can from the child’s medical and physical history. For example, I explain how the child’s errors might be related to his positive history of ear infections, oral injury, structural deficit, neuromuscular disorder, sensorimotor dysfunction, and so forth. Second, I draw conclusions from information I have about the client’s cognitive level. For example if the client is four-years-old, but he…
