Tagged "baby with Down syndrome"

Ask A Therapist: A good start for a child with Down Syndrome

Posted by Deborah Grauzam on

Hi there, my daughter is 2.5 years old, she has Down syndrome. We live in New Zealand. Can you please let me know what you would recommend for her? She is making sounds and attempting to say a few words. She uses sign language - and has approx 30 signs. Her tongue protrudes every now and then. She has no dribbling issues.


Thank you,




Hi Cassy,

I would start with the videos: "Developing Oral Sensory Motor Skills to Support Feeding in the Down Syndrome Population" and "A Three Part Treatment Plan for Oral Placement Therapy". These will help you get the clear understanding of how to do TalkTools Therapy with your child if there is not a trained therapist available. The Parent Kit would be a good place to start as far as tools go to use with your child. You will probably need more in the near future but I think that is a good place to start.  

Please let us know if you have any other questions.




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: TMJ Sensory Feedback for Calming

Posted by Deborah Grauzam on

Hey Sara,


Recently you had a parent open question meeting in Corpus Christi, TX. I was there with my 8 month old baby. You were talking to a woman who's 5ish son with Down syndrome was repeatedly hitting his chin and you mentioned he was satisfying a feeling that was in his jaw by that action. I have noticed my baby has started doing that with her left hand. What do you recommend to help correct/redirect this behavior now?



Hi L,

The sight of stability and calming for an infant is in the temporomandibular joint. This joint is where the upper and lower jaw meet right below the ear. There are more nerve endings going through that joint than any other location in the human body. When a baby sucks his/her thumb, sucks from a bottle, sucks on a pacifier, etc. the nerves in that joint are stimulated and the baby calms or even falls a sleep. If your child is doing other behaviors to stimulate the jaw like hitting the chin or for older children it may be teeth grinding, then it is probably time to introduce the Bite-Tube Hierarchy. You can learn more about this and other activities to increase jaw skills for both feeding and speech clarity in my book, "Assessment and Treatment of the Jaw: Putting it all together, Sensory Feeding and Speech."

If you do decide to purchase that book please read the chapter on Sensory first as it will explain to you in more detail the reason why babies and children with muscle-based deficits develop "habits" to compensate for the jaw weaknesses. I would also encourage you to share this information with your SLP as she may have additional suggestions.

I hope this has answered your question.

Sara Rosenfeld-Johnson, MS, CCC-SLP

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Ask a Therapist: Down syndrome Infant Treatment Ideas

Posted by Deborah Grauzam on


I have used your therapy approach for a while and would like to know what Sara would recommend for me as I am starting with a 7 month old child with Down syndrome.  I am ordering the CEU DVD, however, I wondered if there was some other resource that I should consider as I start out with this infant.

Thank you


Your email was referred to me for a response but I have to say you have anticipated my answer.

Lori Overland's DVD entitled "Developing Oral-Motor and Feeding Skills in the Down Syndrome Population" is exactly what I would have encouraged you to purchase.  I say this because after 40 years of working with children with this diagnosis I have never met two who need the same exact intervention. Lori's DVD will give you the knowledge you will need to best address this client's individual needs.

Other suggestions at this time are the following:
1.  Feed the child with the ear higher than the mouth to prevent liquid from going into the child's ear via the Eustachian tubes.
2.  Do not push down or in on the child's tongue
3.  Read the The Oral-Motor Myths of Down Syndrome
Have fun with this client as the potential for the development of normal feeding and speech skills is very high based on appropriate intervention.  
Once this client reaches twelve months of age you might want to watch the DVD of my class "A Three-Part Treatment Plan for Oral Placement Therapy," as it will give the next steps in our treatment model.  

I hope this has answered your question,  

Sara Rosenfeld-Johnson

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