FWIW, is she driving it around with OD enabled under 55mph? It could be damage from gear-hunting a lot, because most people don't lock out OD when they're cruising around town or whatever under 55mph. I think the driver's manual of most OD automatic cars recommend 45mph as the minimum for it, but realistically, when you consider hills and so on, 55mph usually keeps it from hunting between 3rd and 4th.
Another possibility might be that it's a variation of the 3-4 torque converter shudder. I don't know if the F-150's have had this problem, but I know that it was common on many Crown Vics from '92 up until '98 or '99 when they dropped the 12" converter and went with a 11.25" converter. If it hasn't been done already, a complete drain and refill with Mercon V usually helps in that case, but if it's been doing the shudder for awhile, the damage is already done and the torque converter will need to be replaced to solve that issue.