Tagged "Three Part Treatment Plan"


Ask A Therapist: My First Time Doing An Eval

Posted by Deborah Grauzam on

Hi TalkTools, 

 

I have a few questions for the staff SLP. I watched the "3 Part OPT" videos and I can see how it generally walks me through the eval process but the language doesn't seem clear to me on the Assessment Form. Did I miss something?

 

It is my first time doing an eval. Here are my questions regarding how to do the eval:

 

1. For "Jaw Grading Bite Blocks", do I use ALL of the in the A, B, and C positions? Or just some or the last one?

 

2. for "Tongue Tip Lateralization", what does this look like? Do I start with asking them to swipe the inside of their mouth left to right 10 times and if they can't then use the tool? What do I ask the client to do?

 

3. For "Tongue Tip Elevation " I don't understand the criteria of 50 seconds, 1 time. What does this mean?... hold the tongue tip at alveolar ridge for 50 secs? What do I ask the client to do?

 

4. "TT Depression"- Where does the tongue go? What do I ask the client to do?

 

5. Same for "TT Up and Down"  - where does the tongue go? What do I ask the client to do?

 

Sincerely,

 

Carrie 

 

Hi Carrie,

Great question!  The Oral Motor Skills for Feeding and Speech Checklist is not intended to “teach” you each section of the form but a place for you to write results, guide you through an assessment and then provide the information you would need to then develop a program plan for therapy. The form assumes you know each technique, or, have the resources to find the protocol for each exercise. The criteria for success listed is a reminder of what the final goal is to complete that activity or step (this is the part that so many, to include myself have difficulty remembering when you are new to using the protocols). You may want to consider looking into our next course, “Assessment and Program Plan Development” that would follow the 3 Part Treatment Plan. In this course we use this form for several different evaluations to help you become familiar with its use! I will answer your individual questions below, directing you to where the complete instructions for each of them are!  If you have further trouble don’t hesitate to email me!

1. Each Bite Block Height would be assessed at each level. For example, you would not move from Bite Block #2 Exercise A to Bite Block #2 Exercise B unless they have met the criteria for Exercise A and so on. These instructions can be found in the books “OPT for Speech Clarity and Feeding” “Assessment and Treatment of the Jaw” and included with the set of Bite Blocks.

2. There is a specific exercise outlined in “OPT for Speech Clarity and Feeding” using a Bite Block and complete instructions with the Tongue Tip Lateralization Tool. There are many steps to this activity to teach the client to lateralize the tongue tip to the lower back molar.

3. Yes, the final goal is that the client can hold the tongue tip to the alevolar ridge for a full 50 seconds, 1X. You will notice that in therapeutic practice we often request multiple repetitions of practice but it is not always the criteria for success.

4. This is another activity that is in “OPT for Speech Clarity and Feeding” or included in the instructions with the Tongue Tip Elevation Tool. 

5. The tongue tip will go to the same two locations previously practiced individually. These instructions are also in “OPT for Speech Clarity and Feeding” followed by a transition technique to teaching the /s/ sound once you have completed this activity!

Renee Roy Hill, MS, CCC-SLP

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Ask A Therapist: 7 year old with Down Syndrome who can't drink

Posted by Deborah Grauzam on

My son who has Down Syndrome will be seven next month and still can't drink.

 

Ben had a high palate and was breastfed. He really latched with his tongue. He only drinks from a hard spout sippy cup. He grinds his teeth really bad too. But he still uses his tongue, even as he drinks from the sippy cup. You can see his tongue out on the bottom of the sippy cup, it's like his sucking reflex is so strong his brain won't let him not use his tongue to suck! He doesn't stick his tongue out and it's not a thick tongue either. We have tried the honey bear and tubing as well, he just wants to use his tongue! Any suggestions on how to help my little guy?

 

Thank you!

 

Robin

Hi Robin,

It sounds like your son is still demonstrating what we call a "suckle pattern" when drinking. If he is not able to drink from the honey bear straw cup at all, I would recommend that you consult a TalkTools Trained Therapist to have an evaluation and get more information on how to work on straw drinking with your child. There is a strategy of using a syringe to place small amounts of liquid in his cheeks by his back molars but I feel this technique would be best implemented by someone with experience, who can guide you through the process. If that is not an option, I would watch Sara Rosenfeld-Johnson's video-on-demand "A Three-Part Treatment Plan for Oral Placement Therapy" and try to teach yourself before implementing the techniques with your son. Please let me know if we can help you with anything else.

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.

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Ask A Therapist: Jaw Stability

Posted by Deborah Grauzam on

Hello. I am working with a 6 year old boy who shifts his bottom jaw when producing most fricative and sibilant phonemes. According to his dentist he does not have any structural abnormalities. When working with him he is able to keep jaw stable but it is not without effort and he has yet to generalize. I was wondering what tool(s) you would recommend for me to use with him.

 

Thank you.

 

Pamela

 

Hi Pamela,

It sounds to me like you may be dealing with some underlying jaw weakness and instability. If you have not seen the 3 Part Treatment Plan video or read the "Assessment and Treatment of the Jaw" book these would be great references. I would work on using the z-vibe with blue tip, and the Bite Tube Set (red bite tube, yellow bite tube, purple grabber, and green grabber).  Jaw stability is the foundation for speech and feeding.  If there is any weakness on one side or both sides these tools will help to correct that. Please let us know if you have any other questions or if anything else comes up.

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.

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