Straw Drinking Prerequisite – Tongue & Jaw Dissociation

Question:  I’m working with a client who has Down syndrome.  She can’t differentiate her tongue from her bottom lip when drinking from a straw.  I’ve tried having her drink from a straw using a Lip block to see if that helps, but the tongue still just takes over everything.  Any ideas?
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I always recommend getting children on straws (ideally with Lip Bloks) for their oral motor benefit.  The straw + Lip Blok combination can help naturally exercise and fine tune oral motor skills / oral positioning.

 

However, some skills / prerequisites have to be in place first before the child can effectively drink from a straw, such as trunk control, suck-swallow-breathe coordination, tongue and jaw dissociation, etc.  You have to walk before you run so to speak (and you have to have a certain amount of strength, coordination, etc. before you can do either).  Most children start straw drinking around 8-10 months old.  So if she’s not at that age level developmentally yet, she may need time and/or your help to get there.

Continue reading Straw Drinking Prerequisite – Tongue & Jaw Dissociation

Lip Closure & Rounding Exercises

Lip closure (also known as lip seal) is the ability to close one’s lips around a spoon, straw, cup, etc.  It’s also important in order to say certain speech sounds, such as /p/b/m/, and it’s a factor in preventing drooling.

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Lip Closure & Rounding Oral Motor Practice

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Recently I was working with a 9-year-old child who has Angelman syndrome.  The mother was asking if there was anything she could do to decrease drooling. One of the first things I look for with drooling is whether or not the child has lip closure.  The child was not closing her lips and could not do so on command, so I touched the Z-Vibe to her lips for about 2-3 seconds, and voila – immediately her lips closed.  I waited a few minutes and repeated the stimulation, and she closed her lips again.  She just needed that extra sensory input to be aware of her lips to close them.

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Sometimes a simple prompt like that will elicit lip closure.  Other times you may need to do extra practice until the concept “sticks,” or until they have the oral motor skill to do it.  It really just depends on the child. Continue reading Lip Closure & Rounding Exercises

The Oral Motor Benefits of Straws

Whenever a parent asks me what they can do to improve their child’s oral motor skills, one of my first questions is usually:  Are they drinking from straws?
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Drinking from a straw is a very simple yet effective way of improving one’s oral motor skills.  It works on lip seal, tongue retraction, cheek strength, correct jaw position, suck-swallow-breathe coordination, consecutive swallows, and more.  Sucking can also help some individuals organize, increase their attention, and soothe/calm themselves.
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Straw drinking usually starts around 8-10 months of age.  An easy way to teach beginners is with the Bear Bottle Kit, which has a special valve that keeps liquids at the top of the straw (so only a small amount of effort is required to drink).  Or, older kids may prefer the Cip-Kup, which functions the same way but has a more ‘grown-up’ design.  For more information on how to teach straw drinking, click here.
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Continue reading The Oral Motor Benefits of Straws

The Right and Wrong Way to Spoon Feed

The Right and Wrong Way to Spoon Feed

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Did you know that there is a right and wrong way to spoon feed?
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The wrong way involves lifting your hand upward as you remove the spoon from the child’s mouth.  This method scrapes the spoon against the teeth, gums, and/or upper lip to get food off of the spoon.
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Scraping is not the normal, natural way to feed.  And specifically for children with oral motor delays, it’s a missed opportunity, as it doesn’t allow the lips to do their job and close around the spoon.  It can also force the child’s head back as they try to “chase” the spoon upward.  You can see this happening in the image above and also in the beginning of the video below.
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Drooling – Getting to the Root of the Problem

I was looking at some of the tools and videos on your site.  I have a 9 year old daughter with low tone in her face and some periodic drooling.  I have taken her to various speech therapists in the area for help with this issue and most say to remind her to swallow.  Now she is 9 and still has this issue – reminding her does not seem to help.  The dentist said maybe strengthening her chewing and jaw muscles might help.  I think there might also be an issue with closing her lips from what I can see from the videos on your site.  I do not think most of the time she is aware that she is drooling as well.  Would the Z-Vibe, etc. help?  Any suggestions for her I would appreciate.  


If reminding her to swallow hasn’t working by now to stop the drooling, then it’s not going to work, most likely because that’s not the root of the problem.
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What to do when saying "remember to swallow!" isn't working

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Drooling can be caused by a few different things.  You mentioned that you don’t think she is aware that she’s drooling – this could very well be true.  Sometimes children have limited to no awareness in their mouths, which means they can’t feel the saliva.  And if they can’t feel it, they won’t know to swallow it.  There are a few strategies you can try to “wake up” the mouth so to speak (including using the Z-Vibe).  For more information on these strategies, click here.
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Continue reading Drooling – Getting to the Root of the Problem

Assisting Lip Closure

Teaching the concept of lip closure.

Just like its namesake, lip closure (also known as lip seal) is the ability to close one’s lips.  It’s important for several different speech/feeding/oral motor skills:
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•  Being able to close one’s lips around a straw, spoon, a piece of food, etc.

•  Being able to pronounce the speech sounds /p/, /b/, and /m/

•  Being able to chew food with one’s lips closed so that food stays inside the mouth (and also for good table manners – I’m not concerned with table manners in feeding therapy, just getting the child to eat well, but post-therapy it could be a goal for the parents)

•  To prevent drooling (poor lip closure can be one reason why some children drool)

•  Correct oral resting posture – lips are closed when our mouth is at rest (when we’re not eating, drinking, or speaking)

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So, how do we work on improving lip closure?  There are several different ways (I’ll link out to more at the bottom of this post).  Specifically here I’m going to show you a simple trick on how to use the Y-Chew to assist lip closure:
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Continue reading Assisting Lip Closure

Fun, Edible Oral Motor Exercises for Kids

Incorporating yummy treats into your oral motor therapy sessions is a great way to spark interest and increase attention.  As long as there are no food allergies, the following goodies will sweeten your efforts to improve tongue elevation, tongue lateralization, oral awareness, lip closure, tongue strength, and much more.
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LOLLIPOPS

Most brands will do, but Dum Dums are my favorite.  They’re not too big, not too small, but just the right size.  And as you can see from the list of ideas and activities below – very versatile!  I give my kids two flavor options and let them pick one to work with.  Too many options can be overwhelming, but two choices is just enough to give them some control over the situation and to let them have a more active role in what we’re doing.
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Edible oral motor exercises with lollipops & more.

Continue reading Fun, Edible Oral Motor Exercises for Kids

Oral Motor Exercises with the Z-Vibe

What is oral motor therapy?

Oral motor therapy works on the oral skills necessary for proper speech and feeding development.  For example, try saying “la la la” right now, paying attention to what your tongue is doing.  In order to produce the /l/ sound, the tongue tip must elevate to the alveolar ridge (just behind the upper front teeth).  It must also be able to function independently – or dissociate – from the jaw.  Oral motor therapy works on these “pre-requisites” for speech and feeding.
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Why is oral motor therapy important?

Think about yoga.  In order to get a pose right, several muscle groups must be working together in a delicate balance of strength, coordination, movement, and endurance.  Speech and feeding are very much the same, only localized to the muscles of the lips, tongue, jaw, and cheeks.  In order to properly articulate sounds and manage food, the mouth muscles need to be in very specific “poses.”   For example, try drinking from a straw right now and pay attention to what your mouth is doing – your lips should be pursed and closed around the straw, the tongue tense and retracted, and the cheeks taut.  Most people naturally learn how to do this on their own.  But some individuals (particularly those with developmental delays) need oral motor therapy to learn those skills.
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Where does the Z-Vibe come in?

Most people are either visual or auditory learners.  Sometimes, however, these two senses are not enough, and we must look to the sense of touch.  Imagine you’re in a yoga class again.  You’ve heard the instructor explain a pose, you’ve seen her demonstrate it, but it’s just not clicking for you.  So the instructor comes over and adjusts your arm into in the right position.  Similarly, sometimes you need to physically show an individual where the tongue should go for this sound, that skill, etc.  This is called giving them a tactile cue.  The Z-Vibe is a tool to help you provide targeted tactile cues within the oral cavity without getting your fingers in harm’s way.  It also takes tactile learning to the next level with the added bonus of vibration.  The gentle vibration of the Z-Vibe provides added sensory stimulation to increase oral focus and draw more attention to the articulators.
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. Continue reading Oral Motor Exercises with the Z-Vibe

Easy Oral Motor Exercises to Try – Today!

Oral motor therapy works on the oral skills necessary for proper speech and feeding development.  These skills include: awareness, strength, coordination, movement, and endurance of the lips, cheeks, tongue, and jaw.  The activities below are an easy way to work on these skills.  Incorporate them into your daily routine whenever you have time.  Practice them on the way to school/work, during commercials, while you’re making dinner, etc.  Make it a game and have fun!  Please note, however, that these exercises should not replace therapeutic intervention.  It is best to see a speech-language pathologist and/or occupational therapist trained in oral motor therapy.  They will be able to assess the situation, prescribe a course of action, and guide you through the process.
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FOR AWARENESS:

•  Use the Z-Vibe to normalize sensation within the oral cavity.  Hyposensitive individuals (with low oral tone) have little to no awareness of what’s going on inside their mouths.  On the other hand, hypersensitive individuals (with oral defensiveness) are overly sensitive and often experience aversions to texture, temperature, taste, etc.  Both cases can significantly affect speech and feeding development.

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•  The tip attachments for the Z-Vibe come in various shapes, textures, and scents.  Use them to stroke and apply gentle pressure to the lips, cheeks (both inside and out), and the tongue.  Vary the pressure, the direction of the strokes, the length of the pressure, etc.  For hypersensitivities, introduce the Z-Vibe gradually.

•  Gum massage is also a simple and effective way to provide oral stimulation.

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FOR THE LIPS:

•  Say “ooo” with exaggerated lip movement.  Then say “eee.”  Combine them for “oo-ee.”  Really round the lips.

•  Say “puh” and pop the sound with emphasis.

•  Make a big smile.  Relax and repeat.

•  Puff out the cheeks while keeping the lips sealed.  Relax and repeat.  Puff out one cheek, then the other, then both.  Then puff out the upper lip followed by the lower lip (or vice versa).  Relax and repeat.

•  Purse the lips to make a kiss.  Slide the kiss to the right and then to the left or vice versa.

•  Blow bubbles.  You can also blow whistles, horns, kazoos, etc.

•  Drink through a straw rather than drinking from a cup.  This is also a great activity for the tongue and cheeks.  Drinking from a straw requires a lot of oral motor work: the cheeks tighten, the tongue tightens and retracts, and the lips purse.  For tips on how to teach straw drinking, click here.

•  In the above exercises, observe to see if the lips are symmetrical.  If not, document what they look like and compare them to future practice sessions to monitor progress.

Continue reading Easy Oral Motor Exercises to Try – Today!