Browsing Category

Feeding

Feeding, For Parents, Little Friends

Why Babies Mouth and How We Can Encourage

Mouthing pinterest.png

“Did your child mouth as an infant?”

I ask this question all the time to the parents of kiddos with severe speech delays, picky eating habits, and other oral motor deficits.
More often than not, the answer is “not very much” or a flat out “no.”

Sounds like a dream, right? A baby who isn’t liable to choke on any little piece of who-knows-what lying on the floor? Jackpot!?

F A L S E

Why Mouthing Is Important:

Mouthing helps babies explore their world from a sensory and oral motor standpoint. They are learning about textures, tastes, and temperatures that will provide them with a solid foundation to move on from purees to solid foods (get it?) and avoid a picky eating rut. Additionally, they will begin to move their tongue and jaw in new, fun, and interesting ways. These movements will later develop into a mature chewing pattern that will allow them to eat a healthy variety of solid foods and help them produce lovely consonant sounds.

Mouthing starts with the rooting reflex. This reflex is innate from birth and allows an infant to turn and attempt to suckle anything  that touches its face. The rooting reflex begins to diminish around the age of 4 months. At this same time, babies begin to gain the ability to bring their hands to their mouth. This is the opening of our mouthing window.

While it may be extremely convenient to not fear for your child’s safety due to the little babe putting ev.ery.thing. in his or her mouth… it may bite you later.

So what can we do?

  1. Provide lots of safe toys to mouth and gnaw on. You may even go as far as modeling what to do with these objects. That’s correct, adult reading this. I want you to put baby toys in your mouth. Lick and chew and move them around. Let that baby watch what to do.
  2. Make it a game. Think “puppy dog” and be silly so baby laugh and think its a fun game. Maybe they’ll be more willing to join in.
  3. Add some flavor. Try dipping an easy-to-wash toy in a juice or favorite puree to increase interest for the child.
  4. Make it cold. Place a toy in the freezer and see if it makes it more enjoyable. Again, we’re thinking about increasing sensory information.
  5. Provide texture. (sensory sensory sensory) We want bumpy toys. Soft toys. Squishy toys. ALL the toys! Bonus points for the language opportunities here.
  6. When your baby explores (safe) objects with their mouth, give praise. Make it a pleasurable experience and they are more likely to repeat their actions.

 

 

Some great options for mouthing can be found at your local retailers:

 

The Boon PULP Silicone Teething Feeder allows you to place a variety of flavors for your baby to safely explore and enjoy. Perhaps a juicy piece of watermelon or a frozen peeled grape? Yum!

 

 

 

A cute teething necklace like this one by BEBE by Me is another great option – you can’t lose it!

 

 

 

This nuby Banana NanaNubs gum massager is another adorable way to get your baby mouthing and ready for tooth-brushing. Here is the texture we’re looking for!

 

 


Perhaps my favorite is a good ol’ fashioned hard munchable. The key here, and this is very important, is that this is something the baby CANNOT chew or break off yet. The purpose at this point is only for sensory and oral motor exploration. Celery sticks work great too!

 

 

A few things to remember…

We never want to force, but we do want to encourage. A cry or a cold shoulder today could be a timid attempt to mouth tomorrow. Keep exposing the child to mouthing and be patient. Keep an eye out for little signs that they are becoming interested and try again soon.

If you are a parent reading this, it is always a good idea to reach out to a local Speech Language Pathologist for any concerns you may have with your child’s speech, language, and/or feeding. For more information, you may be interested in these parent handouts for late talkers.

 

Of course, safety is always first.

Please be sure that an adult is always present and watching closely as these options are explored. Use good common sense, folks. But we DO need that baby to learn all the awesome things their little mouth can do when it gets movin’!

 

Happy Mouthing, Speechy Friends!

-Lindsey

Articulation Therapy, Feeding

Frontal Lisps

Slide08.png

We can talk about “hiding our tongue” and keeping “tight teeth” ’til we’re blue in the face… but for some kiddos it seems that pesky frontal lisp just WILL. NOT. GENERALIZE. into a crisp, beautiful /s/. Why? Because the way the tongue of many frontal lispers moves is different and, to be honest, disordered all day every day. Often times, they have an immature swallow pattern. If you watch them eat, you will see that little tongue peep out more than it should.

.

We see a huge correlation between frontal lisps and kiddos who have (or had) prolonged usage of sippy cups, pacifiers, and thumb-sucking. Their swallowing pattern got stuck a little too close to the suckle stage and they continue to use a tongue-thrust pattern to swallow. We swallow about 600 times a day. That means every time our kiddos clear their saliva they are reinforcing their frontal lisp.
.
Furthermore, you will notice our kiddos have a low at-rest posture for their tongue. I like to joke that my superpower is being able to identify people who used to have a lisp just by watching them speak for a few seconds. Lispers tongues hang low in their mouth – you can check out what I mean by watching THIS video.

.

SO WHAT CAN WE DO ABOUT IT?

.
Before I start articulation therapy with any of my frontal lispers… we do a few things.

.
1. Nose Breathing

Ensure that your kiddo is a nose breather. Perform an oral mech and check for enlarged tonsils. Ask about seasonal allergies. Refer accordingly. Mouth-breathing promotes a low, forward resting posture of the tongue.

.
2. No more sippy cups

Or thumb sucking. Or pacifiers. Or finger sucking. Cup drinking and straw drinking only, please.

.
3. Make sure their tongue tip can elevate to their alveolar ridge.

Some kiddos just haven’t figured this out yet. If you need some help getting tongue-jaw dissociation, take the jaw out of the equation by having them bite down on something that well help prop open their mouth. (My favorite is to stack a few popsicle sticks and tape the together. It’s cheap and easy to replicate at home.) This will stabilize their jaw and allow them to put all their focus on getting that tongue in position. You can always add a tactile cue by putting some sour spray or ice cream on their alveolar ridge. I find kiddos don’t need these cues for very long once they figure out where their tongue should be. We need to be able to elevate our tongue tip to swallow properly, to produce appropriate alveolar phonemes, and even to get a good clear /s/.

.
4. Tongue checks.

Have the kiddo engage in a silent activity- be it iPad time, coloring, building blocks, or anything in between. Periodically do a “tongue check” to see that they are keeping their tongue tip elevated to their alveolar ridge. We are trying to change the resting posture of their tongue here. For a tongue check freebie, click here.

.
5. Feeding therapy.

If you watch a frontal lisper eat, you will likely see that tongue sneak out during or after their swallow on most food consistencies (liquid, puree, crunchy, etc). They will tell you they are just licking their lips- nope. Target a mature swallow in feeding therapy- and consider referring out if you are not trained in feeding. Again, we swallow 600 times each day!

.
6. Look beyond the /s/

Watch their tongue on all alveolar sounds. There is an awfully good chance that if they are lisping on /s,z/ sh, ch, j… that /t,d,n.l/ aren’t correct either. Watch close and remember to follow a developmental pattern when targeting phonemes.

.
7. Consider an appliance.

If you are signed up for our newsletter then you have already heard about these awesome appliances. Think of it as a tiny speech therapist in their mouth 24/7. The idea is that they receive speech and feeding therapy to learn how to place their tongue at the alveolar ridge for their swallow and for all alveolar sounds. This little bead serves as a warning that their tongue is going too far forward.

.

And there ya go!
.

Just some food for thought, friends. There may be so much more going on than just that pesky /s/ sound. We want to be sure to treat the whole child and hopefully this post will shine some light on your students. Once  you’ve addressed these concerns, you’ll be ready to kick some articulation booty and get them cookin’ with some drill work and generalization activities. Have fun, speechy friends! Conquer the frontal lisp!

-Lindsey

(puppy photo credit: Marion Michele via unsplash.com)

 

Articulation Therapy, Feeding, For Parents, Generally SpeechyThings, Language Therapy, Little Friends

Parent Roadmap to Therapy : Keeping Families in the Loop

sylwia-bartyzel-442

Photo By: Sylwia Bartyzel via unsplash.com

Think back to (insert number here) years ago when you were a young therapist. Now take it back to your CFY… and then grad school.. and then undergrad… and then back to a day before you knew anything about cueing hierarchies, Brown’s stages, or the alveolar ridge. That is where most of our parents and families are.

Let’s clue them in and teach the parents… not just the kids.

It’s easy to forget just how much we, as speech therapists, actually know. We can get lost in professional jargon and in our own thoughts during therapy. Sure, WE know why you chose that activity and the level at which you’re cueing your kiddo to answer a question…. but our families don’t. If they are present in the session, they will likely miss many of the nuances of your therapy.

There are 3 people who should always know a child’s goals: you, the child, and their caregiver.

When everyone works as a team, knows their job, and knows the goal… we are a cohesive unit. Of course there are exceptions, but this trifecta brain-share is the ideal. This way everyone can see the big picture and home programming is no longer a chore- it has a very specific purpose.

I recently had a chat with a ROCKSTAR parent. She is all on board with treatment and so supportive of both me and her sweet kiddo. I realized one day we had been in our groove for so long that I needed to check in with her and remind her of the big picture. In this  case, our little guy is a late talker. We have been working on songs with gestures, vocalizing during play, and adding a few signs to our expressive vocabulary. But I needed to remind mom WHY. WHY we needed to start with gross motor imitation and vocal play. WHY we weren’t hitting it hard and demanding words from him. WHY WHY WHY.

Of course, we can always ask parents if they have any questions…

but you can’t ask questions about things you don’t know exist.

 

(i.e. cueing hierarchies, Brown’s stages, or the alveolar ridge)

It’s our job to put ourselves in the parent’s shoes (or the child’s, depending on the situation) and anticipate their needs and questions. Some parents may feel like it’s not their place to question our methods… even though maybe they don’t understand why we’re having their child do something that seems counterintuitive to them. Some may just feel so overwhelmed that they don’t know where to start.

We are part therapist, part playmate, and part hand-holder.

It’s easy to forget that we literally have a masters degree in COMMUNICATION disorders. We should be *awesome* at communicating… but we’re also human. I’m sure we could all take a little more time to explain the intricate process of speech, language, and feeding development now and then.
(OH DARN, we have to talk more about the most wonderful field on the planet? )

Yes.
-Lindsey