Hi Chayie,

1. As far as the red and purple bite blocks go I have a set of both. I always try to use the red first because they are more durable and then use the purple if the client does not tolerate them. Many of my clients prefer the texture of the purple so I just know I have to replace those more frequently.

2. Yes, the straws do work on tongue retraction orally. They work on different levels of tongue retraction.  There is a diagram that will come in the straw kit and is also in the book that shows exactly where the retraction takes place with each individual straw. The Horn Kit and the Bubble Kit are two other activities that I often do while working on the straws for tongue retraction. These are all great!

Let me know if you have any other questions.

Always 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.

Hi Kellie,

It sounds like you have done a great job explaining the straws and how to use them to this mom. The only other idea I have would be to encourage her to put the straw in the large TalkTools cup with lid and have the curly part of the straw under the lid. That sometimes helps if it is tipping or they are playing with it. I just try to explain that the straw is working on tongue retraction in the mouth at different levels. It is important that they are that particular length because that is what makes them more difficult and requires more work for the tongue and lips.

As far as the insurance billing, I personally do not bill insurance but there is a CD called "OPT Goals & Objectives for IEPs and Insurance Reimbursement" that will help with goals and objectives for insurance reimbursement and IEPs. It does not include coding but it should help with what you are talking about. It sounded like it was more of what you were looking for than the CD you mentioned.

Good luck with the mom you are working with and please let me know if you have any other questions.

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.

Hi,

 

I'm beginning to work with a 7 year old boy with Down Syndrome and Apraxia. For the straws, he protrudes his tongue under the straw. He also does this with the Honey Bear. His Mom says she has a verbal cue of "fishy kiss" which will help him to round lips, and tongue will retract.

 

He also does the horns. He mastered #1 today :) ! We're also working with chewy tubes. Red is great, compressions become weaker with yellow. Bubbles are still needing cueing with the blue apraxia tube to get the lips rounded. He has a lot of force, but his lower lip protrudes and elevates and all of his air is directed up instead of out. It's getting better.

 

Is there something else I should be doing to get that tongue to the right position for straw drinking?

 

Thank you,

 

Meredith

Hi Meredith,

Great question regarding tongue retraction. The straw kit will work on tongue retraction at different levels of the tongue. It is important to have your patient work through the whole straw kit to achieve the retraction. It is also important to note that he does not have to demonstrate tongue retraction with straw drinking until he reaches straw #5. I do think using the "fishy kiss" verbal prompt before offering the straw is a great idea to set him up for the right movement pattern on the straw.   As far as the bubbles, try using the toothette with vibration as a sensory warm up right before the bubble activity. This should help him to achieve lip rounding more at mid-line without the upward movement he is demonstrating. Then I would transition immediately to using the green bubble tube that comes in the kit for blowing bubbles. Attempt blowing bubbles with this tube and see if that helps. Please let me know if you have any other questions. I hope this all helps. 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.

I have a student that will be transitioning to straw #4. The ¼ of an inch varies depending on how she puts the straw in her mouth. Do you have guidelines for this?

Thank you for the question!

In this case, the first twist must be resting perpendicular to her lower jaw. The first twist of the straw should not pass her lips, and if the twist is perpendicular to her lower jaw, she can not put more of the straw into her mouth.

Best,

Sara Rosenfeld-Johnson

I am using your straws for therapy with several of my students. When we get to the thickened liquid steps I am not sure what food to use at the puree and pudding consistencies, as my student is allergic to wheat and dairy products. Can you offer suggestions or guidance?

This is a great question and one I hear regularly from SLPs.

“Puree” and “pudding” are suggestions for the textures and thickness required, any food that can be thickened or thinned can be used. For example, you could use a baby food fruit puree for the puree level or make a shake from any fruit. You can also use agar or a thickener to thicken a liquid. Look at the child's diet to see what foods can be used and go from there.

Good luck!

Sara Rosenfeld-Johnson