Tagged "self study"


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

Read more →

Ask a Therapist: Feeding Therapy Self-Study Follow-Up

Posted by Deborah Grauzam on

Dear Lori,

I just completed your "Feeding Therapy: A Sensory-Motor Approach" DVD. What an amazing course! It certainly gave me a great deal of confidence in working with children with feeding disorders. While it was extremely thorough and informative, I do have several questions for you. I would love your input!

1. When would you typically recommend an OT evaluation?  Or perhaps I should say,  in which cases would you not refer a child (with an apparent feeding disorder) to an OT?  ***Great question! I look at the whole child and ask a lot of questions about how the child moves through life. In my case history form I ask questions like: does your child get upset easily, does your child have difficulty calming, does your child have difficulty in new situations, transitions, separation etc, does your child have complicated routines for bed, bath, daily living activities, etc... During the evaluation I watch how the child responds to input in the environment. If I observe underlying sensory concerns (sometimes parents just think their child is challenging, or high maintenance and do not realize the behaviors they observe are secondary to sensory issues) I immediately refer to an OT. If the child seems to be able to self regulate, modulate incoming information (for everything but feeding) ....I would not necessarily refer to an OT immediately. I might start an oral sensory motor pre-feeding program and see how the child progresses.***

2. You spoke a bit about breastfeeding, and I was wondering, what role would a lactation consultant play in breastfeeding support if you are working with a nursing mother?  Would our job be the same as a lactation consultant's or would you ever refer the family to one?***I work with great lactation consultants. They are often the first ones to see the baby. They call me in when they observe oral sensory motor issues which are not related to the mothers milk production, bonding, positioning etc. If it is a mom issue...it is definitely the lactation consultants role to consult. If the baby has oral sensory motor issues....that is our role.***

I would also like to order some tools from your website for my practice.  I want to add the Mickey Mouse attachment, but I am not sure if I should buy the hard or soft one.  ***It depends on your child's sensory system...but overall I prefer the soft mouse*** When would you use one vs the other? ***If a child needs more input I would recommend the hard one*** And what about the cat?  I don't think you talked about it in the video, but I am curious to know when it should be used. ***I use the cat ears to get tongue tip pointing. For example, I may present the cat ear at the lateral incisor for chewing hierarchy level #3, and then alternate lateral incisors!!!!***

I really wish I was able to physically attend your course and get to meet you in person!  You are such an inspiration to me!!  Thank you for all of your incredible work. ***Thank you for taking the class on video, and I hope one day we will meet in person. I am doing a one-hour seminar at ASHA this year!!!! If you are there, please come and introduce yourself!!!!

My very best,

Lori***

Read more →

Ask a Therapist: Down syndrome Infant Treatment Ideas

Posted by Deborah Grauzam on

Hi,

I have used your therapy approach for a while and would like to know what Sara would recommend for me as I am starting with a 7 month old child with Down syndrome.  I am ordering the CEU DVD, however, I wondered if there was some other resource that I should consider as I start out with this infant.

Thank you

Hi,

Your email was referred to me for a response but I have to say you have anticipated my answer.

Lori Overland's DVD entitled "Developing Oral-Motor and Feeding Skills in the Down Syndrome Population" is exactly what I would have encouraged you to purchase.  I say this because after 40 years of working with children with this diagnosis I have never met two who need the same exact intervention. Lori's DVD will give you the knowledge you will need to best address this client's individual needs.

Other suggestions at this time are the following:
1.  Feed the child with the ear higher than the mouth to prevent liquid from going into the child's ear via the Eustachian tubes.
2.  Do not push down or in on the child's tongue
3.  Read the The Oral-Motor Myths of Down Syndrome
 
Have fun with this client as the potential for the development of normal feeding and speech skills is very high based on appropriate intervention.  
 
Once this client reaches twelve months of age you might want to watch the DVD of my class "A Three-Part Treatment Plan for Oral Placement Therapy," as it will give the next steps in our treatment model.  
 

I hope this has answered your question,  

Sara Rosenfeld-Johnson

Read more →