Oral Motor Exercises to Improve Jaw Stability

This young man in the video above has a jaw slide, meaning that his jaw shifts either to the left or to the right when he talks.  Since the tongue is connected to the jaw, the tongue follows the jaw, also shifting to the left or right.  Why is this a problem?  Speech sounds are properly articulated when the jaw and tongue are midline and symmetrical.  If the jaw and tongue shift to the side during speech, certain sounds may seem slushy and unclear.  So in order to clearly articulate sounds, we’ll need to stabilize his jaw at center.  To work on jaw stability:
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Jaw stability oral motor exercises

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1.  
Put the extension of the Grabber (or Y-Chew or Probe) in between the molars, as shown in the pictures above.  Ask the child to bite down and hold for a count of 10.  Repeat a total of 3 times on each side.  If necessary, provide support to the chin with your free hand.
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Bilateral jaw stability with the Grabber

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As you try this exercise, check to make sure that the space between the upper front teeth is lining up with the space between the lower front teeth.  If it’s not, switch to using the loop of the Grabber instead, and place it in the front of the mouth (see the picture above).  This position will force the child to bite on both sides at the same side so the jaw can’t shift and will instead stay centrally aligned.
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Jaw stability with the Grabber placed laterally

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3.  
You can also do this with the extension of the Grabber (or Y-Chew) placed laterally in front of the mouth (as shown above).
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4.  Finally, another way to stabilize the jaw is to use two Grabbers (or Y-Chews or Probes) simultaneously – one of either side of the mouth in between the molars.  This is essentially step 1, only with a tool on both sides of the mouth.
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As always, keep in mind that you may have to start with a shorter count, and work up to 10.  If you only get a couple counts, that’s okay!  Make a note of the progress, and try to do more in the next practice session.
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A note on counting: you’ll notice that I don’t always have the same beat to my counts in the video.  If I sense that the child is losing interest, I mix things up to refocus their attention.  You can change the beat, count faster or slower, say it with a deep voice or a high voice or anything in between, count backwards, use funny voices, and so forth.  Just have fun :)
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Debbie

Debra C. Lowsky, MS, CCC-SLP
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Oral Sensitivities and Low Tone in Children with Down Syndrome

“I have a 12 day old infant with diagnosed Down Syndrome. She has moderate tongue protrusion. A friend suggested your products.  I was wondering which ones you recommend and any suggestions you might have?  Thank you for your help with this!”
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Oral Sensory Strategies for Children who Have Down Syndrome

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Dear New Mom, although each child is different, there are several goals that I usually work on:
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ORAL SENSITIVITIES

In my experience, children who have Down Syndrome often develop oral defensiveness and texture aversions, which can significantly impact their diet and ability to eat.  So it’s important to work on normalizing these sensitivities if they’re already present.  Or even better – to work preventatively before they start.  There are several things you can do:

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•  As early as possible, get into the mouth to provide stimulation and introduce new textures.  Use the Oral Motor Probe and proPreefer to stroke and apply gentle pressure to the gums, palate, cheeks, lips, and tongue.  Stroke the sides of the tongue, run the tools across the tongue, inside the cheeks, over the lips, etc.  For infants and toddlers, the proMini is a smaller version of the Probe designed to fit inside their little mouths.  These therapy tools have different textures on them to provide a varied sensory experience.  You can also dip them in food to introduce texture into mealtimes and for nutritive stimulation.  Sticky foods work well, such as applesauce, yogurt, and stage 2 baby foods.

Continue reading Oral Sensitivities and Low Tone in Children with Down Syndrome

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.

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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

Jaw Grading & Stability

Jaw grading is the ability to visually judge how far you need to open your mouth to take a bite out of certain foods and to say certain speech sounds.  For example, say “ooooo” versus “aaahh” – can you feel the height difference in your jaw?  It needs to open just a little bit for “eeee,” but wider for “oooh.”  Or, imagine taking a bite out of a thin cracker versus a burger – there’s a big difference in jaw heights.

 

Jaw Grading & Stability

 

One of my favorite ways to work on jaw grading is with the Z-Vibe Animal Tips.  Individually, each tip is a great sensory oral motor tool – they have lots of different ‘pockets’ for the tongue to explore, textured surfaces to experience, and friendly faces that kids really gravitate to.

 

Jaw Grading & StabilityBite Blocks for Jaw Grading

 

The Animal Tips also have bite blocks on their reverse sides to practice jaw grading (the parts circled in the image above).  The Dog Tip has the thickest block, the Mouse Tip has a thinner block, and the Cat Tip has the thinnest.  Because they are three distinct thicknesses, you can use them in sequence to gradually increase the difficulty level:

 

1.   Start with the Dog Tip.  It has the thickest bite block, so it will be the easiest to visually judge and bite down on.  Instruct the child to bite down on the bite block and hold for a count of 3-5 seconds.  Release and repeat.
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2.   Once the child can visually judge how to correctly bite on the Dog Tip, progress to the Mouse Tip and repeat the process.  The Mouse Tip’s bite block is not as thick, and so it will be a little harder to judge.
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3.   Once the child can visually judge how to correctly bite the Mouse Tip, progress to the Cat Tip.  The Cat has the thinnest bite block, and so it will be the most difficult.

 

Jaw Grading Bite Block Hierarchy

 

Before you start, be sure to explain to the child what you’re doing and why.  This helps increase compliance and decrease anxiety.  Also, make sure that the child is not chewing on the bite block.  You want them to hold the bite (this is called a sustained bite).  Last but not least, pay attention to the jaw as well.  You don’t want the jaw to open too wide or not enough.  The child needs to practice gauging what the “just right” height is.  This may take some time and practice before they get it.

 

For a visual of the above, see the video below (the first part of the video is about mouthing.  Skip to 1:25 for jaw grading):

 

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You can also work on jaw grading by allowing the individual to mouth and explore the Animal Tips.  Their cheeks, ears, faces, etc. all differ in height/thickness to provide a range of high and low jaw positions.  For example, you can present the Cat’s ears to the individual with the face facing upwards.  Or, you can hold the tip sideways, which will provide a different height and require the jaw to open wider.  I also like using the Y-Chew for the same reason – the three “arms” of this chew tool have different thicknesses to practice jaw grading.

 

 

Before you can work on jaw grading, keep in mind that the child may need to see a physical and/or occupational therapist for trunk control and proper positioning.  The child will need to have stability in the trunk, for example, before he or she can have control over the mouth.

 

For more related exercises on jaw strength & stability, click here and here.
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Cheers,
Debbie
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