Monday, February 1, 2010

Osiyyah & What We Do for Speech & Oral Motor

As I've blogged about before, Osiyyah's weakest area is speech. Thankfully due to Longvida Curcumin, our diligent efforts of oral motor therapy (OMT) and God's kindness, Osiyyah's speech is blossoming. And has been blossoming for a few months.

As with many of the other therapy areas with Osiyyah, we do most of the work at home with him. A few days ago someone asked what we did with Osiyyah on an email group, so I figured it would be good to post up on here as well.

What resources do we use?

I’ve found the resources from Sara Rosenfeld Johnson & TalkTools extremely helpful ( Yeah, I know they are kind of pricey, but it's been well worth it to spend a bit extra $$. I’ve watched hours of video from them and read hours of their books.

The books I've read:

-Oral Placement Therapy for Speech Clarity and Feeding
-Assessment and Treatment of the Jaw

The jaw book by far was *the* most important book I ever read on speech therapy. Everything started making so much more sense after that. Jaw strength & stability is such a critical part to speech therapy. And so many seem to overlook it.

Not all kids have a weak jaw, but many of them do (especially kids with DS). My brother, Osiyyah, definitely has lack of jaw strength. That’s his underlying problem. When I was reading the jaw book, I felt like I was reading about Osiyyah.

If the jaw is weak, everything else in the mouth & jaw are going to be weak. Once the jaw starts getting stronger, the exercises you do with everything else (tongue, lips) will all start working better. The hierarchy goes "jaw, tongue, lips." Many people tend to focus on the tongue & lips and forget about the jaw. When it really is the other way around . . . jaw first and then tongue & lips. Don't get me wrong, the tongue & lips can be worked on at the same time as the jaw, but the jaw is so essential.

The videos I’ve watched:

-Down Syndrome Population (6hr)

All of those videos were very helpful. The DS population one was especially helpful.

But, I still can’t stress enough how important the jaw book is!

TalkTools also has a cheaper DVD (the above are all kind of pricey) for parents:

-As A Parent: What Can I Do?

I have not watched the Parent DVD, but I’ve heard it is good. And, it would certainly be worth a try, since it is TONS cheaper than the other ones.

What I do with Osiyyah in regards to oral motor work:

-Bite blocks (10x per side for 20 seconds per time)
-Horn #2 (for lip closure)
-Horn #9 (for prolonged breath)
-Button pull (to encourage lip strength, rounding & closure - hold for about 10 seconds, 3-4x)
-Bubble blowing (lip rounding, adequate breath)
-Chewy tube (15 seconds per side to encourage jaw strength)
-Popsicle stick held between the lips and gently pulled on to encourage lip closure
-Popsicle stick with a penny taped onto each end held between the lips. As strength gets better, add more pennies onto it. We don't do this exercise every time we do speech.
-Z-vibe & alligator Jiggler massage to encourage oral muscle tone. We work in a massage pattern, in small circles, from the TMJ (top of the jaw) to the mouth, around the lips, on the lips and inside the mouth under his lips
-Straw #3 to promote lip closure & tongue retraction
(There are a few tongue exercises we do here and there too.)

We also do some PROMPT and visual cues to encourage certain sounds and help tongue retraction. PROMPT cues to encourage tongue retraction are particularly the "Guh" sound. It is a sound made at the very back of the throat, with the back of the tongue and requires a lot of tongue retraction to get the correct sound.

There are certain sounds we don’t work on at the moment, because I know Osiyyah’s jaw/mouth/tongue are not able to do or make that sound because of lack of strength & tone. As we work on those muscles, we continue to try the sound here and there to see if he is ready yet to work on learning the sound better. One of those sounds is the "K" sound. It's a hard one for him, for sure!

Hope this gives some ideas and feel free to leave any questions in the comments and I'll try to answer them as best as I can.



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