Tagged "jaw weakness"


Ask A Therapist: Bite Block & Tongue Depressor Questions

Posted by Deborah Grauzam on

I have a student who is using the red bite blocks. He just started. When I put the bite block #2 between his teeth he slides them over. Is this normal or should I reposition them?

I have another student who is having a very hard time holding the tongue depressor between his lips. He has a hard time dissociating between his lips and his tongue and jaw. His tongue is retroflex for l. He is currently working in l in the final positing of words and is having a hard time bringing the tongue forward and not back. Any advice?

Thanks

Rebecca

 

Hi Rebecca

I would definitely reposition. I often have to have the patient bite a couple of times until it is positioned correctly especially with patients with severe weakness. You may even want to practice the biting without the bite block for correct position first and then go in with the bite block. Sometimes that helps as well. 

As far as the second part of the question, I would make sure that I have addressed any jaw weakness first. That is typically the foundation of the issue. As far as the tongue placement I would work on stimulating with the toothette the forward placement of the tongue. I would touch with the toothette on the alveolar ridge where you want the tongue tip to touch and then I would touch the tip of the tongue with the toothette. You can use vibration with the toothette if your client will accept that. This has helped many patients I have worked with find the appropriate placement. 

Please let me know if you have any other questions. We are always here and happy to help.

Thanks, 

Liz

 

Elizabeth Smithson, MSP, CCC-SLP is a Speech-Language Pathologist who has over 11 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: Tongue Lateralization

Posted by Deborah Grauzam on

Hi TalkTools,

 

I completed your training a little over a year ago, but still would like some support when making therapeutic decisions.

 

I am working with a 12 year old boy who has both language and speech issues (the /r/ and vocalic /r/ phonemes). I just completed a screening and the oral-motor portion of the screening revealed that: a. he could not protrude his tongue straight out of his mouth (it would lateralize), b. his tongue seemed to have a little tremor, c. he had difficulty dissociating his lips/tongue.

 

I would like to add some Oral Placement Therapy exercises to his therapeutic program. Can you please make some suggestions?

 

Many thanks,

 

Wendy

 

Hi Wendy,

I have your question and will try to give you some pointer on things to try. If you haven't worked on the Bite Tubes with this client yet, I would if you identify jaw weakness. The jaw is the foundation for everything else to work properly. Next, I feel he probably has tongue weakness and increased weakness on one side based on your report. I would work on tongue lateralization exercises to the Z-Vibe tip and with the Tongue Tip Lateralization & Elevation Tools bilaterally. You will have to work twice on the weaker side depending on what you see with your assessment. You could also work on straws and horns to help with tongue retraction for the /r/ sound.

Please let me know how this goes or email back any other questions.

Thanks so much,

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.

Read more →
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