Tagged "Oral Motor Therapy"


Success Story | Colter and Vanessa

Posted by Admin TalkTools on

In April of 2015, I received an e-mail about a little boy with Down syndrome named Colter. His mother was desperately seeking help…he couldn’t chew his food and she was at her wits end trying to figure out how to teach him.

Even though this is “speech therapy,” his actual speech was not an issue at this point…yes there were delays but if a child can’t eat that is priority #1. Plus, in the back of my mind I knew that if we targeted his feeding goals his verbal speech would start to develop as well.

I love feeding therapy! When we meet goals, it means we are getting nutrition and hydration to little ones and it positively impacts the whole family. Many people take for granted the ease that there is in getting a baby or toddler to eat meals and snacks throughout the day. However there are many families out there that experience a battle EVERY TIME, EVERY DAY they try to feed a child. There has got to be few things more stressful to a parent than a child not being able to eat or being an aspiration risk. Colter was a mix of both of those.

Colter was 18 months old and swallowed almost every solid he put in his mouth but without chewing. He yearned to eat but couldn’t get the motor plan down to do so. He couldn’t move his tongue side to side (also known as lateralizing) so if food was placed in the front of his mouth he would suckled it and then swallow. What is frightening about a child doing this is that if it happens frequently they actually lose their choking reflex. We had our work cut out for us.

I educated his mother on how to place meltable solids on the side of his lateral molars so he had a better chance at chewing it and keeping it there. For practice, we used the TalkTools Pre-Feeding Hierarchy, as described in Lori Overland & Robyn Merkel-Walsh’s book A Sensory Motor Approach to Feeding. This eliminated the risk associated with choking on food and focused solely on practicing chewing and tongue lateralization. This paired with a pre-feeding program began to work wonders on Colter. We used a Z-Vibe with pre-feeding exercises from Lori Overland’s TalkTools course Feeding Therapy: A Sensory-Motor Approach before we started any feeding therapy.

Colter’s mom was diligent about keeping up with this program, which was a major factor in how far he came! Within 6 months Colter was eating much more solid food and the best part was he was being safe while doing it!

A few months later, his verbal speech exploded. He always had a higher receptive ability than expressive and thanks to getting his feeding on track, his verbal expression blossomed. When I explained to his mother that his talking was most likely a direct result of oral motor therapy, she said “I know you said that him talking more could be a possibility when we first started therapy but I didn’t think it could happen!”

Currently Colter is 2 years, 9 months old and is eating everything. One of his first words was “eat”! He loves beef jerky, hummus with veggies, fruit snacks, watermelon, and grapes. He is beginning to speak in 2 word utterances and has great intelligibility when doing so.

TalkTools | Success Story - Colter & Vanessa

The next frontier we are on is drinking from a straw. Colter still uses a bottle and isn’t thrilled with learning to drink from anything other than that! Now our focus has shifted to drinking from the Honey Bear. We had to put the beloved Honey Bear “away” for a month or so as he was so opposed to it. Then during therapy one day, I started to do some lip rounding pre-feeding exercises with Colter and he was successful, so we brought it out on a whim. All of the sudden, it clicked for him! While we are still working on him getting used to it, his family and I are thrilled with how far he has come!

What I love about Colter’s story is that he is a textbook case about what TalkTools can do for kids. In Lori Overland and Robyn Merkel-Walsh’s book A Sensory Motor Approach to Feeding, it is discussed that you cannot separate speech and feeding. While it may not be a 1:1 ratio, speech and feeding have a very close connection. Colter is proof of that!

~ Vanessa Anderson-Smith

TalkTools | Vanessa Anderson-SmithVanessa 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. 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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Success Story | Lily and Vanessa

Posted by Deborah Grauzam on

Lily, 3 years 4 months old, Unilateral Cleft Lip and Palate

image2When I saw that my former supervisor from my job during college and graduate school was adopting another special needs child from China, I was glued to their journey (the family had adopted a boy with cleft lip/palate from China previously). I watched from my computer screen as the Shields family adopted another child with a cleft lip and palate. That little girl was Lily (pictured on the left). And oh my, I have learned so much from her!

She had many medical complexities, surgeries, and hospital stays in her first year home. I continued to follow her story and literally thought: “I need to find a way to work with this girl because I know I can help!” How was I going to help? Using my OPT skill set of course! I knew in my heart that using Oral Placement Therapy and a motor-based speech and feeding program would get her where we wanted her speech the most efficiently.

Finally, the time came for me to see Lily for therapy. She was 2 years 6 months when we started. She was communicating wants and needs by pointing, grunting, and whining. She had a g-tube but was able to eat orally, just not enough. I looked at her repertoire of speech sounds and we started at the beginning with /p/, /b/, /m/. She wasn’t getting adequate lip closure needed for consonant-vowel productions (such as “moo, bye, pa”). The first thing I did was create a sensory warm-up plan for her to bring increased awareness to her muscles in her mouth. I used a toothette and various exercises from Lori Overland’s “Feeding Therapy: A Sensory-Motor Approach” course, as well as exercises Monica Purdy taught in “A Three-Part Treatment Plan for Oral Placement Therapy” course that I took.

image1 IMG_2538 IMG_2543

Next we started the Straw Hierarchy to help with lip closure, lip rounding and protrusion. I explained to her family that while this does not look like “traditional” speech therapy, it will help her to get the motor plan of lip closure so we can generalize it to speech. In addition, we began the Bite Tube Hierarchy due to jaw weakness and asymmetry, as well as the Horn Hierarchy to build up her abdominal grading.

Lily’s family was beyond committed to the program I designed and the whole family got involved. Every week I tweaked her program plan as she moved up through the hierarchies. Each session we started with her sensory-motor warm up, followed by her OPT and feeding exercises, a small snack, and ended with mass production of speech sounds.

Her endurance during eating still needs improvement but it has come quite far since the start of therapy. Due to her improving health and no recent hospitalizations, she is off of her tube feeding! The little girl that was struggling with one syllable word productions is now speaking in 3-4 word sentences consistently. Currently Lily is on Straw #5, Horn #6, Bite Block #3 (step one), and 4 pennies on a tongue depressor. Next, I plan on introducing the Button Pull Program and working through the hierarchies since it has been so successful for her already.

What I love about the TalkTools program is how diverse it is. I can adapt techniques to work with a variety of populations whether it is Cleft Lip and Palate, developmental delay, Apraxia of Speech, and countless other diagnoses. I am so thankful to have OPT in my “speech therapy tool box”!

Vanessa~ 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. 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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Success Story | Diane

Posted by Deborah Grauzam on

In celebration of 30 years of successful therapy, we asked you to share your success stories with us at the last ASHA Convention and the response was amazing! Here is Diane Felton’s inspiring testimonial.

“I’m Diane Felton. I’m a speech therapist in Durham, North Carolina. I first met Sara through a patient who was referred to me because the local therapist who has been seeing him said she did not believe in oral motor therapy. So I was fortunate enough to pick him up, and when I was asked about taking him on, I decided to look into TalkTools, and everything that I saw in the program made sense to me. So I agreed to take him on and was fortunate enough to have Sara as a co-treator really throughout the whole process of treating this patient. He was a seventeen-year-old who has been in a car accident, suffered a traumatic brain injury and was non-verbal. He was able to type using a communication typewriter kind of thing that he called “typer,” but he had no speech other than one word which is “ma.” He had been in therapy for two and a half years at that point, which was what caused his mom to kind of go out and look for something else, something she felt like he wasn’t getting in the therapy. She was frustrated and he was frustrated.

“They started the program with Sara and worked at home for six months just on building his strength. He couldn’t blow out a candle, he had really severe verbal apraxia ... so a lot of the initial steps focused on getting his strength back for speech, then later he started working on the apraxia piece which is kind of where I came in and worked with Sara’s guidance on getting him some sounds. It has been seven years since I started seeing this patient and he is completely verbal. He gave up his communication device about two years ago and he is doing great. We are still working on prosody, that’s the main thing that is keeping him from being a pretty normal speaker, he is also a little bit slow still, but he is intelligible to me almost 100% of the time. Occasionally I need him to clarify, but even unfamiliar listeners understand him most of the time. It was a really great experience working with Sara and getting to know this program.

“I have had other patients who have had great success. I saw a three-year-old who was focused on communication devices because she had no speech and basically everyone had decided that she was not going to talk. She had a diagnosis of autism, she was also a twenty-four week premie, one of triplets, and she had no speech. I used the TalkTools program with her and she had a very hard time getting the oral motor planning down, but TalkTools really helped her. It was about a month for her to get the word “up” and her mom asked if every word was going to take that long, but within three months she had a pretty good vocabulary, and a year later she was pretty much completely verbal and only was really working on speeding up her rate of speech which is still slow but she has done great.

“I have had lots of other patients who have done exceedingly well. Sara coming into my life was one of the greatest things that ever happened to me. I have loved the TalkTools program. I have been just so thrilled to be able to help people who come sort of as their last ditch effort and just kind of not sure if they should continue to even try, and TalkTools program has worked for them. So thank you Sara.” ~ Diane Felton, MA, CCC-SLP

We are incredibly appreciative of those who shared their stories, let us know if you have a story to tell.
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Cerebral Palsy treated with Oral Placement Therapy in Norway

Posted by Deborah Grauzam on

LineVildeIn a recent article published in the Norwegian publication Cerebral Palsy Magazine,  TalkTools® Instructor Line Avers, MS, SLP is featured along with one of her long date client diagnosed with Cerebral Palsy. The main focus of the article is TalkTools Therapy and the huge gains that this little girl has made. TalkTools® Instructor Renee Roy Hill, MS, CCC-SLP also evaluated her way back, and Line Avers has followed that therapy plan. Her name is Vilde, and her picture makes the front cover of the magazine!

Line Avers has been Vilde's therapist since she was two and a half years old. Vidle's parents heard of Line Avers in conversations with other parents in a Cerebral Palsy Association. They recommend to seek speech therapy services early, as many children with Cerebral Palsy have speech and feeding issues. "Vilde still faces challenges related to eating and speaking, but the problems have been reduced after several years of regular oral-motor therapy," says Linn, Vilde's mom.

"Vilde therapyWe started the work on strengthening the functional movements by strengthening the muscles in the mouth that we use when we eat and speak. We took small steps, and it was important to find a balance between pushing slightly while respecting boundaries," says Avers. "When Vilde became accustomed to the therapy, I introduced new exercises. Jaw strength was the focus. A stronger jaw provides more support, and more support means more words. This is how Oral Placement Therapy works."


"After a few months we could already see improvement. Vilde was better at chew, was willing to try several types of food and produced more different sounds," says Linn, Vilde's mom.

TalkTools Therapy involves a range of tools for exercising your jaw, tongue and sensory system. Vilde has used bean bags (small pillows with different textures), straws, horns, bite tubes and vibrator with toothettes.

Daily monitoring and training is important. Vilde's parents have been present from the beginning during training to learn the method and exercises. Every day after school, the family spends 15-20 minutes going through the latest exercises. "It may sound like a lot, but it really takes very little time. It has become part of our daily routine. It is easy, and the program is very affordable," says Linn.

bean bagsIn addition to working directly with children, staff in schools and kindergartens, and parents, Line Avers's center also organizes live workshops. Parents, grandparents and professionals who want to become familiar with TalkTools Therapy can participate. The goal is that after two days of training, you should be able to initiate the procedure.

Vilde's family hopes that her story can inform other families about an important service that they may have no knowledge of and maybe even inspire them to start training.

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.

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Success Story | Terrance and Vanessa

Posted by Deborah Grauzam on

Who is ready to hear a therapy success story? Terrance was 26 months old when Vanessa first met him and was unable to drink from a straw. What Vanessa did with this little boy is amazing and truly inspiring. We are so glad TalkTools® was able to provide her with the tools and techniques she needed to assist this client!

TalkTools | Terrance

"I always had a passion within feeding and oral motor therapy and that journey lead me to TalkTools. After my first training, I was hooked. I watched inpatient and outpatient Physical Therapists and Occupational Therapists use equipment and weights to strengthen patients before going into functional activities … Why hadn’t SLPs been doing this?! Needless to say, TalkTools was my missing link in therapy and I quickly took more courses to better understand Oral Placement Therapy.

In April of 2015 I had a phone call from a distraught mother and I heard words I hear often from the families of prospective patients: “He doesn’t eat”, “I am so worried”, “He hates to eat”, “He is still on his bottle.” Then I heard something worse than what typically comes from the other end of the phone, “I was told he will never chew or eat food properly.” I explained that there must be something that can be done and that I was confident that with the training from TalkTools I had, I could make some sort of a difference. Maybe I couldn’t get him to eat what his siblings were eating at the dinner table but I thought we could get somewhere. Challenge accepted!

Terrance and his family lived 2 hours away from my practice but I happened to be treating patients a little closer to them and we met half way. For an hour and a half I was able to sit down with Terrance and his family and conduct a full Oral Placement Therapy assessment. I expected to see a boy who had no oral motor skills and I anticipated we could struggle through the assessment. Well, Terrance surprised me (the first of many times)! In front of me sat a little boy with a sparkling personality who had a great foundation of skills, he just had to figure out how to use them to eat!

TalkTools | Terrance & Vanessa

The little boy who “would never chew or eat properly” was able to fully compress both the yellow and red Chewy Tubes multiple times and he learned how to drink from the Honey Bear within minutes. Food wasn’t fun for him yet but I knew that we would get there. I explained to his parents that while the end goal was of course to eat and enjoy food, we had to prepare his sensory-motor system for it first. We were able to use the Pre-Feeding Chewing Hierarchy to teach the task of chewing without the overwhelming sensory input of food. Every chewing exercise began with a Chewy Tube and ended with food, even if he spit it out. Everything we did was fun and play-based, yet still pushed his limits. The best thing was he was so distracted by having fun, he soon began putting food in his mouth himself.

I put together a TalkTools program plan and gave his family homework each week. In May, we were fortunate that TalkTools® Instructor Renee Roy-Hill was in the area and created an in-depth Oral Placement Therapy plan for him. His family was very dedicated to working on homework I assigned them each week as well as following his program plan.

Six months later, Terrance has worked his way up to Straw #3, Horn #1, Bubble Blowing Hierarchy Step #4, just to name a few. He no longer requires a bottle for the source of his main nutrition or for hydration; instead he uses a straw. The biggest accomplishment is that Terrance is eating everything his family is eating! Casseroles, sandwiches, fresh fruit … He loves it all. There is no doubt in my mind that this would not have been achieved with any other program or training besides TalkTools. Terrance and his family travel 2 hours for our weekly therapy visits and continue to work very hard at home on his speech and feeding.

TalkTools | Vanessa

I am so blessed that TalkTools has come into my life. The skill set it has given me in invaluable to not only my practice but also the lives of the families I work with!" 

Vanessa and Terrance are now working on jaw stability, lip rounding, and tongue retraction among other things.

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. 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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