Tagged "lip mobility"

Ask A Therapist: The right duration of vibration

Posted by Deborah Grauzam on



I have a question about using vibration (as with the Z-Vibe or Vibrator & Toothettes). I understand that using vibration can be used to "wake up" the sensory system, and I believe I’ve heard that it can have a temporarily positive effect on low muscle tone. I’ve read that vibration should be used in short durations, but I was wondering if you had any guidelines for the maximum or minimum duration of vibration? I’m thinking especially in a case of low muscle tone as in children with Down syndrome.


Thank you very much!




Hi Jennifer,

My name is Lori Overland and I teach the two day sensory-motor feeding class for TalkTools. Your email was forwarded to me, and it is an excellent question.

You cannot separate out the sensory and motor systems. Sensory feedback always impacts movement and movement provides feedback. It is important to make sure you have a specific motor goal (i.e.: in the case of spoon feeding, perhaps the goal is lip closure). Vibration facilitates a contraction of the muscle, so it may be used in conjunction with a tool to facilitate upper lip mobility for spoon feeding. If you leave vibration on a muscle for too long, the muscle relaxes. If you are using my pre-feeding exercises, I recommend  4-5 repetitions (maybe a little more or less depending on my client's sensory system) of an exercise. If you think about your motor goal and map sensory on to motor, you will not have to be concerned about using too much vibration. Feel free to email me if you have a follow up question.



Lori Overland, MS, CCC-SLP is a speech and language pathologist with more than 35 years of professional experience. Lori specializes in dealing with the unique needs of infants, toddlers, pre-schoolers and school-aged children with oral sensory-motor, feeding and oral placement/speech disorders. She has received an award from the Connecticut Down Syndrome Association for her work within this population. Lori consults with children from all over the world, providing evaluations, re-evaluations, program plans and week-long therapy programs. Lori also provides consults to local school districts and Birth-to-Three organizations. Her goal in addressing feeding and speech challenges is to improve the quality of life for both the children she serves and their families. In addition to her private practice, Alphabet Soup, Lori is a member of the TalkTools® speakers bureau. Lori has lectured on sensory-motor feeding disorders across the United States and internationally. Her classes, "Feeding Therapy: A Sensory-Motor Approach" and "Developing Oral-Motor Feeding Skills in the Down Syndrome Population" are approved for ASHA and AOTA CEUs. Lori is the co-author of A Sensory Motor Approach to Feeding. She holds degrees from Horfstra University and Adelphi University and has her neurodevelopmental certification.

Meet her!

- Oct. 14-15, 2016 for the workshop Feeding Therapy: A Sensory-Motor Approach in Cape Giraudoux, MO

- Oct. 29-30, 2016 for the workshop Feeding Therapy: A Sensory-Motor Approach in Minneapolis, MN

More dates at: TalkTools.com/Workshops

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Ask a Therapist: Cleft Palate and Feeding Therapy

Posted by Deborah Grauzam on


I've taken your courses for Down's syndrome and Assessment and Planning. I'm fairly new to feeding, but am having some success with Down's clients (thank you and they thank you :).

I just got a 15 month old with cleft on my caseload.  He's had lip repair and his palate only has a small hole after surgery (will be fixed at 3).  His mother said she used a squirt bottle because he couldn't suck (and still uses it before he goes to bed).  He can drink from a cup without spilling if it only has a tiny amount in it.  Is there any reason this child could not start using a straw or have more control with a cup with intervention?  His upper lip has no movement for retraction or protrusion, but he does get closure for the /m/ sound.



Thanks for your email. I am so glad you have been using what you learned in the Down syndrome class with success! You should absolutely start working on upper lip mobility and lip rounding with this child!  You may have to work through the scar tissue, and I have found that a vibrating upper lip stretch (one gloved finger under the scar, one outside the lip on top, use a vibrating movement with your fingers through the scar tissue) or a myofascial release.  Then do your upper lip stretch, and mickey mouse /m/. Once you get mobility, start doing single sip cup drinking.

Best of luck and let me know how your client progresses!

Lori Overland

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