Tagged "spoon feeding"


Ask A Therapist: Exercises to Remediate Speech Lateralization

Posted by Deborah Grauzam on

Hi TalkTools,
What would you recommend for a 12 month old who is talking and lateralizes many of her sounds? Currently, she is drinking from cups, not sippy cups, she does nurse 1 time a day and is eating solids. She is using straw #1, and the lateralizations decreased, but when she moved to straw #2 they increased. She is also using the maroon spoon for the spoon feeding exercise. She is not on the horns or bubbles at this point.
Thank you,
Sandi

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Ask A Therapist: The right duration of vibration

Posted by Deborah Grauzam on

Hello!

 

I have a question about using vibration (as with the Z-Vibe or Vibrator & Toothettes). I understand that using vibration can be used to "wake up" the sensory system, and I believe I’ve heard that it can have a temporarily positive effect on low muscle tone. I’ve read that vibration should be used in short durations, but I was wondering if you had any guidelines for the maximum or minimum duration of vibration? I’m thinking especially in a case of low muscle tone as in children with Down syndrome.

 

Thank you very much!

 

Jennifer

 

Hi Jennifer,

My name is Lori Overland and I teach the two day sensory-motor feeding class for TalkTools. Your email was forwarded to me, and it is an excellent question.

You cannot separate out the sensory and motor systems. Sensory feedback always impacts movement and movement provides feedback. It is important to make sure you have a specific motor goal (i.e.: in the case of spoon feeding, perhaps the goal is lip closure). Vibration facilitates a contraction of the muscle, so it may be used in conjunction with a tool to facilitate upper lip mobility for spoon feeding. If you leave vibration on a muscle for too long, the muscle relaxes. If you are using my pre-feeding exercises, I recommend  4-5 repetitions (maybe a little more or less depending on my client's sensory system) of an exercise. If you think about your motor goal and map sensory on to motor, you will not have to be concerned about using too much vibration. Feel free to email me if you have a follow up question.

Lori

 

Lori Overland, MS, CCC-SLP is a speech and language pathologist with more than 35 years of professional experience. Lori specializes in dealing with the unique needs of infants, toddlers, pre-schoolers and school-aged children with oral sensory-motor, feeding and oral placement/speech disorders. She has received an award from the Connecticut Down Syndrome Association for her work within this population. Lori consults with children from all over the world, providing evaluations, re-evaluations, program plans and week-long therapy programs. Lori also provides consults to local school districts and Birth-to-Three organizations. Her goal in addressing feeding and speech challenges is to improve the quality of life for both the children she serves and their families. In addition to her private practice, Alphabet Soup, Lori is a member of the TalkTools® speakers bureau. Lori has lectured on sensory-motor feeding disorders across the United States and internationally. Her classes, "Feeding Therapy: A Sensory-Motor Approach" and "Developing Oral-Motor Feeding Skills in the Down Syndrome Population" are approved for ASHA and AOTA CEUs. Lori is the co-author of A Sensory Motor Approach to Feeding. She holds degrees from Horfstra University and Adelphi University and has her neurodevelopmental certification.

Meet her!

- Oct. 14-15, 2016 for the workshop Feeding Therapy: A Sensory-Motor Approach in Cape Giraudoux, MO

- Oct. 29-30, 2016 for the workshop Feeding Therapy: A Sensory-Motor Approach in Minneapolis, MN

More dates at: TalkTools.com/Workshops

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Ask a Therapist: Sensory Feeding For An Infant With Medical Issue

Posted by Deborah Grauzam on

Dear Lori,

I attended the Sensory Feeding Course in England in June, and would like to thank you for a full two days of professional input.  Before I left Manchester, I had already thought of how I was going to utilize some of the techniques in my therapy sessions.

You had mentioned that you would not mind answering questions, so I hope you do not mind me taking advantage of the very generous offer.

I have my first appointment to see a 4 month old boy with feeding problems next week.  Mom reports that he breast fed nicely (after an initial period of latching difficulty, and the need to suck using a nipple shield). After 1 week, baby got floppy, stopped feeding, and was taken to hospital, where he stayed for a few weeks. He is currently being fed through a nasal feed tube.  Although he is reported to have a strong suck, he does not suck on breast for long. Bottle feeding has the same results.  This child has had extensive genetic testing, endoscopy (up to larynx), videofluroscopy, and EMG--all without any abnormal findings. He is scheduled for an endoscopy to investigate the esophagus.  He has reflux, and I was told that milk came through the nose.  The ENT did not find any sub-cutaneous cleft, nor velo-pharyngeal insufficiency.  He will also have an MRI.  The current medical opinion seems to indicate problems with swallowing.   All this information was received by phone. I have not seen any reports, as yet.

My goal for the session (aside from meeting and assessing the child), is to show mom the oral and sensory-motor stimulation techniques and massages (as well as hand, foot and body massages).  I also would like to introduce some pre-feeding activities, to try to prevent, or, at least minimize oral sensitivity and aversion to food taken orally.

Question: With a dry spoon (Beckman E-Z feeder), shall I introduce spoon feeding with a front feed, or side feed technique? I am inclined to do both, as they involve different oral motor movements.  However, I do not want to instill incorrect feeding behaviors.  (This is the first time that I am working with an infant).

I would like to thank you in advance for your input.

Best regards,

You are absolutely welcome to ask questions! I am so glad you have been able to use the techniques in your therapy.  I am wondering if this baby was tested for food allergies. Does he have reflux? What are his bowels like? Was he scoped? Do you know if they explored inflammation of the intestines or colon?  Does he have infantile spasms? There sounds like there is an underlying medical issue which has not been identified yet. I agree that your best course of action is to address his underlying oral sensory motor skills to support feeding. At 4 months of age and with so many unanswered medical questions I would not want to start spoon feeding just yet. 

When you do get ready to address spoon feeding if he has low tone, I would recommend side spoon feeding with either the small maroon spoon or the EZ spoon. Good luck with this little one!

Lori Overland, MS, CCC-SLP, C/NDT

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Ask a Therapist: Nutritive Feeding for Charge Syndrome

Posted by Deborah Grauzam on

I have a 4 year old student with CHARGE SYNDROME. He has minimal intake and could be looking at a feeding tube if this declines any more. Mom is totally fighting with him (holding one hand with her mouth, the other with her non-feeding hand and then spoon feeding with the other!). Feedings take at least an hour to get adequate intake. Would love to pick your brain!

Hi Lisa, I would be happy to talk to you about your little one with CHARGE. I often see parents who are frantic to get their child to take adequate nutrition. In therapy, your goals should be to assess this child's sensory motor skills to support feeding and to work on the underlying motor skills to support safe nutritive feeding. I would also recommend consulting with a nutritionist to make sure this child is getting adequate nutrition. Perhaps you can look at a complete nutritional shake (something like Complete), so he does not need to be force fed, while you are working on sensory motor skill development. If this child is unable to get adequate nutrition by mouth, tube feeding may be a the best option. It often allows parents to relax, work on developing the motor skills for oral feeding and to enjoy mealtime with their child.

Hope this helps!

Lori Overland

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