Tagged "jaw grading"


Ask A Therapist: Jaw Grading Bite Blocks and Dissociation

Posted by Deborah Grauzam on

Hello TalkTools,

 

I am Speech and Language Therapist working with an 11 year old with autism. He has a TalkTools® Program Plan, but I would value the opinion/support of one of your Instructors.

 

A significant priority at present is supporting him with dissociation of his jaw movements and then with grading. However, we have not been able to get a reliable bite on the Jaw Grading Bite Blocks. Interestingly, after about a month, he has achieved a bite/hold on the DnZ-vibe (not what I had initially planned that we would work on) with the vibration turned on. When the vibration is turned off, his bite is not so reliable. We are working at present on transferring the bite/hold to the #5 Jaw Grading Bite Block.

 

Do your instructors have any thoughts or experience with this? He does have complex sensory needs that are clearly factors in his eating, speech and other motor skills. I will certainly seek out advice from his Occupational Therapist once he has settled into a new school placement soon.

 

Many thanks,

 

Sally

 

Hi Sally,

I'm Robyn, a TalkTools® Instructor, and I've received your inquiry.

You are actually answering your own question, so great observation! This client needs more input to understand what's expected.

Hold the Bite Block in your right hand. With your left hand, hold a Jiggler in place on the top of the Bite Block and place at the correct spot as directed. I usually grab both tools with one hand and apply upward pressure on the mandible and say " bite and hold".

If this doesn't work, try reversing the hierarchy and working from 7 to 2 on the Bite Blocks, because the weakness may be in the high position. If there is a low jaw posture, sometimes reversing the order of the hierarchy is required.

I hope this helps!

Sincerely,

Robyn Merkel-Walsh, MA, CCC-SLP

Read more →

Ask a Therapist: Biting and Feeding Improvement

Posted by Deborah Grauzam on

Hi and Good Morning!

 

I am writing from Israel, I have participated in your course that you have presented in November in Jerusalem. Thank Goodness I have been using many of your techniques to assist my clients and I have seen success.

 

Sara, I have an important question to ask regarding an adorable child, Charlie. I will describe Charlie and my results of oral-motor exam administered as best as possible so that you may answer us accordingly! Thank you for your time!

 

I have been seeing Charlie since mid February. Charlie is 3.5 years old. He is developmentally and cognitively delayed (has seizures). According to exam he is both hyper-hypo sensitive, he enjoyed the toothette (with orange juice) in his mouth- at home he constantly requests for the pink, fluffy toothette. He allowed me to go around his mouth and in the mouth after a lot of work. (The second session he only let the toothettes). Charlie's jaw, tongue and lips are weak, and there is not enough dissociation between jaw, lips and tongue. Little grading of jaw, needs jaw assistance to drink from straw #1.

 

Tongue thrust while drinking. Lip closure, protrusion, rounding is poor. Speech is limited to single syllable words (deletes sounds), or short phrases-he is not so clear. He is being treated by PROMPT therapist since he is 2 years old. I have given them a structured program including many tools you have taught (ice stickchewy tube, etc.). They have been practicing and carrying out exercises every day...he is starting to feel his mouth, they have seen a lot of drooling, sticking hands in mouth constantly and even so more, a lot of biting (siblings, friends). Parents are very concerned, they understand that the exercises will help him feel and strengthen lips, jaw and tongue, better speech and feeding. But, now there is excessive biting and touching of the mouth!

 

Sara, is this a normal occurrence?

Yes I do see this response when a child first identifies the positive sensory feedback from increased jaw movements. It is actually a positive sign but I can see why the family is concerned. I will make the following suggestions:

1. Make sure they are doing the Bite-Tube Hierarchy set with as many of the 4 tubes he can use, 10 times each day and to do them as soon as he makes the move to bite someone or touching his mouth.

2. Add the Bite Block exercise and the gum chewing exercise.

If you do all of these exercises, everyday, he will not need to bite. I hope this answers your question.

Sara Rosenfeld-Johnson, MS, CCC-SLP

Read more →
script type="text/javascript" src="//downloads.mailchimp.com/js/signup-forms/popup/unique-methods/embed.js" data-dojo-config="usePlainJson: true, isDebug: false">