Tagged "Chewing"


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.

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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.

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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.

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Ask A Therapist: Jaw Jutting

Posted by Deborah Grauzam on

Hi TalkTools,

 

How can I inhibit jaw jutting for Horn #1? We are working on the Bite Tube Set and establishing the natural bite with Bite Blocks but this child presents with frequent jaw slide or jaw jutting. Thanks,

 

Anne

 

Hi Anne,

I would provide firm jaw support to inhibit the jaw jutting. You can use jaw support for Horn #1 and Horn #2. Beginning with Horn #3 you would no longer provide jaw assistance.  I would be using the jaw support and gradually try to decrease use as the patient will tolerate. I hope this helps. Please let us know if you have any other questions.

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.

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Ask A Therapist: oral motor therapy services report for insurance

Posted by Deborah Grauzam on

Hello,

I am trying to write a report to justify services to insurance for oral motor therapy.  The client I am working with has Down syndrome, he has had difficulty with chewing recently and his speech has become more slurred according to family. I purchased the CD "OPT Goals & Objectives for IEPs and Insurance Reimbursement" but am having much difficulty writing a report.  Do you have any sample evaluation reports available?

Peni

 

Hi Peni,

We unfortunately do not have examples of reports to offer but we do have sample evaluations and program plans in Sara Rosenfeld-Johnson's new book A Therapist's Guide to Rehabilitative Feeding and Speech Techniques for Teens and Adults and her book Assessment and Treatment of the Jaw. The first book mentioned focuses on adults but includes diagnostic codes and treatment codes for each example patient. They are not ICD-10 codes but they can be converted on the ASHA website. The second book has children examples (an infant with Down Syndrome) but no codes. I am not sure which book would fit your needs best but I wanted to give you options. I hope this helps. Please let me know if you have any other questions.

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 →
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