Tagged "muscle weakness"


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: Bite Tube Hierarchy for TMJ stimulation

Posted by Deborah Grauzam on

Dear TalkTools,

 

My son, David, is 4 years old and has Down Syndrome. He has in the last year started chewing on his tongue. I have tried giving him the P & Q to chew on and also the Gator Jiggler. The Gator works for a time and the P's and Q's do not seem to help at all. I looked on your website for potential ideas to no avail and was wondering if you have additional thoughts/ideas. We are a very oral family -- I chew on my pens (usually when I'm thinking), my two oldest daughters were thumb suckers until older, my 2nd daughter bites her nails, my 3rd daughter chews on her shoelaces...thanks for any ideas that you may have!!

 

Robyn

 

P.S. Sara has seen David informally the last two years at NDSC.

Hi Robyn,

I am so pleased you decided to email TalkTools with this question. I must say this tongue chewing is often seen in kids with the diagnosis of Down syndrome as well as with other children with low tone and associated muscle weakness. In my second book, Assessment and Treatment of the Jaw - Putting it all together: Sensory, Feeding and Speech, I devote an entire chapter as to why children with jaw weakness find these habits: tongue sucking is only one of them. Other kids choose teeth grinding, finger sucking, sucking on clothing, biting themselves or other, prolonged use of pacifiers or sippy cups and nail biting. What all of these "habits" have in common is the need for stimulation to the temporomandibular joint for calming. This is the joint where the bones of the upper jaw and the bones of the lower jaw meet right below the ears. This joint has more nerve endings than any other place in the human body. It is where we go to relax. In your email you mentioned you bite on a pen and your daughters bite on shoe laces or nails. The up-and-down movement of the jaw relaxes us and helps us to organize our bodies.

Because your son needs stimulation directly to the joint the two techniques you listed: P&Q and Jiggler vibrator are not giving him the correct input. The muscles that need to be activated are the masseter muscles and the tools you are using are not reaching those muscles.

We, at TalkTools, have developed many techniques to give this necessary TMJ stimulation. One which seems very appropriate for your son would be the Bite Tube Hierarchy, in which four tubes are used to not only satisfy the need for TMJ stimulation but also are used to improve speech clarity and chewing skill levels. The instructions for how to implement the technique is included with the therapy tools. There are many more options to substitute for the tongue sucking and these can be found in the book I mentioned above.

I hope this answers your question,

Sara Rosenfeld-Johnson, MS, CCC-SLP

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