Setting up an evaluation time with me

I have to apologogize for not paying attention to my blog for the last month. To say I have been busy would be an understatement. ASHA was a terrific success and since I have been home the interest in my work has been overwhelming. I am feeling so good about this but must admit it is getting harded and harder to answer all of the emails. In response to the query about how to set up an appointment with me or one of the other TalkTools therapists... please go to the website: www.talktools.net and send us a message. It is going to be a very busy year with trips to Puerto Rico, Mexico City and China within the first few months of 2010 but I love what I do and teaching other therapists to use Oral Placement Therapy has become my passion. When I travel for teaching I do see kids for evaluations so do check the website. I just want to end by thanking each and every one of you for your support of my work and I wish for you a happy and a healthy New Year. Sara

Success at ASHA

Let me start by thanking all of you who supported me at my recent presentation at ASHA. What a thrill to stand up there with all of you smiling and cheering me on. The vidoes of the child I used to demonstrate the effectiveness of Oral Placement Therapy for children with the diagnosis of Down syndrome was terrific. For those of you interested here is my PowerPoint (bottom of page session # 2543) and I also included a single subject study available here Part 2 .

Reports from Scandanavia!

Cannot believe I am sitting her in Gothenburg, Sweden after a full day of teaching speech therapists here about TalkTools. The excitement is electric and they are so eager to try these techniques with their clients. After the class today we met friends for a dinner of salmon, potatoes and carrots. And they call this work... Life is good!

Accepted to speak at the 2009 ASHA (American Speech-Language-Hearing Association) Convention in New Orleans

Great news! I see a change in the acceptance of my work and I know this is going to be very good news for a lot of therapists and parents out there. Many of you have seen the benefit of using my “Oral Placement Therapy” (OPT) to improve feeding skills and speech clarity but have been faced with professionals who are told not to work on muscle movements for speech. I think the problem here is that my work has been lumped with others who are working on movements not related to speech. I only work on movements that are related to speech. Well this year at ASHA I am going to be able to present my work to my peers at our national convention. This is a big deal as for the first time I will be in a position to explain what we do at TalkTools Therapy not what they think we do. My presentation is called, “Early Intervention: Oral Placement Therapy for Children with Down Syndrome.” I would love to hear your success stories using my techniques so I can share them at this conference.

Low Tone Affects Taste as well as Movement

I found the following comment on a website I frequent; it was from a mother of a child with the diagnosis of Down syndrome who was questioning her child's eating behaviors.

• My little guy (21 mo old) refused to eat his lunch I had cooked for him but loved the spicy jambalaya I had fixed for some of the older folks in the family. When he started eating it, he'd grab his mouth (like it was spicy hot!) and fuss and cry. I'd give him some of his coconut water, he'd calm down, then he'd sign "more" for the jambalaya. He did this several different times during the eating session. I know it was spicy because I was eating it, too. (hot pepper, red pepper sauce, Creole seasoning) He only ate about 3/4 of a cup, and at that point I stopped feeding it to him because italso had onions and green pepper in it. It was fairly healthy (made w/brownrice, etc...) but not something I would feed a "baby". Has your child(ren) done this? Is this bad? Is spicy stuff too much for kids w/DS? Am I overly concerned about nothing?

Once again I am amazed that pediatricians and therapists do not explain to their families that when children are diagnosed with Low Tone/Hypotonicity it also means they may have Hypo-sensitivity/Hypo-responsivity to touch, taste and smell. This little guy is demonstrating my point. He likes foods that are highly flavored because he can "taste" them. Kids with hypo-sensitivity like foods they can taste so increasing flavor for these kids is essential. It will also encourage them to chew because they can perceive the food in the mouth. For many of my clients I use dips (ketchup, salad dressing, bar-b-que sauce) to increase the flavor of any foods I want them to eat for nutritional intake. I worked with one kid whose mom described him as having adult taste buds. So in response to this parent the "spicy stuff " is only a part of what your child is telling you...it is the taste he wants. I would encourage her to increase the flavor as we really do not know how the "spicy stuff" is affecting his digestion.

Early Intervention Feeding

As many of you know I travel a lot for business. I am now in NYC for my youngest daughter's graduation and to see a few clients. It amazes me how many of these kids still do not have therapists who know about early intervention feeding. I saw a child today with a significant tongue protrusion during swallowing and talking. The home-based therapist told this mother to press down on the child's tongue blade with the spoon to stimulate retraction. Mom was also told to press in on the tongue tip whenever the child's tongue blade was "hanging out of the mouth." Mom followed this professional's suggestions to a “T.” Guess what happened? Three weeks later this kid has a stronger tongue protrusion and does not want mom to put a spoon with "anything" in her mouth. When I teach my feeding class to the Special Educators at the University of Arizona I have them do these 2 tasks and feel what their students will be feeling. The response is generally a gag and a desire to stick the tongue tip out.

SLPs and OTs are being asked to do early intervention feeding with clients as part of our birth-t0-3 jobs. Before feeding anyone I would require them to watch Lori Overland's DVD: Feeding: A Sensory-Motor Approach.

We have to stop feeding kids like we "think" they should be fed and start feeding them to promote safe feeding and improve speech clarity.

The Sippy Cup Issue

What a great email I got today! An SLP forwarded me a link to an article on why “sippy cups” are not the best choice for transitioning kids off of bottles. In this article in Baby Talk they talk about the fact that to drink from a “sippy cup” the child has to use a suckle pattern. The best quote is from an SLP “There are only a few sounds we produce with the tongue out like ‘th.’ Most words are spoken with the tongue in, and the sippy cup does not encourage that.” Finally! I have been teaching this same information in my class, A Three-Part Treatment Plan for Oral-Motor Therapy, since 1992 but for some reason the message has not gotten out there. Even though Jonathan Eig wrote an article many years ago in the Wall Street Journal, in which I was quoted, this is the first resurface of the issue I’ve seen and I’m elated.

I have spoken with many dentists who also discourage the use of these cups as they foster an open bite. These cups are carried around and allow kids to have a sugared liquid in the mouth frequently throughout the day. For this reason the incidences of cavities is increased in kids who use them habitually. Many pediatricians don’t like them because a child can drink from them with the head tilted back allowing liquid to enter the Eustacian Tubes so these kids are at greater risk for ear infections.


There are so many reasons why they should not be used especially with our clients with tongue-thrusts which already impact negatively on their speech and feeding skill development. Using a recessed lid cup, Honey Bear with Straw or a Straw Drinking Hierarchy (admittedly biased source – other sources exist but I cannot vouch for quality) is a much better way to ensure adequate liquid nutrition, avoid spilling and actually improving oral placement and movements for speech.