Tagged "OPT"

Every day, as an SLP: A Letter to the Parents of Children I Work With

Posted by Deborah Grauzam on

TalkTools | Vanessa Anderson-Smith

"Every morning I wake with cautious optimism for the day, hoping I have breakthroughs with your child and every other child I work with.

Every day I comfort a parent and a family. When I say we are on the right track to get your child to speak just one sound or even eat one mere meal a day, I believe it with all my heart.

Every day I pray that my small words may help the parent and family to get through not even the day, but the hour.

Every day I think and sometimes agonize about my patients from sun up to sun down. While I may be running late between sessions or seem frazzled, your child is never far from my mind.

Every day my heart bursts at the seams when your child accomplishes what could be considered a 'small' feat by some. It is never a small feat to me.

Every day I boast to my husband, sister, parents, and anyone else with ears about the accomplishments your child made.

Every day when I give hugs, a high-5, or a 'good job' I can feel the love and happiness in my bones.

Every so often the reality of working with children who have struggles ahead weighs heavy on my heart.

Every so often I am known to sit in my car and break down over the mountains my patients must climb in order to complete the most basic tasks of a human: eat and speak.

Every day I live out my dream and passion through my career of speech-language pathology.

Every night I count my blessings. You allowing me to be a part of your child's life story is the greatest gift you can give me."

~ Vanessa Anderson-Smith

Vanessa Anderson-Smith is a Speech-Language Pathologist born and raised in South Dakota. She received her Bachelor’s Degree at Augustana University and Master’s Degree from The University of South Dakota. In 2013 she began Anderson-Smith Speech Therapy, LLC. She is now the only TalkTools® Level 3 Trained Therapist in South Dakota. Her practice focuses on assessment and treatment of motor-based speech and feeding disorders among children and adults. Vanessa lives in Canton, South Dakota with her extremely supportive husband, Ryan.

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How this researcher took a step toward clinicians: Ray D. Kent, PhD's latest findings

Posted by Deborah Grauzam on

Recently, Ray D. Kent, PhD has published a review article entitled "Nonspeech Oral Movements and Oral Motor Disorders: A Narrative Review," in the American Journal of Speech-Language Pathology, November 2015, Vol. 24, 763-789. In this article, Kent proposes careful definitions and task descriptions to analyze if nonspeech oral movements have substantial clinical value to oral motor disorders.

This is important to us, as TalkTools® strive to help speech and feeding disabilities using oral motor exercises. More specifically, we call our method Oral Placement Therapy. To learn more, visit our page What is OPT?

Ray D. Kent, PhD is Professor Emeritus at the University of Wisconsin-Madison. He has published over 150 articles and reviews, and is the author of The MIT Encyclopedia of Communication Disorders, among other books and manuals.

Kent defines NSOMs as "motor acts performed by various parts of the speech musculature to accomplish specified movement or postural goals that are not sufficient in themselves to have phonetic identity." At TalkTools®, we have a passion for challenging the NSOME "nay sayers."  Our argument is that OPT is a modern extension of Van Riper’s Phonetic Placement Therapy (PPT), and uses tactile cueing to help individuals who cannot respond to visual-verbal treatment cues. We have seen numerous client successes since we began implementing this technique, and believe it is not just a good luck streak. There is enough evidence available in the form of clinical data, and parent, client and clinician testimonials, to warrant open discussions on the value of nonspeech oral movements. However, as Kent pointed out, the lack of definition and clarity clouds the evidence. This is why we are thrilled by this step from a researcher toward clinicians.

"Muscles do not transform themselves as they perform one task or another."

Here are a few excerpts from Kent's review article: "Although it was initially assumed that specific language impairment is not related to problems in other areas such as motor development, recent research points to the contrary conclusion. Children with language disorders or dyslexia often present with atypical motor skills." As Kent puts it, "muscles do not transform themselves as they perform one task or another." Actually, "speech production involves more than 100 muscles located in the trunk, neck, and head." But the issue is that "rather little attention has been given to the interplay with motor control, although motor performance is intrinsic to the task [of speech]."

Kent also mentions in his review article specific diagnoses that have been proven to benefit from NSOMs. "Among the therapeutic components that a speech-language pathologist might address are efforts to increase awareness of the muscles and postures of the orofacial system and to improve muscle strength and coordination (American Speech-Language-Hearing Association. (2011). Speech language pathology medical review guidelines). Presumably, NSOMs are one means to achieve these objectives. Although research on clinical outcomes from orofacial myology is not extensive, promising reports have been published on speech production in cerebral palsy (Ray, J. (2001). Functional outcomes of orofacial myofunctional therapy in children with cerebral palsy. The International Journal of Orofacial Myology, 27, 5-17) and adult dysarthria (Ray, J. (2002). Orofacial myofunctional therapy in dysarthria: A study on speech intelligibility. The International Journal of Orofacial Myology, 28, 39-48)." He later adds: "oral motor performance also appears to be a predictor of verbal fluency in individuals with autism."

Additionally, Kent writes that "the learning of a motor skill proceeds through stages," hence the hierarchical approach of TalkTools® Therapy, such as the Horn Hierarchy, the Bubble Hierarchy, or the Straw Hierarchy. He adds that nonspeech motor exercises should be used as one component of therapy, and we agree that this should be an essential component to consider when practicing Oral Placement Therapy.

In conclusion, research is still needed to follow Kent's work in proofing the value of NSOME, but therapy services should not be denied to clients on the ground that these techniques are not developed enough in literature. Many times, TalkTools® Trained Therapists have won cases where a client was denied the necessary therapy on this ground. We hope more researchers will follow his path toward clinicians' work.

If you are interested by this subject, read Diane Bahr and Sara Rosenfeld-Johnson's article "Treatment of children with speech oral placement disorders (OPDs): A paradigm emerges" in Communication Disorders Quarterly, 31, 131-138 (quoted by Kent), where the authors study the case of children who do not respond to traditional speech therapy techniques. Robyn Merkel Walsh and Sara Rosenfeld-Johnson also recently published on this topic and have found similar conclusions to Kent's in the literature. In a recent interview with Jeff via the podcast Conversations in Speech, Robyn Merkel Walsh discusses as well how years of clinical data is a form of Evidenced Based Practice.

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TalkTools Instructor in Norway, Line Avers in Media Planet

Posted by Deborah Grauzam on

In this article in Norwegian published in Media Planet, Line Avers discusses the need in many cases to look at the child´s foundational skills for feeding and speech.

"In feeding therapy just as in speech therapy, it's about doing exercises that contribute to strengthen mouth muscles and improve oral motor skills," says TalkTools® Instructor in Norway, Line Avers.

"Det er mange barn som sliter med å spise, og det henger ofte sammen med nedsatt munnmotorikk. Fysioterapi i munnen kan være en løsning.

Det er godt dokumentert at barn med Downs Syndrom og Celebral Parese ofte sliter med å spise. Årsaken er gjerne at musklene er svake, særlig i kjeven, og disse barna tyr ofte til myk mat, unngår brødskorper og bruker ofte lang tid på måltidet. De har ikke gode nok tyggeferdigheter, fenomenet henger gjerne sammen med dårlige språkferdighet og gjelder også barn uten disse diagnosene, ifølge logoped ved Barnas språksenter, Line Avers.

Motoriske øvelser

– Akkurat som ved språkproblemer handler det om å gjøre øvelser som bidrar til en bedre muskulatur og motorikk i munnen. Det kan gjøres både hjemme og i barnehage/skole, og er effektivt i kombinasjon med spesifikk spisetrening. Det er viktig å begynne tidlig, og vi jobber alltid sammen med foreldre og barnehage/skole når vi følger opp, sier Avers.

Sensoriske problemer

En annen årsak er at mange barn også strever med sensorikk, og derfor prøver å unngå mat med klumper. Det er gjerne forbundet med negative opplevelser, og resultatet kan da bli et ensidig kosthold. Både i forhold til det sensoriske og det motoriske er det viktig at treningen foregår 1:1, ifølge Line Avers."


Line Kristiansen Avers, MS, SLP is a Speech-Language Pathologist who has over 12 years of experience specializing in topics within Apraxia, Alternative and Augmentative Communication (AAC), and Oral Placement Therapy. Line teaches classes in Apraxia and AAC at the University of Oslo, lectures at numerous seminars within Norway, and is a member of the TalkTools® speakers bureau. Line heads a private oral-motor, speech and language clinic in Norway, BARNAS språksenter. She has an M.S. from Penn State University and was a Fulbright Scholar.

Hint: if you don't read Norwegian, click right and select "Translate to English". 

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TalkTools News: new credentials for our very own Jennifer Jones!

Posted by Deborah Grauzam on

TalkTools - JenniferCongratulations to TalkTools® Instructor Jennifer Jones, who became this weekend one of only 2 SLPs in the world with the credentials: PhD, CCC-SLP, BCS-S, C/NDT!

What does this all mean?

A PhD (the abbreviation for the Latin "Philosophiæ Doctor", literally, Doctor of Philosophy) is the holder of a doctor's degree, which is the highest university degree. This degree rewards substantial contributions to a discipline by published work. It was originally granted to middle age individuals who had demonstrated a productive career in Philosophy. Holders of a PhD have lead an original research documented by substantial dissertation. This degree is often required to be hired as a university lecturer or a researcher in some sciences, although this varies from place to place.

A CCC-SLP is a Speech-Language Pathologist who is "certified": who has earned an ASHA (American Speech-Language-Hearing Association) Certificate of Clinical Competence in the field of Speech-Language Pathology. It is a professional credential that is nationally recognized and that represents a level of excellence. As ASHA puts it, "those who have achieved the CCC ASHA certification have voluntarily met rigorous academic and professional standards, typically going beyond the minimum requirements for state licensure. They have the knowledge, skills, and expertise to provide high quality clinical services, and they actively engage in ongoing professional development to keep their certification current."

A BCS-S is a Board Certified Specialist in swallowing and swallowing disorders, also called Dysphagia. A BCS-S maintains high-level skills and clinical experience in the evaluation and treatment of swallowing disorders. Thanks to continuing training, a BCS-S knows the latest clinical approaches and can most effectively and efficiently evaluate and treat individuals with swallowing disorders.  As the American Board of Swallowing and Swallowing Disorders puts it, "the BCS-S specialist provides appropriate, evidence-based treatment techniques to address the swallowing problem(s) of each individual, based upon the comprehensive swallowing assessment."

A C/NDT is a Certified Neuro-Developmental Therapist, who has been certified by the NDTA™ (Neuro-Developmental Treatment Association). As the NDTA™ puts it, "NDT is a holistic and interdisciplinary clinical practice model informed by current and evolving research that emphasizes individualized therapeutic handling based on movement analysis for habilitation and rehabilitation of individuals with neurological pathophysiology." This certification is one of the most prestigious in this field as it requires a continuous process of updating knowledge with current NDT theory and practice.

Jennifer is looking forward to her upcoming classes in Puerto Rico on Dec. 4-5 and is glad so many people registered! (In fact, it is sold out ;).) The subjects are "Pediatric Dysphagia: Interpreting the MBSS and Planning Treatment" and "Adult Dysphagia: Interpreting the MBSS and Planning Treatment." Stay tuned for more TalkTools news!

Read articles by Jennifer:

"Why Every SLP Needs to Understand Dysphagia" Jones, J., (2015). TalkTools Blog

"Targeted Treatment: Cranial Nerve Based Assessments" Banotai, A., Jones, J., (2012). http://www.advanceweb.com/

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November 2015 Live Workshop Schedule

Posted by Deborah Grauzam on

We have speech and feeding therapy workshops across the U.S. this November. Our 1 and 2 day hands-on courses cover a variety of diagnoses including Down syndrome, Apraxia of Speech, Dysphagia, Autism (ASD), and Dyspraxia among others. Therapy techniques that improve speech and feeding by focusing on abdominal grading, tongue mobility, lip rounding, and jaw strength, stability and grading are demonstrated.

Detailed workshop information and registration is available here. We are also very excited for the 2015 ASHA Convention next month in Denver and hope to see many of you there!

TalkTools November Workshop Schedule
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