Tagged "Ask a Therapist"


Ask A Therapist: Horn blowing for a 3-year-old with Autism Spectrum Disorder

Posted by Deborah Grauzam on

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

 picture1

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.

Read more →

Ask A Therapist: Chewy Tubes for a one-year-old

Posted by Deborah Grauzam on

Hi!

 

I am working with a little boy who is about a year old, developmentally (orally) is around 8-9 months. I gave the family the yellow chewy tube to practice biting/chewing, in addition to desensitizing gag reflex--instructing them to use with close adult supervision. The caregiver reports to me that his pediatrician told her not to give him the chewy tube as it is "too advanced for him". My question: is there a particular age range for these chewy tubes? Is there any information I can provide this doctor to support the use of chewy tubes in the treatment of feeding for speech therapy?

 

Thank you so much!

 

Sarah

 

Hi Sarah,

I am sorry the child's pediatrician is not as accepting of the chewy tubes.  I have used the chewy tubes with much younger children so I am not sure why the pediatrician is opposed to it.  It might be worth calling and discussing with him.  Maybe giving him the website, blog link, and more information about it would be helpful.  

The only other chewy tube that you could try that would be easier is the red chewy tube.

Please let me know if you have anything else come up or have any other questions. We are always 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.

Read more →

Ask A Therapist: A client bites down on baby bottle

Posted by Deborah Grauzam on

Hello! 

 

My name is Yael and I have a patient who is 18 months, has low tone in the oral area, likes a lot of sensory input inside the mouth but won't suck on a straw or drink from a cup. He only drinks from a baby bottle and kind of bites down on it. How can I start working on his suckling skills so I can work with the straws and all the other tools?

 

Thank you!

 

Yael

 

Hi Yael,

I will give you a number of things to try and see what works for your patient.  I would work on providing a good sensory warm up with the Vibrator & Toothette, chewing on gloved finger, using the z-vibe, or red Chewy Tube (depends on where your client is with jaw strength). I would question if your patient has jaw weakness based on your description.  You can also try rocking the bottle in and out of the mouth to encourage more of a front/ back pattern versus the up/ down biting. Then I would try to use the Honey Bear with Flexible Straw to encourage drinking.  You will load the straw for the patient and provide jaw and cheeks support if needed. I hope some of this helps.

Please let me know if you have any other questions. We are 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.

Read more →

Ask A Therapist: Down Syndrome & Teeth Grinding

Posted by Deborah Grauzam on

Hello, 

 

I have a 23 months old baby boy with Down Syndrome, who is grinding his teeth so bad lately. It is so annoying sometimes. He has 9 teeth and feeding is doing much better at this time. We have the Parent Kit and we are using the Straw #1. My husband is thinking to take him to a pediatric dentist, but I believe I can find an answer from the TalkTools experts. Please help us, we are desperately.

 

 

Thank you,

 

Lucy

 

Hi Lucy,

What you are mentioning is a common concern I hear from parents of children with Down Syndrome.  You are right to follow your instincts. Often we see children grind their teeth as a sign of jaw weakness and a need for sensory input. When I see patients who are often grinding their teeth we work on chewing on the chewy tubes frequently throughout the day. This will help with jaw strengthening and providing sensory input.  If you would like more information about how to do this and why, there are two video that you might find helpful: "A Three Part Treatment Plan for Oral Placement Therapy" and "Developing Oral Sensory Motor Skills to Support Feeding in the Down Syndrome Population.". Please let me know if you have anymore questions. 

We are always 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.

Read more →

Ask A Therapist: Straw D

Posted by Deborah Grauzam on

Hi, 

 

I have a student who just started straw D with the pudding today and after 25 mins with very little progress we called it a day (I work on a school so missing an hour of class won't work). After he left, I tried it myself with the same results! What is normal for this straw? He has gone through the whole program working on his /r/ and I know this last straw is very important for retraction but it seems impossible to drink pudding through straw D. Is it common for people to feel this way initially?

 

Also, any recommendations for cleaning the straw? Water from the faucet didn't get the pudding out and neither blowing. I see quite a few kids for the program so I would prefer to only have to use one straw per student and not one each day.

 

Thank you so much!

 

Alicia

TalkTools | Straw D new cleaning kit

Hi Alicia,

I hate that you are having a hard time with straw D.  I know this is a very difficult straw but it definitely should not be taking that long.  The things going through my head first of all would be: if you cannot drink it, then it may be too thick.  Every pudding is different, but you may have to thin it to a point where you can do it. It does still need to be pudding consistency.  If you have thinned it to the point that you can drink it and your client cannot then I would question if your client still needs to be on the previous straw.  Just a thought.

As far as cleaning it, we recently developed a Cleaning Kit that includes, among others, a bulb syringe to push the liquid out of straws and a 30" flexible tube brush that fits into most straws.  If you still cannot clean straw D, I would suggest that you order that straw in bulk for all of your clients.  Unfortunately because of the diameter of this straw having to be so small to achieve the tongue retraction required, it makes it almost impossible to clean.  

Please let me know if you have any other questions.  We are always 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.

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">