Tagged "Apraxia"

Jaw Grading Bite Blocks vs. Apraxia Speech Blocks... What's the Difference?

Posted by Casey Roy on

Good morning! I am a litlle bit confused, could you please help me in something? I would like to buy the Bite Blocks from TalkTools. I just want you to tell me the difference between them and the Apraxia Speech Blocks. Is it the same if I buy the second (Apraxia Speech Blocks) and not the Red Bite Blocks? Are they doing the same job?



Read more →

Ask A Therapist: Sound production roadblock

Posted by Deborah Grauzam on

Hello therapists,


My daughter has been working on TalkTools program since she was 3 months old. She bites well on chewy tubes (red and yellow), does her straw drinking and cup drinking. Here are my few questions:


1) My daughter seems to be drinking well from cup and does horn exercise well, but we have a hard time translating the horn exercise to "m" sound. Do you have any advice to encourage the "m" sound?


2) We feel like we are reaching a roadblock with her exercise because we cannot get her to make sounds that we want, i.e.: "mmm," "me," "moo," etc. She would round her lip but has a hard time saying "wooo" or "oooo". Is there any exercise we should work on to help with making those sounds?


Thanks a lot, we love your program a lot and hope to hear from you!




Hi Jessie,

Thank you for your questions. I would try the Apraxia Shapes. They are great. They will help you with exactly what you were describing in both your questions. I believe that they will be able to bridge the gap for you. There is a video that you can watch to show you exactly how to use them and instructions that come with the tools.

Please let me know if you have any other questions. I am happy to help anyway I can.

Have a great day.




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.

Read more →

Ask A Therapist: Client with Autism and Apraxia of Speech

Posted by Deborah Grauzam on

Hello TalkTools,


I am an SLP working with a four year old boy with autism and apraxia of speech. He has some significant drooling and is non-verbal. I completed the "Three-Part Treatment Plan for Oral Placement Therapy" on-demand course, but was hoping for some guidance from your Instructors.


He is the first child I've used Oral Placement Therapy (OPT) with, and we're working on the Drooling Remediation Program. He's progressing really well with the Chewy Tubes and the Straw Hierarchy but is not able to volitionally blow on Step 3 of the Bubble Blowing Hierarchy, nor is he able to blow for Horn #1 or hold a tongue depressor between his lips for any length of time.


He is able to produce the /m/ and /b/ sounds, but often not on command. He just recently began to show some lip rounding while producing a /w/ sound.


I did purchase the Pre-Hierarchy Horn and have been working on the ball/exhalation activities. Is there anything else I can/should be doing to help him with blowing?


Also, when he eats, he sometimes will chew the food, remove the bolus from his mouth, rest for a few seconds and then place the food back in his mouth and finish chewing/swallowing. Do you have suggestions on how to address this?


Thank you in advance,




Hi Amber,

I'm Robyn, a TalkTools® Instructor, and I will answer your questions the best I can without knowing the child.

I will start with the feeding issue first. This sounds like a self-stimulatory associated with the autism or an issue of bolus mobility. He certainly could have chewing fatigue, or perhaps cannot lateralize the bolus to where it needs to go to swallow it. You will need to assess this, and if needed, implement a pre-feeding program such as, Feeding Therapy: A Sensory-Motor Approach. If all is assessed and nothing is wrong from an oral motor perspective, I would work with the child's behaviorist on a regimented plan to keep his hands down and away from the mouth during feedings.

On to your OPT questions... Phonatory control and volitional blowing can be a very big problem with apraxia. The sounds the child is making can be reflexive in nature but not achievable on command. This is also a defining trait of apraxia. I would consult with OT/PT to start working on rib cage expansion, trunk stability, and core strength as prerequisites for blowing. For now, expose him to the Bubble Program staying on step 2 of the Bubble Hierarchy and practice placing Horn #1 in the mouth and taking it out for the lip closure motor plan. You may also model it for him with your own horn. I often sing, "If you are happy and you know it blow a horn toot toot" and place the horn in the lips when I say 'toot'. I also place children in a prone position on an OT wedge during this task. Immediately after drilling the horn, use the Apraxia Bilabial Shapes to practice the bilabials.

Good luck!


Robyn Merkel Walsh, MA, CCC-SLP

Read more →

Ask a Therapist: Proper Tongue Elevation & Retraction

Posted by Deborah Grauzam on

Dear Therapists


I need advice please! I am seeing a 5 year old child with severe childhood apraxia of speech together with dysarthria (specifically weakness of tongue and lips). So far his lip strength and movement has improved a lot, but I am really struggling with his tongue. He can protrude his tongue beautifully, retraction we are working on, but he is doing ok so far. Lateral movements we are also working on, but tongue elevation seems impossible!  Both posterior and anterior tongue movements just aren't happening! Any advice will be appreciated!!!


Kind Regards




Hi Denise,

Thank you for your email.  I understand your frustration!  I can tell you in looking at motor development, tongue tip elevation does not occur if you do not yet have retraction and stability along with lateral border stability which all allow the tongue tip to develop so it may just be a matter of continuing to work on the underlying skills necessary for tongue tip dissociation.  Often, children who have motor planning deficits in conjunction with oral motor weakness can progress at a rather slow pace and therapy can be difficult when compared to children who only have dysarthria.  I'm happy to help you sort out what might be missing!  I often find that the order I do treatment in can be as important as the exercise itself.  For example, many children with CAS and Dysarthria have difficulty isolating the motor skill I'm looking for, thus a good sensory-motor program may be useful immediately before targeting the motor task I have as a goal.

I'm not sure what education you have in TalkTools but the Three Part Treatment Plan teaches of our systematic approach to motor speech disorders based on normal development. I look forward to hearing from you!

Renee Roy Hill, MS, CCC-SLP


Read more →

Ask A Therapist: Trouble Blowing

Posted by Deborah Grauzam on

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.



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 

Read more →
script type="text/javascript" src="//downloads.mailchimp.com/js/signup-forms/popup/unique-methods/embed.js" data-dojo-config="usePlainJson: true, isDebug: false">