Tagged "speech production"

Ask A Therapist: Straw D

Posted by Deborah Grauzam on



I have a student who just started straw D with the pudding today and after 25 mins with very little progress we called it a day (I work on a school so missing an hour of class won't work). After he left, I tried it myself with the same results! What is normal for this straw? He has gone through the whole program working on his /r/ and I know this last straw is very important for retraction but it seems impossible to drink pudding through straw D. Is it common for people to feel this way initially?


Also, any recommendations for cleaning the straw? Water from the faucet didn't get the pudding out and neither blowing. I see quite a few kids for the program so I would prefer to only have to use one straw per student and not one each day.


Thank you so much!



TalkTools | Straw D new cleaning kit

Hi Alicia,

I hate that you are having a hard time with straw D.  I know this is a very difficult straw but it definitely should not be taking that long.  The things going through my head first of all would be: if you cannot drink it, then it may be too thick.  Every pudding is different, but you may have to thin it to a point where you can do it. It does still need to be pudding consistency.  If you have thinned it to the point that you can drink it and your client cannot then I would question if your client still needs to be on the previous straw.  Just a thought.

As far as cleaning it, we recently developed a Cleaning Kit that includes, among others, a bulb syringe to push the liquid out of straws and a 30" flexible tube brush that fits into most straws.  If you still cannot clean straw D, I would suggest that you order that straw in bulk for all of your clients.  Unfortunately because of the diameter of this straw having to be so small to achieve the tongue retraction required, it makes it almost impossible to clean.  

Please let me know if you have any other questions.  We are always here and happy to help.




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 Placement

Posted by Deborah Grauzam on

Hi, I am hoping you can offer a suggestion.

I am an SLP and see a 2 YO child who began sucking on his tongue and had a forward tongue posture before I started seeing him. Once I started working with him I had the family switch to straws only and eliminated the sippy cup. They did that and he continued to have tongue sucking behaviors. Now, he has switched to twisting/turning his tongue around his mouth and it is interfering with his speech sound productions.

I tried to introduce vibration to provide sensory stimulation, but he does not tolerate that in his mouth. I also gave him a chewy tube as a substitution and he will tolerate it, but it is not eliminating the problem.

Do you have any product suggestions? I would greatly appreciate it. He has no drooling, no muscle weakness, and no feeding difficulties. I have never seen a child do this before.

Thank you in advance for any suggestions or product recommendations!

I have a few thoughts on this to help you:

1. Make sure there is not a structural or physiological problem, for example enlarged tonsils and adenoids. If the tongue must be displaced forward for breathing for example it could start these odd habits. Look for a tongue tie.

2. The sensory-motor systems cannot be separated. Though you say there are no feeding issues, I suspect there may be some breakdown in oral-motor development. Look carefully at developmental norms. This will soon be available in the feeding book Lori and I wrote, or you can look into taking Lori's feeding class if you have not already. If this child sucks his tongue at rest, there may be similar patterns on the straw.

3. Use of chewy tubes and sensory motor activities are most useful when you work from the outside of the mouth to the inside of the mouth and the therapy is led by the therapist. So I would not recommend handing the chewy tube to the child, but rather follow Lori's pre-feeding Chewing Hierarchy.

4. Finally, for the tongue sucking, I would recommend tasks that work on tongue retraction. The TalkTools Straw program and TalkTools Horn program, when executed by the directions on the tools kits would be excellent, as would TalkTools Bubble Kit. If you wanted to learn more, we have self-study courses for each of these kits!

Thanks for your interest in TalkTools!

Robyn Merkel-Walsh

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