Tagged "Bite Straws"

Ask a Therapist: Straws and Tongue Placement

Posted by Deborah Grauzam on

Hi Sara,

I have taken your Oral Placement course and you currently have devised a plan regarding this program for my son Cole. I have a question however it is regarding something I am seeing in treatment (I am an OT) when using the straw program. I have a patient who has down syndrome, 6 months ago could not form a seal around a straw much less retrieve fluid. She had/has frequent tongue protrusion which limited this skill. Using your techniques she has gained the ability to form a good lip seal (with cheek cueing provided) and can retrieve liquid. What is happening however is that after she sucks 1-2 times (I believe when she is going to swallow) she protrudes her tongue which then breaks the seal and continues to use a pattern we are trying to correct. Any suggestions or insight on this situation? This child has also learned to blow horn #1 and can do with cheek cueing for 8 blows before compensation. At times she has some nasal airflow which I believe her tongue (midblade) elevates and impacts based on the sound she makes when this happens. She can do bubbles as well with same cueing. Last bit of information on whistles and bubbles I included in case it helped with answering my original question. Thank you for your time!

I have seen the behaviors you describe concerning the suckle pattern with straw drinking.  Here is what I would try.  Have her draw the liquid 1 time, remove the straw, once she swallows, put the straw in again.  See if the single-sip technique helps with the tongue retraction.  Also, make sure the tip of the straw is on the surface of her lower lips and that she is drawing the liquid back using lip protrusion with tongue retraction.  If the straw is on her tongue blade that might also explain why you are seeing the protrusion.  I hope this helps. 

Sara Rosenfeld-Johnson, MS, CCC-SLP


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Ask a Therapist: Feeding Therapy with Bite Straws

Posted by Deborah Grauzam on

Hi Lori. Without seeing the student, can you tell me if this sounds like accurate application of the Feeding Therapies we learned in your workshop? When using the bite straws with a one year old girl with Down's, she moves her head to the side to which the straw is presented to instantly suck the applesauce out of the straw. I believe this is due to the rooting reflex not being totally integrated and also her ability to suck vs bite is much delayed. Mom notes she seems to be moving her tongue around a little better since she started with the bite straws. Mom continues to give facial massage to the outside of face, using tapping when wiping her face. She is doing some cup drinking and tolerating it just a bit. She can drink from a straw and mom has been instructed in straw drinking. We are working on reducing tongue protrusion and mom is providing a lip block when drinking. I know I need to try tongue lateralization and tongue hugs with her. Thanks, Lisa

Hi Lisa. You probably need to address cheek mobility, and upper lip mobility, given her age and diagnosis. As for the lack of dissociation, try positioning yourself behind her, using the "v" support and then doing the ice straws with chewing hierarchy level #1, as explained in my book A Sensory-Motor Approach to Feeding.

Lori Overland

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