Tagged "Lori"


Ask a Therapist: Nutritive Feeding for Charge Syndrome

Posted by Deborah Grauzam on

I have a 4 year old student with CHARGE SYNDROME. He has minimal intake and could be looking at a feeding tube if this declines any more. Mom is totally fighting with him (holding one hand with her mouth, the other with her non-feeding hand and then spoon feeding with the other!). Feedings take at least an hour to get adequate intake. Would love to pick your brain!

Hi Lisa, I would be happy to talk to you about your little one with CHARGE. I often see parents who are frantic to get their child to take adequate nutrition. In therapy, your goals should be to assess this child's sensory motor skills to support feeding and to work on the underlying motor skills to support safe nutritive feeding. I would also recommend consulting with a nutritionist to make sure this child is getting adequate nutrition. Perhaps you can look at a complete nutritional shake (something like Complete), so he does not need to be force fed, while you are working on sensory motor skill development. If this child is unable to get adequate nutrition by mouth, tube feeding may be a the best option. It often allows parents to relax, work on developing the motor skills for oral feeding and to enjoy mealtime with their child.

Hope this helps!

Lori Overland

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Ask a Therapist: Feeding Therapy with Bite Straws

Posted by Deborah Grauzam on

Hi Lori. Without seeing the student, can you tell me if this sounds like accurate application of the Feeding Therapies we learned in your workshop? When using the bite straws with a one year old girl with Down's, she moves her head to the side to which the straw is presented to instantly suck the applesauce out of the straw. I believe this is due to the rooting reflex not being totally integrated and also her ability to suck vs bite is much delayed. Mom notes she seems to be moving her tongue around a little better since she started with the bite straws. Mom continues to give facial massage to the outside of face, using tapping when wiping her face. She is doing some cup drinking and tolerating it just a bit. She can drink from a straw and mom has been instructed in straw drinking. We are working on reducing tongue protrusion and mom is providing a lip block when drinking. I know I need to try tongue lateralization and tongue hugs with her. Thanks, Lisa

Hi Lisa. You probably need to address cheek mobility, and upper lip mobility, given her age and diagnosis. As for the lack of dissociation, try positioning yourself behind her, using the "v" support and then doing the ice straws with chewing hierarchy level #1, as explained in my book A Sensory-Motor Approach to Feeding.

Lori Overland

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Ask a Therapist: Oral Motor Strengthening

Posted by Deborah Grauzam on

I was just assigned a 13 month old who was diagnosed at birth with bells palsy. He is much better now and the weakness on one side only shows up when he smiles (mom showed me how it droops in pictures). I want to do some oral motor strengthening. I have chosen a combination of your oral motor work and some Beckman strategies, but do you have any specific tips for this case?

I think one of the most important things you can do is to work on his cheeks. (My course “Feeding Therapy: A Sensory Motor Approach” has been updated with new pre-feeding exercises.) I would start with the cheek stretch, then work on cheek resistance and finally fish lip pops. If you can make some specific observations about function, I may have additional suggestions.

Lori Overland

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