April 3, 2010

Oral Placement Therapy

Game on!!

I have way too much to say, so I'm going to try to do this in stages so you won't get bored and you won't get overwhelmed. This is the boring part--at least to me. Hope you're not snoozing when you're done with this post.

I don't know exactly where I learned about oral motor--likely it was from someone on the Einstein listserv when Hannah was about 2.5 years old. We were working on her IEP transition, and I met with a public school Speech Therapist (hereafter known as an SLP--speech and language pathologist). Hannah had been getting private speech since she was a year old. At age 2.5 her language skills were pretty good--she had about 250 spoken words and at least 200 signs. She was reading approximately 50 words. But her speech was sloppy making it difficult for anyone to understand her other than close friends and family. I knew that regular plain old speech therapy was not producing clear articulation in the Down syndrome population--I had met too many teens and adults whom I could barely understand. It wasn't going to cut it. I needed to find something out of the box.

I asked the school SLP if she knew anything about oral motor, specifically about Sara Rosenfeld-Johnson's techniques (hereafter known as SRJ). She said she didn't, but she'd research it. She came back with some exercises that she found on the internet. I thought they were weird (turns out I was right). She had Hannah try to touch her tongue to her nose, and to her chin, and side to side. What I know now is that it is TOTALLY inappropriate to do muscle (tongue) exercises outside of the mouth--ESPECIALLY for a child who is dealing with tongue thrust. She already knew how to keep her tongue out of her mouth--I needed help getting her to keep it in her mouth. The goal of oral motor therapy is to normalize the musculature in the mouth--sensory, strength and fine tuning. Those low toned weak jaw, tongue and lip muscles need specific exercises to get strong. If the muscles are "normalized" then "normal" articulation is possible.

After a few weeks with the school therapist she gave me the name of a private therapist who worked on muscle based therapy. We immediately set up an appointment with Miss Jenn. Miss Jenn had training in Debra Beckman's techniques. I didn't really like them very much, but it was better than nothing. Over time I introduced Miss Jenn to SRJ's website. Blessedly, Miss Jenn was fascinated with Talktools. She decided to pursue training and became our first viable link to oral motor therapy.

Hannah started working with therapy tools like therapeutic drinking straws, bubbles, horns and re-learning how to chew. She was not a pleasant client. It was hard work to get her to comply with her "mouthwork". Hannah has always been independent minded (is that a euphemism for stubborn?).

Oooh. What a glare!

Fortunately she survived her preschool years (and so did I), and she has gradually become more compliant.

When Hannah was four years old she had an opportunity to get an evaluation with SRJ. My parents had been saving college funds for each grand child. They asked if we'd like to use Hannah's college money for an evaluation. YES, PLEASE! And away we went...

Next up: The Nitty Gritty facts about the Jaw. I know, you can hardly wait!


Sasha@ Blyssfulhealth said...

This is very interesting. I haven't been blogging much lately. I am just peaking in an saw that you are talking about SRJ. We just had an evaluation with Sara last week for our son. I would love to hear more on what you think.We have had a feeding team for a year and just decided to go for it with SRJ. Anyways I love that Hanna had so many sings and words by the age of 2.5. That is amazing.

Tara said...

Well, I can hardly wait! Really. Eon's 14 mos and just starting speech, but our 4yo neurotypical child has speech apraxia and his private therapy is NOT working.

Crittle said...

Oh, I'm all over this series of posts! And I'm really hoping that the person you were working with when Hannah was little-little is still around and even more experienced and that we're heading her way. Because we need lots and lots of help in this area.

Mom who can't get past horn #2

Lisa said...

Love this stuff... we're doing the straws and will attempt the horns again soon (last time we tried they scared the crap out of Sheridan)... can't wait to hear your experience and pick up some extra tips!

mauimom said...

Hi Beth! Hope you are doing well. I've been delinquent from blog world for quite some time now. It is so fun to read your post about oral placement therapy. On the secluded island I live on, the speech therapists are trained in Beckman. Although not as user friendly as SRJ...at least they are familiar with oral motor. I researched the SRJ stuff, and found a oral motor and feeding video specifically for the DS population (by Lori Overland, on Talk Tools website). I purchased it and Sylas' speech therapist has watched it. We are now looking into the assessment/treatment of jaw book. Looking forward to your future posts!

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Unknown said...

Hi I am from the Philippines. My nephew who has Autism is undergoing his Oral Placement Therapy sessions. My family and I can say that it was really effective because he was non-verbal then, but now he can utter vowels and consonants already and express himself. Even if it is just approximation. At least he can say what he wants and we are very much happy! Thanks to SRJ and her associates :)