Tagged "Ray Kent"


An interview with Diane Bahr, MS, CCC-SLP, CIMI before her first TalkTools Workshop

Posted by Deborah Grauzam on

While Diane Bahr’s first workshop with TalkTools is approaching, we wanted to highlight her recent addition to the team.

TalkTools: What was your first encounter with Oral Placement Therapy (OPT)?

Diane:  I took courses with Sara Rosenfeld-Johnson and Lori Overland when they were first teaching workshops. I have been using TalkTools products and programs in my own treatment, as well as teaching about them in my graduate course and continuing education ever since.

TalkTools: You contributed to several publications about OPT since then. Can you tell us more about them?

Diane: Absolutely. Firstly, Sara and I wrote the first article using the terms OPD and OPT: “Treatment of Children With Speech Oral Placement Disorders (OPDs): A Paradigm Emerges.” You will also see my name on the acknowledgement page in Oral Placement Therapy for Speech Clarity and Feeding, as well as the Introduction to the 4th edition. Sara mentions me as well in her acknowledgement page in Oral Placement Therapy (OPT) for /s/ and /z/, and Lori in A Sensory Motor Approach to FeedingSo, I have a long history of helping and supporting the work of TalkTools.

TalkTools: Why did you decide to join the TalkTools team?

Diane: Sara had invited me to join the team many years ago, but we were working through the oral sensory-motor controversy and decided to work separately until we had some resolution. We now seem to have this resolution particularly with Ray Kent’s 2015 article and all of the orofacial myofunctional research that is coming out around the globe. I decided to join the TalkTools team now because the timing is right. Both my textbook (Oral Motor Assessment and Treatment: Ages and Stages, 2001) and my parent-professional book [Nobody Ever Told Me (or my mother) That!, 2010] discuss the work of TalkTools.

TalkTools: How is your workshop going to help therapists?

Diane: My 15-hour workshop “Integrated Treatment of Feeding, Speech and Mouth Function in Pediatrics” can be taken either by therapists new to TalkTools who want an introduction or by therapists who have taken TalkTools workshops and want integration regarding the many aspects of oral sensory-motor treatment (i.e., feeding, motor speech, and mouth development/function). My course was a graduate course for many years, and I have been teaching it in continuing education since 1989. The goal of this workshop is to help all therapists integrate the wealth of oral sensory-motor information (re. feeding, motor-speech, and mouth development/function) that is currently available. I keep the workshop updated with the newest and best information I can find. Basically, I have spent 33 of my 36 year career studying and doing oral sensory-motor treatment.

TalkTools: Thank you and welcome to the TalkTools team!


TalkTools | Diane Bahr
Diane Bahr is a certified Speech-Language Pathologist and infant massage instructor. She has practiced Speech-Language Pathology since 1980 and has been a feeding therapist since 1983. Her experiences include teaching Graduate, Undergraduate, and Continuing Education courses; working with children and adults who exhibit a variety of speech, language, feeding, and swallowing disorders; and publishing/presenting information on oral sensory-motor function, assessment and treatment. She is the author of the textbook Oral Motor Assessment and Treatment: Ages and Stages (Allyn & Bacon, 2001). She has also written a book for parents entitled Nobody Ever Told Me (Or My Mother) That! Everything from Bottles and Breathing to Healthy Speech Development (Sensory World, 2010). Diane maintains a private practice, writes articles appearing in a variety of publications, is interviewed frequently on radio and in magazines, and is an international presenter.

She will be teaching the workshop “Integrated Treatment of Feeding, Speech and Mouth Function in Pediatrics” offered for 1.5 ASHA & AOTA approved CEUs on December 8-10, 2016 in New York, NY. Learn more and register here.

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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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