Tagged "OPT"


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: My First Time Doing An Eval

Posted by Deborah Grauzam on

Hi TalkTools, 

 

I have a few questions for the staff SLP. I watched the "3 Part OPT" videos and I can see how it generally walks me through the eval process but the language doesn't seem clear to me on the Assessment Form. Did I miss something?

 

It is my first time doing an eval. Here are my questions regarding how to do the eval:

 

1. For "Jaw Grading Bite Blocks", do I use ALL of the in the A, B, and C positions? Or just some or the last one?

 

2. for "Tongue Tip Lateralization", what does this look like? Do I start with asking them to swipe the inside of their mouth left to right 10 times and if they can't then use the tool? What do I ask the client to do?

 

3. For "Tongue Tip Elevation " I don't understand the criteria of 50 seconds, 1 time. What does this mean?... hold the tongue tip at alveolar ridge for 50 secs? What do I ask the client to do?

 

4. "TT Depression"- Where does the tongue go? What do I ask the client to do?

 

5. Same for "TT Up and Down"  - where does the tongue go? What do I ask the client to do?

 

Sincerely,

 

Carrie 

 

Hi Carrie,

Great question!  The Oral Motor Skills for Feeding and Speech Checklist is not intended to “teach” you each section of the form but a place for you to write results, guide you through an assessment and then provide the information you would need to then develop a program plan for therapy. The form assumes you know each technique, or, have the resources to find the protocol for each exercise. The criteria for success listed is a reminder of what the final goal is to complete that activity or step (this is the part that so many, to include myself have difficulty remembering when you are new to using the protocols). You may want to consider looking into our next course, “Assessment and Program Plan Development” that would follow the 3 Part Treatment Plan. In this course we use this form for several different evaluations to help you become familiar with its use! I will answer your individual questions below, directing you to where the complete instructions for each of them are!  If you have further trouble don’t hesitate to email me!

1. Each Bite Block Height would be assessed at each level. For example, you would not move from Bite Block #2 Exercise A to Bite Block #2 Exercise B unless they have met the criteria for Exercise A and so on. These instructions can be found in the books “OPT for Speech Clarity and Feeding” “Assessment and Treatment of the Jaw” and included with the set of Bite Blocks.

2. There is a specific exercise outlined in “OPT for Speech Clarity and Feeding” using a Bite Block and complete instructions with the Tongue Tip Lateralization Tool. There are many steps to this activity to teach the client to lateralize the tongue tip to the lower back molar.

3. Yes, the final goal is that the client can hold the tongue tip to the alevolar ridge for a full 50 seconds, 1X. You will notice that in therapeutic practice we often request multiple repetitions of practice but it is not always the criteria for success.

4. This is another activity that is in “OPT for Speech Clarity and Feeding” or included in the instructions with the Tongue Tip Elevation Tool. 

5. The tongue tip will go to the same two locations previously practiced individually. These instructions are also in “OPT for Speech Clarity and Feeding” followed by a transition technique to teaching the /s/ sound once you have completed this activity!

Renee Roy Hill, MS, CCC-SLP

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Ask A Therapist: Straw Length

Posted by Deborah Grauzam on

Hi Guys!

 

I have a couple of questions. First of all, I am utilizing Sara Rosenfeld-Johnson's Drooling Remediation Program and OPT on a 2.2 year old for drooling. Dad is a dentist and is totally on board. Their little guy is a twin and has three other siblings. The little guy has progressed to straw #5 and although he struggled with horn #4, he has now successfully moved on to horn #5. Mom is very unhappy with the length/height of the straws ... I have explained 'calibration' of each straw to her. Is there anything else I can say to appease this busy mom? We are also needing some help writing up the report for insurance purposes. I purchased the "Forms for Oral Placement and Treatment" CD, thinking that it would contain that type of helpful information. Insurance can be so persnickety!

 

I am also trying to get insurance to cover services for a 10 month old with Down Syndrome that I have screened for services. He is being seen through ECI, has not feeding issues currently but would benefit from OPT!

 

I have been working with a 27 year old with Down Syndrome very successfully! Her parents are amazed and thrilled!

 

Thank you for any information you can provide that will assist me in helping my clients!

 

Sincerely,

 

Kellie

 

Hi Kellie,

It sounds like you have done a great job explaining the straws and how to use them to this mom. The only other idea I have would be to encourage her to put the straw in the large TalkTools cup with lid and have the curly part of the straw under the lid. That sometimes helps if it is tipping or they are playing with it. I just try to explain that the straw is working on tongue retraction in the mouth at different levels. It is important that they are that particular length because that is what makes them more difficult and requires more work for the tongue and lips.

As far as the insurance billing, I personally do not bill insurance but there is a CD called "OPT Goals & Objectives for IEPs and Insurance Reimbursement" that will help with goals and objectives for insurance reimbursement and IEPs. It does not include coding but it should help with what you are talking about. It sounded like it was more of what you were looking for than the CD you mentioned.

Good luck with the mom you are working with and please let me 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.

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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: Sound production roadblock

Posted by Deborah Grauzam on

Hello therapists,

 

My daughter has been working on TalkTools program since she was 3 months old. She bites well on chewy tubes (red and yellow), does her straw drinking and cup drinking. Here are my few questions:

 

1) My daughter seems to be drinking well from cup and does horn exercise well, but we have a hard time translating the horn exercise to "m" sound. Do you have any advice to encourage the "m" sound?

 

2) We feel like we are reaching a roadblock with her exercise because we cannot get her to make sounds that we want, i.e.: "mmm," "me," "moo," etc. She would round her lip but has a hard time saying "wooo" or "oooo". Is there any exercise we should work on to help with making those sounds?

 

Thanks a lot, we love your program a lot and hope to hear from you!

 

Jessie

 

Hi Jessie,

Thank you for your questions. I would try the Apraxia Shapes. They are great. They will help you with exactly what you were describing in both your questions. I believe that they will be able to bridge the gap for you. There is a video that you can watch to show you exactly how to use them and instructions that come with the tools.

Please let me know if you have any other questions. I am happy to help anyway I can.

Have a great day.

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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