Tagged "horn blowing"


Ask a Therapist: Significant Tongue Thrust Swallow Pattern and Tongue Protrusion

Posted by Deborah Grauzam on

Hello!

 

I have a 13 month old with Down syndrome who has a significant tongue thrust swallow pattern and tongue protrusion. Her tongue is ALWAYS out of her mouth, far. Almost as if she is intentionally pushing it all the way out. She retracts her tongue when I place a straw in the corner of her mouth, place a puff on her molar ridge (and will maintain tongue lateralization for a short period), and when I place the elephant jiggler in her mouth. As soon as she attempts to control the puff with her tongue or swallow, her tongue pushes forward again. I can prompt her to retract her tongue at rest but it comes right back out. What else can I do? I only get to see her one time per month at this point. Mom sits in on sessions and carries over at home. Pediatrician and ENT have no concerns about size of tonsils; I have not observed them myself yet.

 

Aubrie

 

Hi Aubrie,

It sounds like you have been working really hard with this patient to address the tongue retraction.  Everything you are already doing sounds great.  I would add bubble blowing, horn blowing and chewing on the back molars (with cubes of food if able, z-vibe and the bite tubes). All of this will encourage tongue retraction in the mouth. The more you can work on the retraction the better.  

I hope this helps.

Please let me know if you have any other questions.

Thanks,

Elizabeth J. Smithson, M.S.P., CCC-SLP 

 

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: Tongue Tip Elevation in Moebius syndrome

Posted by Deborah Grauzam on

When people need help with therapy or products, we put TalkTools® Instructors to work and then publish the exchange for anyone in the same situation to get help, too. This question is from Danielle, by Facebook message.

Hello,

I was wondering if you could possibly help me. My six-year-old son has Moebius syndrome and recently had facial reanimation surgery. We have been doing TalkTools therapy for years and love it. We do a lot, from the Z-Vibe to Chewy Tubes to the horns! We have him try to follow the Z-Vibe with his tongue, but I can’t get his tongue to lift up. My question is: how can I help my son improve tongue movement? He has twelfth cranial nerve palsy, and his tongue has become so much stronger with therapy, but tongue tip elevation is still so hard for us. Any tips? Thanks so much for your help.

Danielle

Hi Danielle,

Here are some questions that may help us think about why he may be having difficulty. When we are looking for tongue tip elevation we need to know first if he has jaw stability, tongue retraction and tongue tip lateralization skills first; these are prerequisite movements we look for. If you are unsure of any of the terminology let me know!

1. Does your son get any lateral movement? If so is he getting lateral movement to both sides? What activities do you see this movement in?

2. Can he chew on his back molars and hold the food there? Do you see his tongue move toward the food as he chews? Does this look easy for him?

3. Can he drink from a straw with tongue retraction? (Or does he protrude his tongue forward)

4. Have you done the Jaw Grading Bite Blocks so we know that he has adequate jaw stability as well?

If you’d like to send a quick video clip doing some stimulation of his tongue I may be able to see something.

All questions that may help us get a “why” answer and maybe a plan! Also, if you haven’t already, you should read this article by Sara Rosenfeld-Johnson about Moebius Syndrome. I look forward to hearing from you and helping any way I can!

Renee Roy Hill, MS, CCC-SLP

Thank you so much for replying, I appreciate it more than you know. My son does have some lateral movement, but it is limited. He uses his fingers so much to move his food to his back molars and has always been a messy eater. When he drinks from a straw his tongue protrudes forward as well. Thank you for taking the time to help us.

Danielle

He still needs help with tongue retraction and lateral movement before working on elevation. He is not yet ready to work on elevation. Good luck with everything and let us know if you still need our help! 

Renee Roy Hill, MS, CCC-SLP

Renee Roy Hill, MS, CCC-SLP has provided therapeutic assessments and program planning for adults and children with oral placement, feeding and motor speech deficits for over 17 years. She is the owner of Crossroads Therapy Clinic in New Braunfels, TX and a member of the TalkTools® speakers bureau. Renee has been an invited speaker for ASHA state conventions and has received specialized training in speech/oral-motor/feeding therapy, Apraxia, sensory processing disorders, Hanen Courses, NDT training, TAMO therapy and PROMPT. She is the creator of the TalkTools® Schedule Board Kit, co-author of Ice Sticks, and author of the TalkTools® Apraxia Program.

Meet her!

  • February 10-11, 2017 in Pasadena, CA
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For more details, visit TalkTools Event Calendar

 

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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.

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Ask A Therapist: /h/ for /k/

Posted by Deborah Grauzam on

Hi TalkTools,

 

I have a 6 year old male student who produces /h/ for /k/. He appears to have placement, and is able to produce /g/. However, we have not been successful in nearly a year of therapy with eliciting /k/. His voice is hoarse during conversational speech. His mother is not interested in visiting an Ear, Nose & Throat Doctor. Do you have any suggestions or theories? Thank you.

 

Angela

 

Hi Angela,

Based on what you have written he just is not associating tongue elevation with his "k" sound and instead is producing the 'h." I would work on "g" repetitively and throw in a whispered "k" in a sequence of sounds (having him repeat). I would try to get him in the right position over and over and over again and then switch quickly to the "k" and see if that works. Work on teaching "k" as the quiet sound. 

Other exercises you can try would be horn blowing, bubble blowing, and straw drinking. This will help to reinforce the back of tongue retraction that is important for that speech sound. Even though it seems he already has the placement with the "g," hopefully the repetition will help get him transitioned to the "k."

I hope these ideas help. Please let me know how it goes and write back with any other questions.

Have a great day.

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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