I am a speech-language pathologist in private practice. One of my clients is a 24 year old male with severe stuttering. He also has a diagnosis of mild cerebral palsy. His most noticeable dysfluent behavior is the inability to initiate speech due to blocks at the vocal fold level. Do you think any of the Talk Tools would help? Thank you!

 

Jody

Hi Jody,

According ASHA, most treatment methods for stuttering are centered around behavior; however there are treatment protocols that focus on breathing. This is true of Dr. Martin Schwartz who wrote Stutter No More in 1991 about the "Passive Airflow Technique". For this method  stutterer is taught to 1. Release air 2. Slow down the first syllable and 3. Intent to rest between verbalizations.

Since the goal of Oral Placement Therapy is to provide tactile cues for speech sound production, we would consider OPT tasks that specifically target phonatory control and diaphragmatic breathing if the client was not using proper airflow to support speech. Phonatory tasks such as the horn kit, spirometer or bubble tube could be tools that would assist improved speech breathing; however we would also be certain that we were using more specific evidenced based therapy techniques for stuttering. These methods alone would not directly facilitate fluent speech but rather assist you in the pre-requisite skills needed to engage in airflow methods.

We would try blowing with horns or bubbles or encouraging airflow of any kind on his hand.  Once we felt like he was able to coordinate his breathing and blowing we would then move to humming or adding the "m" sound. We would work on this very gradually.  

Hello,

 

I'm hoping for some advice. My 3 year old ASD (Autism Spectrum Disorder) son is doing TalkTools through our SLT. He couldn't blow at all to start with so we taught him using a water flute first, now he has gone onto Horn #1 but he can't make a sound. His neurotypical twin sister can't either so I'm wondering if his lungs are maybe too small to be able to use this horn? (He is small - more the size of a two year old.) Our SLT said just keep trying but I'm worried it will put him off blowing as he won't be getting any noise feedback like he did with the water flute.

 

Thanks,

 

Claire

Hi Claire,

I think I would continue working on the horn as your therapist recommended but I would also try using the Pre-Hierarchy Horn while bouncing on a therapy or yoga ball and providing abdominal pressure. This horn is extremely easy to blow and with the abdominal pressure and bouncing I feel you would be more likely to get a sound, which would be rewarding for your son. I do not think the lung size is the issue but that is not really a question I can answer.

Please let me know if you have any other questions.  

We are here and happy to help.

Thanks,

Liz

Elizabeth Smithson, MSP, CCC-SLP is a Speech-Language Pathologist who has over 10 years of professional experience working with infants, children, adolescents and adults. She earned her Master of Speech Pathology at the University of South Carolina. Liz is also a Level 5 TalkTools® Trained Therapist. She has received specialized training in Oral Placement Therapy, Speech, Feeding, Apraxia, Sensory Processing Disorders, and PROMPT©. Liz works with clients with a wide range of disabilities including Cerebral Palsy, Down Syndrome, and Spinal Muscular Atrophy. She works through her own private practice Elizabeth Smithson Therapy, LLC in the home setting and in the TalkTools® office in Charleston, SC.

Elizabeth Smithson, MSP, CCC-SLP is a Speech-Language Pathologist who has over 10 years of professional experience working with infants, children, adolescents and adults. She earned her Master of Speech Pathology at the University of South Carolina. Liz is also a Level 5 TalkTools® Trained Therapist. She has received specialized training in Oral Placement Therapy, Speech, Feeding, Apraxia, Sensory Processing Disorders, and PROMPT©. Liz works with clients with a wide range of disabilities including Cerebral Palsy, Down Syndrome, and Spinal Muscular Atrophy.  She works through her own private practice Elizabeth Smithson Therapy, LLC in the home setting and in the TalkTools® office in Charleston, SC.

Hi TalkTools,

 

I am working with a 4 year old boy with Sensory Processing Disorder. When producing the /s/ phoneme he takes a quick inhalation of air. He is able to produce /z/ and /sh/ with appropriate outward flow of air. We have worked on discriminating correct vs. in correct airflow, horn blowing, air hockey with cotton ball or whiffle ball, and cheerio for tongue tip placement with adding the airflow as well. Despite max attempts he is unable to produce the sound in isolation. Any tips or advice you could provide would be greatly appreciated!

 

Thank you!!!

 

Randee

Hi Randee,

I would work on voice versus voiceless sounds. Having him feel your throat to see that with the "z" you are using your voice box and call "s" your quiet sound and work on the difference that way.  Another thing that I have tried to help with placement is a straw placed on the tongue down the middle out of the front of the mouth.  This helps kids to feel where the air needs to go. But it sounds like he has the placement piece since he is able to say the "z". Just something extra to try. There is also a complete list of oral placement activities to work on "s" and "z" on page 18 in Sara Rosenfeld-Johnson's book: Oral Placement Therapy for Speech Clarity and Feeding. This will give you a list of other activities to try. Let us know if we can do anything else to help.

Thanks,

Liz

Elizabeth Smithson, MSP, CCC-SLP is a Speech-Language Pathologist who has over 10 years of professional experience working with infants, children, adolescents and adults. She earned her Master of Speech Pathology at the University of South Carolina. Liz is also a Level 5 TalkTools® Trained Therapist. She has received specialized training in Oral Placement Therapy, Speech, Feeding, Apraxia, Sensory Processing Disorders, and PROMPT©. Liz works with clients with a wide range of disabilities including Cerebral Palsy, Down Syndrome, and Spinal Muscular Atrophy.  She works through her own private practice Elizabeth Smithson Therapy, LLC in the home setting and in the TalkTools® office in Charleston, SC.

Hello. I recently purchased the parent kit to use with my son, Patrick. Patrick is 4 years old, has autism and low-muscle tone, and is not yet speaking.  I would like to begin the program with him as soon as possible, but he does not understand how to blow yet. I have begun to work on this by modeling and using bubbles, and will ask his school to focus on this goal. Do I need to wait until he can blow a horn to start or can I begin with just the straws and chewy tubes?

 

Also, Patrick constantly pulls straws out of cups while drinking. Do you have any suggestions for this? I thought about buying more lip blocks to put under the cup lid so that he won't be able to remove it.

 

Thanks!

Hello and happy new year!

Thanks for your questions regarding our parent kit.

You can start with straws and bite tubes before blowing tasks absolutely. In fact by working on jaw lip tongue dissociation you are targeting the necessary skills to move towards phonation tasks.

I'd consult with PT/OT to help with blowing. This is often a sign of apraxia but also is an issue with core strength and rib cage expansion. Start with bubbles step A of the hierarchy - this is is when you pop the bubbles on the lips. It's great to do this with your child laying in a prone position pushing up on the hands for core stability.

Finally I often put a rubber band under the lid on the straw wrapped rightly 5 or 6 times so the straw can't be pulled out!

Thanks for your interest in TalkTools!

Robyn Merkel Walsh, MA, CCC-SLP