Tagged "Oral Motor Therapy"


Elizabeth: Our Summer Speech Therapy Schedule

Posted by Deborah Grauzam on

So many parents, at this time of year, find themselves throwing out old notebooks, half used crayons, semi-dried-out markers, ripped folders all with the excited feeling that it is summer! Time to just relax. Right?

Well, if you have a child with special needs, that time of sheer freedom does not arrive in quite the same way.

True, you have a bit less of a rigid schedule, a bit less to prepare for each day, but to simply throw out the old school stuff and grab a magazine, lawn chair and plan what to grill for dinner is not how it plays out, at least in my experience.

If you ask anyone who knows me what I love the most, they would answer when my children are home. So of course, I greeted summer with a happy heart, and of course I tossed many a backpack into the corner of the hallway, but then I turned my thoughts on how to make summer fun while still meeting the goals and needs of Elizabeth.

So how did I do it and truthfully continue to do it?

Well, I think one thing I do is to spend some time thinking about some of the goals from Elizabeth’s new IEP that I would like to focus on during summer. And since we adjust her IEP in the Spring, I could use it as a bit of a guide. Once I have some ideas I try to visualize how I can slip them into the day.

Then I think of the things I wish to put into our everyday schedule, like instead of the TV in the afternoon, we would have some music time or some quiet reading time. For those who are younger, we would color or do play dough. Just something to calm ourselves, especially Elizabeth who needs this calming time, and to take a break from the “go” of the day. This is usually around three or four in the afternoon.

We also build in a bit of rest time. So after lunch, we all go to our neutral corners to either watch a video (them, not me) or rest (me, not them).

Of course, there are trips to the park, pool and friends’ houses in our days but I like having this loose structure because then you can build in the therapy play around it.

Something that I think is important is to know that therapy can be built into the play or activities of the average day. And this holds true for speech therapy as well. It’s just that you have to see each thing you do as a potential learning time and/or find ways to incorporate therapy without making it a “therapy time.”

TalkTools | horn kitFor example, something we did to help with Elizabeth’s oral motor work was to blow horns. We would get a number of different ones like the ones of TalkTools Original Horn Kit.  We would sit on the driveway, put a CD in the player and have fun blowing horns to the songs. I would encourage deep breaths and proper lip placement but after that, it was just fun to do this. Emily, our oldest, loved it too and she and Elizabeth would especially love Horn #4, that has the little spinney thing on top.  So we actually bought Emily her own set of horns to use to eliminate any fighting amongst the ranks.

So see, you get the oral motor work, breathing, fresh air and all the while it is fun.

TalkTools | bubble bearSomething else that is fun is to be on the driveway or deck and to bring out the bubbles.  We used to have the largest supply of bubble soap in the neighborhood and ours were even scented! Anyway, we had big wands to use standing up and this would work her whole body to turn and twist and to run after the bubbles to pop them. Then we would use TalkTools Bubble Bear to have her work on her ability to blow bubbles. The face of the bear made it fun. I would actually look forward to this because it was simply fun … but still therapy. One caveat is that you need bubble soap that makes good bubbles, like TalkTools Bubble Refill. This instant gratification is critical when a child is working so hard to make it work.

TalkTools | straw kitEven when bringing your child a fun, summer drink, remember that using certain straws, such as those of TalkTools Straw Kit, will help work with your oral motor goals.

If you are working on language skills, remember the rides in the car are great places to talk, to use descriptive language as you do errands, to ask questions of your child and to help verbally highlight words they may say incorrectly.

If your child needs help with knowing left or right, this can be worked on when driving as well.

TalkTools | toothettesFor those times when more concentrated work needs done, say with oral stimulation like with Toothettes or lemon swabs and perhaps some work with letters or words, I have found that a visual schedule is so very helpful. It lets the child see just what you have planned for the session and allows them to see what comes next. Which will hopefully help with the transition from one thing to the next. And in the case of Elizabeth, knowing when she was DONE was huge to her.

TalkTools | schedule boardI made my own schedule chart but one that I love and only wish I had when we were early on in our journey with Elizabeth is the TalkTools Schedule Board Kit.  I offer that using one of these is something that is so worth considering.

There really is so much you can do, these of course are just a few that we did. Maybe they will help get some ideas flowing. Please feel free to comment with questions or additional summer speech therapy schedule ideas below.

I wish everyone a happy, safe, productive summer. Ours begins tomorrow and I will again toss a backpack or two and then look to having a fun time as Elizabeth and I begin our 18th summer together.

Blessing to all.

-Michele Gianetti 

Michele writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder and Dyspraxia. Follow her story since the beginning here. 

 

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Middle School Awaits

Posted by Deborah Grauzam on


TalkTools_Blog_Elizabeth_July1015It is funny but just as soon as you get used to something, that something changes.  I am sure everyone can sympathize with that, right?  Well, this is how I was feeling about Elizabeth’s new school year, her last year in elementary school.

I had managed to figure out a few things: 

 

 

  • How the school worked
  • How to advocate for her needs
  • How to make sure all the IEP goals were met
  • The things I needed to do each day to keep communications open
  • The need for me to visit the school for monthly check-ins

And suddenly, we were looking at our LAST year in this building.   Our last year with this group of aides and intervention specialists….it almost made me scared for the next step.

Being a person who likes control, (I am continually working on this part of my personality), I felt frightened of the next step for Elizabeth, middle school.  At the same time, I felt excited for the next stage of her life and the new challenges that awaited her.

Elizabeth’s fourth grade year was actually quite smooth. I was able to continue my monthly check- ins, incorporate the goals of the IEP into our school work at home, and communications between the school and our home were flowing quite well. I was so proud of Elizabeth and how well she was doing in school.  She had gained confidence in herself and her social skills.  In fact, I received many notes home regarding her gains in social skills.  Those notes made us all feel proud and excited at the same time.

We continued our work with Mary that included asking more thinking, open ended questions such as: “How do you think you should act in church?” as opposed to the previously asked “Please behave in church”, or “Let’s talk about the things you did properly in church”  as opposed to the ever present “Elizabeth, please use good behavior”. I learned that the thinking language was the next step in her growth, as it allows for her expression and language and it is not led by my words. We also continued the oral-motor protocol from before, even if she was not the happiest speech student to participate in this protocol of oral stimulation.

Something new to add to our daily lives was the realization that she is a “tween”, and as such some topics and concerns need to be addressed.  As children progress to middle school, the thought of puberty and all it brings does cross one’s mind.  Something to keep in mind with children with dyspraxia and SPD is that talking about new things early and often is the easiest way to introduce things.  And if you can do this talking BEFORE the time you might be needing them to act on this information, you will be more likely to have success.

With this in mind, Mary introduced a book to me titled “Taking Care of Myself” by Mary Wrobel.  I would quite highly recommend this book to anyone with children at the crossroads of their lives. The book is easy to read and understand, easy to discuss, and full of pictures for visual learners. As you can see, our work with Mary has changed a great deal.  Gone are the gross motor exercises and the work to get any sounds made, and in its place are the higher-level thinking questions and the focus on the typical areas of a middle school child.

It is so hard to believe that Elizabeth is a middle schooler.  It is so hard to believe how far she has come and to believe that our crying, scared, blue-eyed infant has grown into a confident, happy, bright-eyed tween.  As I say in my book, “Middle school, here we come!” Words cannot ever truly express the depth of our love for this special child or our belief in her or even our thankfulness that she is in our lives.  I know those who have a special needs child will understand and may be nodding their heads right now.

For those who have read my book, you will know this is technically the end of the “journey” covered there.  For those of you following my blog or my Facebook page, you will know our journey has continued and Elizabeth is now 18 years old. I look forward to writing future posts about Elizabeth’s life past those covered in my book, because we all know ….the journey continues.

-Michele Gianetti

Michele writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder and Dyspraxia. Follow her story since the beginning here.

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The Best Gift from Elizabeth

Posted by Deborah Grauzam on

As our journey continued, I was able to revisit the “to do” category of a preschool for Elizabeth.  We initially had tried a preschool in our area that had half typical developing children and half special needs children attending.   We had thought it would be a nice fit for Elizabeth as she would get OT and Speech services as part of her day, some nice socialization and a new experience.  But what we thought would happen and what actually happened were two different things.  Elizabeth started to pick up some behaviors and sounds that we had not seen before.  As this was our first foray into any preschool setting with Elizabeth, we were taken aback.  We came to see that the school did not truly understand how Elizabeth “worked” and as such we knew our time at the preschool had to come to an end.  The whole experience lasted less than three months.  We were quickly learning that our role in helping our child included education of caregivers and new therapists and advocacy.  We were also learning that every twist and turn on this journey was teaching us something….even if we were not in the mood to learn.

This time of Elizabeth’s life, in my mind, is kind of the one that pulls on my heart a bit more.  We really wanted her to have a place to go to be with other children….but we were quick to see that wanting something for Elizabeth and actually finding it are two different things.  We could not simply sign her up for another preschool….this would not be something we could all happily anticipate.  No, with her dyspraxia, speech delay and SPD,  it would be work….we were quickly coming to see that even though we had done so much work with her prior, more awaited us.

We continued to work on Elizabeth’s speech as well as her OT.  We discussed with Mary, that we were going to look for another speech pathologist, one who would work the muscles in Elizabeth’s mouth or a Myofunctional Speech Pathologist.  Mary agreed that this would be a good fit and encouraged us to find her.

This type of speech therapy seemed to be just what we needed next.  We went three times a week to start.  We told the therapist all about Elizabeth’s disorders and she seemed knowledgeable about them and was very willing to try to help Elizabeth.

With much work, think oral stimulation with lemon glycerin swabs, actual physical manipulation of her tongue and lips, many oral exercises to make certain sounds many times. We continued these exercises at home, purchased many glycerin swabs and also the boxer vibrator from TalkTools to help with the oral stimulation of Elizabeth’s mouth and lips. We had new work to do at home but we knew all we did was making progress…and soon I got the best gift from Elizabeth right before Christmas.

The very best day of my life with Elizabeth happened…..syllable by syllable, with the therapist guiding her…  Elizabeth read a sentence from a Dr. Seuss book.   It was AMAZING.  Yes, it was slow.  Yes, it was syllable by syllable.  But it was a sentence.  Our first one…clear and understandable.    I really could not hold back a tear as I held this child on my lap and heard that voice that up until now had been half words, occasionally whole words, when nervous no words…….but was now present and showing us a sentence.

Something else that was wonderful was that this therapist had tested Elizabeth’s responses as we had been going along these few months and shared with me, my second gift, something I had been saying to everyone who worked with Elizabeth.  “Mrs. Gianetti, this child is extremely bright and motivated and she wants desperately to be able to talk.”   It felt wonderful to hear it from someone else and I did not ask her for this information, it was offered to me.

This helped us feel stronger in our advocacy for our child and whatever the next step was on this journey. Sometimes we have to realize, as parents of special needs children, that we need to listen to our heart and to do what feels right for our child.  With that said, we found a wonderful preschool for Elizabeth.  It was run by a friend of a friend.  Elizabeth loved it.  And just like Kathy said, she was so wanting this social outlet. Actually, this is the place she first met her lifelong friend Erica.

I am a firm believer that there is good in every situation in life, that some good comes of all things.  In the case of our first preschool experience, the good of it was that we learned about our need to advocate for our child.  We learned the need for good communication as well as the need for us to fully educate that staff about our daughter.

Well, we did these things and that preschool proved to be a wonderful, happy place for Elizabeth.

I guess you could say we showed Elizabeth the world this year. It definitely took effort and the need for us to regroup and try again.  But ultimately, so much good occurred.  Elizabeth was enjoying life, she made a friend, she had a place to go that was hers and we kept on working hard at home….we even had a first sentence the will always be remembered….yes I would say it was a good year.   The journey continues…..

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-Michele

Michele Gianetti writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder. Follow her story since the beginning here.

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Seeing the Trees in the Forest: Elizabeth Grows Beyond Expectations

Posted by Deborah Grauzam on

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I can remember that I was living so deeply “in the forest” this year that I did not “see the trees” I was so deep in concentrating on Elizabeth’s sensory needs, her therapies and their follow-ups at home as well as our older daughter’s needs and well...LIFE that I don’t think I looked up to take full notice of that changes in Elizabeth and some of her new growth. “Michele, she needs her own social group. Elizabeth is such a social child” That was the direct quote from our first speech therapist when Elizabeth was four years old. Kathy was her name and I simply trusted her completely. She explained how Elizabeth would follow and attempt to engage the children who had appointments before and after hers and how Elizabeth looked so happy being with other children. I remember taking a moment to let her words sink in and during this moment I wondered if Kathy WAS right...was I so busy doing “life” that I did not notice? WAS I so busy getting from day to day that I simply did not have the time to see that this was the next step for Elizabeth? Sometimes when you are dealing with the special needs of your child, you can forget the “typical” needs they may have.

I found myself quite thankful for our therapist for a new reason. At this time, we had been on our journey for about two years, maybe a bit more and as such, so much was new to us. But the one thing I realized for the first time then and truly countless times since, is that the therapist can become a dear friend to you and your child. And as such they can have opinions and ideas for and about your child that can be very helpful. They can teach your child things you cannot, and expose them to ideas you don’t have the ability or brain space to figure out how to do. This is a good thing...no, this is a GREAT thing. Listening to Kathy made me think of this thing called socialization....So much socialization takes place in the school or preschool setting....Social skills are being learned and mastered and one of the key pieces of socialization is the ability to talk. Which Elizabeth is working hard to do. It is the sharing of feelings and thoughts. This is not such an easy task when words are at a premium, clarity is questionable and sentences still remain a future goal. I heard what Kathy said, filed it away in my “ Look into it soon” category and started to look.

The preschool hunt was on but it troubled our hearts that the words said by our daughter were coming but they were still half words and if she was stressed, there were no words and if she had fluid in her ears, (which we began to battle as long as 2 years ago), there were only unrecognizable sounds. There seemed to be a piece that was needed. We visited Mary and she discussed our need to work on the muscles in Elizabeth’s mouth not so much the oral stimulation as we talked about last post but to add in muscle work...kind of like a gym workout for her mouth. This was to help address the dyspraxia, which was why Mary showed us the bite gradient sticks from TalkTools and told us we were to try to use these to help strengthen Elizabeth’s jaw. She told us how to count to 10 while Elizabeth bit down and then to have her stop and then repeat. This was quite the undertaking as sensory issues always played a part. But we were able to achieve the goal.

Mary also had us working on using a tiny circle, called a lip block, that we were to put on the end of Elizabeth’s straw to keep her from putting the straw so far in her mouth that she was sucking on the straw without using her lips to create the seal. Therefore we would be working the muscles in her lips and how she used a straw each time she drank. Please note at this point, two important facts. Number one, Elizabeth absolutely never drank without a straw and so, number two, Elizabeth grew to hate the little circles. I bought several so that if they were to “mysteriously” disappear another one would magically appear. It was the battle of the straw circles, I smile as I think of her spunk regarding these lip blocks.

But as were doing these things we were strengthening those muscles that helped make CLEAR sounds then CLEAR words.... Mary also had us use some time each day to look at and talk about facial expressions. To help her see and talk about feelings associated with the faces. When you have been afraid of life for so long as Elizabeth was....and when you can’t hear as clearly all the time, it is difficult to discern emotional expressions. It was kind of fun doing this with her. To play act the emotion. And it helped Elizabeth to talk about feelings and emotions and to know that EVERYONE feels all the things that she feels.

These additions to our already rather full follow-up therapy schedule was hard, we were already working on a number of things so adding more was difficult and the very fact that we needed Elizabeth’s cooperation to accomplish these new ones made it difficult Elizabeth was still being brushed to help with her SPD and she appeared happier than ever but.....those sensory issues can rear themselves when she is stress and I can remember quite a few tears as we worked our way through these new sessions. But what kept us motivated was knowing that what we were doing was not just teaching her newwords but helping her mouth and its muscles be stronger for life.

Dyspraxia and these sensory issues just do not let go....but we now had a plan to address this oral component of her dyspraxia...we had new and a bit tougher work to do and we had the idea placed in front of us that preschool may be a good fit for Elizabeth. Quite of few new things are in front of us on our journey...the path twists and turns a bit but we are seeing good things...our journey continues......

-Michele

Michele Gianetti writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder. Follow her story since the beginning here.

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It's Not a Sprint, It's A Marathon: Elizabeth Begins Therapy

Posted by Deborah Grauzam on

The words did start to come but they were words that required a great deal of work to understand or as in the case of many, they required me to translate. I remember how it was to automatically have the person to whom Elizabeth was speaking turn to look at me as if to say “ WHAT is this child trying to say?” I would of course translate and all would be well. But what I wanted to know was why the words were said halfway or why she would mumble.

I guess I thought that once we started speech therapy it would be like a dam opening up and “Voila” we would have words, sentences and thoughts...in other words, all would be well and we could get over this thing called a “speech delay” and move on.

We were new to this therapy thing...in fact since we had started occupational therapy, it was like we were waiting for SOMETHING to simply fix the problem. The problem being her SPD and dyspraxia.

“Ahhh, so much to learn” is what my current self wishes I could tell my former self. “Be patient” is another, “Settle in for a marathon, not a sprint” is the third but the most important thing I wish I knew at the beginning of this journey is “ There is no FIX as Elizabeth is not BROKEN, just wired differently” Had I not been looking for a fix so much, I might have been able to adjust my reality but it was like I was just waiting for the “Ah-ha” moment, the thing that would set it all right” Alas, so much time and thought wasted....

We were blessed to find Mary, our still beloved speech therapist, who works on the SPD and dyspraxic issues with Elizabeth. Mary explained that Elizabeth’s dyspraxia affects all of her muscles and motor planning including the ones used to make breath, make sounds and words. I did not know this and once I did it all made sense. That is why the mumbling, that is why it is such effort for her to talk. I finally understood.

One session with Mary elicited a seven page list of things to do to help Elizabeth with her dyspraxia and SPD. A brushing protocol every two hours, exercises to help with balance, lotion rubs. And many things for her speech.

This appointment with Mary was life changing, the brushing protocol was one of the things that made the biggest change in Elizabeth’s life. We stuck to the protocol and as we did, the calmness and peacefulness came. We had made some headway before, but this protocol by far made the difference. As a quick side bar here, we brushed Elizabeth every two hours, everyday, while awake, for over two years....that is how much this protocol helped her!

I learned about a thing called “oral stimulation” As I learned we needed to stimulate certain areas of Elizabeth’s mouth to help her learn to feel those areas and to help her use this new awareness to get her to move those oral muscles and make words.

We used a special brush called a NUK brush. It was a special soft bristled brush, used in non-therapy settings to clean an infant or young toddler’s gums and teeth. But used in this therapy setting, it created an awareness of her mouth. We were to try getting Elizabeth to do blowing exercises to strengthen those muscles and instead of my usual filling in the blanks of each half said word, I was to do it with verbal highlighting. For example, if Elizabeth said “ I wah...” I was to say “ What is it that you WANT?” Thereby helping her to think of what she wanted and also to hear the word she said halfway, said in completion.

That was a very new way for me to do for Elizabeth as I always just said things for her. One of the things that this journey was teaching all of us is that the way we used to do things is no more...there is a new normal now. This attitude became the prevailing one in our house, as we all learned to do everything with a purpose. Meaning we began to look at all the things we did in a day and see how we could incorporate some sensory or motor benefits for Elizabeth. So pushing in the chairs at the table....sensory input,marching up the stairs...sensory input, pillow fight...motor planning...

Once you get in the mindset, therapy can happen all day without it being THERAPY!!! You can accomplish so much more this way and the child can see it as play and you can be happy because there is a hidden benefit.

First we saw the beginning of words...now we have a more complete picture of Elizabeth’s needs, a wonderful new therapist at the helm...and a new therapy plan made to address ALL of Elizabeth’s needs. I think we may just now have stepped onto the road that will get us to the next goal....I cannot wait to walk on it.

-Michele Gianetti

Elizabeth

Michele Gianetti writes for TalkTools Blog every month about her experience caring for Elizabeth, her daughter with Sensory Processing Disorder. Follow her story since the beginning here.

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