Tagged "Autism Spectrum Disorder"

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

Posted by Deborah Grauzam on



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.






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.




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.

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Ask A Therapist: Introducing Therapy to a Child with Sensory Processing Disorder

Posted by Deborah Grauzam on



I bought the Complete Jaw Program from you a few months ago to use with my three year old son who has Sensory Processing Disorder, and is in the Autism Spectrum. He has very low muscle tone in his mouth and does not chew at all. He eats a wide variety of foods but only in purees. He also drinks perfectly from a straw.


He drools constantly, mostly when he is doing an activity that requires his full attention.


He has great pronunciation of words, so for all the evaluations that he has had, the main problem in his mouth seems to be sensorial.


I have been struggling with the kit because he won't let me go into his mouth that easily and I'm afraid I might hurt him.


Do you have any course that I could take in order to learn how to use the kit?


Thank you for your comments.






Hi Amber,

I am going to answer your question, as I teach a class on Oral Placement Therapy and Autism.

This is a typical problem in children with sensory processing issues, so the key is adding a desensitizing program prior to the Jaw Program. You can also use Applied Behavior Analysis strategies to condition the child to the therapy.

1.  Start the sessions with general body sensory tasks such as deep pressure, jumping on trampoline, etc. Ask your Occupational Therapist or your Physical Therapist for suggestions.

2. Engage in pre-feeding exercises from A Sensory Motor Approach To Feeding, Chapter 7, specifically massage, tapping and myofascial. The Jiggler and Z-Vibe tasks as well as the chewing hierarchy are also great.

3. Then introduce the tool. Do not place it in the mouth at first. Touch, accept to lips, accept to molars with no pressure, and then you can use vibration paired with the tool (Bite Blocks) to provoke a "bite and hold". The key is to be sure and provide direct , immediate reinforcers (often edibles) so the child pairs the tool with a positive.

For more information, please refer to the course Solving the Puzzle of Autism: Using Tactile Therapies.


Robyn Merkel-Walsh MA, CCC-SLP

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Ask a Therapist: Picky Eater

Posted by Deborah Grauzam on

I have a question regarding a 4 year old boy diagnosed with autism in a school setting. At first, he was only eating baby food (various flavors). Now, he eats baby food with Beech Nut baby cereal, still a puree, but a thick oatmeal texture. Sometimes I add a mashed banana to that mixture. He also eats mashed potatoes with some mashed egg whites (although sometimes he needs that dipped in banana baby food in order to eat it). My problem is not getting enough for him to eat, but getting him to accept more textures, and CHEW FOOD!

He accepts a chewy tube, but he will not chew on it if he sees, smells, or feels anything come out of it. He spits out pieces of banana in his babyfood/cereal/banana mixture. He will not allow Gerber puffs near his mouth. It took 5-6 months to transition from the baby food-only stage to where we are now, and I am at a loss, as nothing is working. I would appreciate any and all suggestions for trying new textures that will eventually (hopefully) lead to chewing.

Thank you so much!

It sounds like you have made some nice gains with this child. Are you doing lateral tongue massage and bilateral tongue hugs? Have you progressed to chewing hierarchy level #2 with the chewy tubes? If so, do you see tongue retraction and lateral tongue movement? If so, will he tolerate cold temperatures? If yes, use a syringe to fill a thick straw (Starbucks or Dunkin Donuts thickness) with a favorite puree, and put it in the freezer. Present the ice straw using chewing hierarchy level #1 (perpendicular to the lateral molar ridge at the first molar) and work on facilitating repetitive chews. This could be a good transition to bite, chew and swallow. If moving directly to solid foods is not working, you may have to task analyze his goals.

Good luck! 

Lori Overland

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