Tagged "sensory issues"


Ask A Therapist: Jaw Grading Bite Blocks and Dissociation

Posted by Deborah Grauzam on

Hello TalkTools,

 

I am Speech and Language Therapist working with an 11 year old with autism. He has a TalkTools® Program Plan, but I would value the opinion/support of one of your Instructors.

 

A significant priority at present is supporting him with dissociation of his jaw movements and then with grading. However, we have not been able to get a reliable bite on the Jaw Grading Bite Blocks. Interestingly, after about a month, he has achieved a bite/hold on the DnZ-vibe (not what I had initially planned that we would work on) with the vibration turned on. When the vibration is turned off, his bite is not so reliable. We are working at present on transferring the bite/hold to the #5 Jaw Grading Bite Block.

 

Do your instructors have any thoughts or experience with this? He does have complex sensory needs that are clearly factors in his eating, speech and other motor skills. I will certainly seek out advice from his Occupational Therapist once he has settled into a new school placement soon.

 

Many thanks,

 

Sally

 

Hi Sally,

I'm Robyn, a TalkTools® Instructor, and I've received your inquiry.

You are actually answering your own question, so great observation! This client needs more input to understand what's expected.

Hold the Bite Block in your right hand. With your left hand, hold a Jiggler in place on the top of the Bite Block and place at the correct spot as directed. I usually grab both tools with one hand and apply upward pressure on the mandible and say " bite and hold".

If this doesn't work, try reversing the hierarchy and working from 7 to 2 on the Bite Blocks, because the weakness may be in the high position. If there is a low jaw posture, sometimes reversing the order of the hierarchy is required.

I hope this helps!

Sincerely,

Robyn Merkel-Walsh, MA, 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 →