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
READ LIZ'S ANSWER
Tagged "straw drinking"
Ask A Therapist: Exercises to Remediate Speech Lateralization
Posted by Deborah Grauzam on
Ask A Therapist: Does Straw Therapy Help Accelerate Speech?
Posted by Deborah Grauzam on
My 2 year old (almost 3 year old) daughter with Down Syndrome is still having difficulty with speech. She has many signs, but her words are limited to ones such as "ball" and "book." I have asked her speech therapist about the Straw Kit. Her therapist does not seem to be in favor of anything other than traditional speech therapy. Does the straw kit help accelerate speech?
Also, her OT would like her to drink out of a cup. Which cup would be best, or is it best to continue with straws for now? Thank you!
Ana
Hi Ana,
Sorry to hear that your daughter is having difficulty with speech. I do believe that the straw kit is something worth pursuing. I often work with children with another therapist in a situation like this. One can work on traditional speech techniques and the other oral placement for speech production and feeding. That might be something to think about. The straws work on different levels of tongue retraction and lip rounding which are both movements used in speech production. I do find with my patients that speech comes faster with oral placement therapy. As far as a cup I would recommend starting with the pink cut out cup.
Please let me know if you have any other questions. We are always here to help.
Thanks,
Liz Smithson
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.
Ask a Therapist: Tongue Protrusion When Drinking From A Cup
Posted by Deborah Grauzam on
Dear Sir/Madam,
I am a speech and language therapist working in the UK. I had the TalkTools training a couple of years back.I assessed a child last week taking over from another therapist who has just left. This child was advised to drink thick and thin fluids from a thick straw (McDonald's thickness). The child can drink thin fluids easily from straw #7 but has not had any success with straw #8. I observed the child with the thick fluid from a thick straw and they managed really well. When drinking from a cup with no straw there was still notable tongue protrusion. I am not quite sure where to move this child on? Should we move to straw #8 (thin fluids) and continue with thick fluids from a thicker straw? Should you be continuing on the straw hierarchy until there is efficient tongue retraction when drinking from an open cup? I would appreciate some guidance.
Best wishes,
Melissa
Hi Melissa,
I would continue on the next straw if she is drinking at ease with tongue retraction as you said. I would want to use the straws for all drinking attempts and minimize the use of the cup. I would work on activities that promote tongue retraction before working on the cup. This will reinforce the motor plan. I would then make sure to place the cup under her tongue and prevent her from using her tongue as her lower lip. If this is not working you may want to remove the cup for a short time and work only with the straw and then revisit the cup. Giving the child a break and only reinforcing the tongue retraction may help.
It is possible for a child to continue demonstrating tongue protrusion with cup drinking after the straw protocol but I would consider that atypical.
Keep me posted and let me know if you have any other questions.
Thanks,
Elizabeth Smithson, MSP, CCC-SLP
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.
Ask A Therapist: Tongue Tip Elevation in Moebius syndrome
Posted by Deborah Grauzam on
When people need help with therapy or products, we put TalkTools® Instructors to work and then publish the exchange for anyone in the same situation to get help, too. This question is from Danielle, by Facebook message.
Hello,
I was wondering if you could possibly help me. My six-year-old son has Moebius syndrome and recently had facial reanimation surgery. We have been doing TalkTools therapy for years and love it. We do a lot, from the Z-Vibe to Chewy Tubes to the horns! We have him try to follow the Z-Vibe with his tongue, but I can’t get his tongue to lift up. My question is: how can I help my son improve tongue movement? He has twelfth cranial nerve palsy, and his tongue has become so much stronger with therapy, but tongue tip elevation is still so hard for us. Any tips? Thanks so much for your help.
Danielle
Hi Danielle,
Here are some questions that may help us think about why he may be having difficulty. When we are looking for tongue tip elevation we need to know first if he has jaw stability, tongue retraction and tongue tip lateralization skills first; these are prerequisite movements we look for. If you are unsure of any of the terminology let me know!
1. Does your son get any lateral movement? If so is he getting lateral movement to both sides? What activities do you see this movement in?
2. Can he chew on his back molars and hold the food there? Do you see his tongue move toward the food as he chews? Does this look easy for him?
3. Can he drink from a straw with tongue retraction? (Or does he protrude his tongue forward)
4. Have you done the Jaw Grading Bite Blocks so we know that he has adequate jaw stability as well?
If you’d like to send a quick video clip doing some stimulation of his tongue I may be able to see something.
All questions that may help us get a “why” answer and maybe a plan! Also, if you haven’t already, you should read this article by Sara Rosenfeld-Johnson about Moebius Syndrome. I look forward to hearing from you and helping any way I can!
Thank you so much for replying, I appreciate it more than you know. My son does have some lateral movement, but it is limited. He uses his fingers so much to move his food to his back molars and has always been a messy eater. When he drinks from a straw his tongue protrudes forward as well. Thank you for taking the time to help us.
Danielle
He still needs help with tongue retraction and lateral movement before working on elevation. He is not yet ready to work on elevation. Good luck with everything and let us know if you still need our help!
Renee Roy Hill, MS, CCC-SLP has provided therapeutic assessments and program planning for adults and children with oral placement, feeding and motor speech deficits for over 17 years. She is the owner of Crossroads Therapy Clinic in New Braunfels, TX and a member of the TalkTools® speakers bureau. Renee has been an invited speaker for ASHA state conventions and has received specialized training in speech/oral-motor/feeding therapy, Apraxia, sensory processing disorders, Hanen Courses, NDT training, TAMO therapy and PROMPT. She is the creator of the TalkTools® Schedule Board Kit, co-author of Ice Sticks, and author of the TalkTools® Apraxia Program.
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Ask A Therapist: A client bites down on baby bottle
Posted by Deborah Grauzam on
Hello!
My name is Yael and I have a patient who is 18 months, has low tone in the oral area, likes a lot of sensory input inside the mouth but won't suck on a straw or drink from a cup. He only drinks from a baby bottle and kind of bites down on it. How can I start working on his suckling skills so I can work with the straws and all the other tools?
Thank you!
Yael
Hi Yael,
I will give you a number of things to try and see what works for your patient. I would work on providing a good sensory warm up with the Vibrator & Toothette, chewing on gloved finger, using the z-vibe, or red Chewy Tube (depends on where your client is with jaw strength). I would question if your patient has jaw weakness based on your description. You can also try rocking the bottle in and out of the mouth to encourage more of a front/ back pattern versus the up/ down biting. Then I would try to use the Honey Bear with Flexible Straw to encourage drinking. You will load the straw for the patient and provide jaw and cheeks support if needed. I hope some of this helps.
Please let me know if you have any other questions. We are happy to help.
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.