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Oral Motor Treatment Strategies: Part 1

Feeding Therapy, Oral Motor, , ,

On Tuesday night, Therapro was pleased to host a highly attended webinar presented by Dr. Kate Barlow, focusing on Oral Motor Treatment and Feeding strategies. This blog is part of a multi-post series that explores key points from Dr. Barlow’s webinar. In this entry, we specifically highlight treatment strategies related to feeding.

Dr. Barlow is an Assistant Professor at American International College. She is also the current ambassador for the CDC’s Learn the Signs Act Early program for the state of Massachusetts. She has over 20 years of clinical experience, including public school practice, early intervention, and a pediatric hospital-based outpatient clinic, as well as management. Dr. Barlow’s passion is in global outreach; she founded the International Interprofessional Mentorship Program that currently provides mentorship to over 100 therapists in developing countries in Africa and South America.

Dr. Barlow’s extensive knowledge in this area was evident as she seamlessly broke down this complex topic into manageable bits of information. Dr. Barlow set out with the main objectives of providing viewers with specific intervention strategies for oral motor deficits and relaying the importance of screening all children for feeding difficulties. As one viewer stated:

“This was one of the best courses I’ve taken in a long time. The instructor was knowledgeable with practical assessment and treatment strategies that I can even use in collaboration with SLPs. So many OTs are intimidated to address feeding, especially in the school setting, but I think it is so important!” -LB

Viewers left with some great take-aways that we will recap in this post:

1. Guidelines for making food recommendations. 

2. The importance of enjoying food.

3. All children should be screened for feeding disorders.

Guidelines for Making Food Recommendations. Match food choice with skill level. When Dr. Barlow discussed guidelines for recommending appropriate food choices, she stated simply  “look at the child in front of you and where they are developmentally.” This bit of advice was a great reminder for new and experienced therapists alike; a child’s skill level isn’t necessarily defined by their age. Dr. Barlow highlighted this further by showing that the development of circular rotary chew could occur on a widely varied timeline, anywhere between 18 to 36 months! 

The Importance of Enjoying Food.  Another important takeaway from Dr. Barlow’s webinar was the importance of enjoying food. She spoke passionately about the importance of understanding underlying medical problems when addressing feeding difficulties. Dr. Barlow explained that behavioral problems around eating can often be addressed when the feeding difficulty is appropriately treated. Another point she raised is the importance of a child being included at the family table. She stressed the importance of this inclusion, in whatever capacity the child is capable (even if it meant that they were just sucking on a lollipop), because the mealtime experience is an important cultural ritual.    

All Children Should Be Screened for Feeding Disorders.  A third take away from Dr. Barlow’s webinar was the importance of screening all children for feeding difficulties regardless of why that child is on your caseload.  She highlighted the prevalence of feeding difficulties as a key factor in this; I was struck by how prevalent feeding difficulties are even in typically developing children.  Dr. Barlow cited research indicating feeding difficulties are present in one in four typically developing children. In children with developmental disabilities and cerebral palsy, the prevalence is significantly greater.  With this information, I found myself reflecting on all that I knew about the role of nutrition in supporting optimal behavior for participation.  The concept of screening all children for feeding difficulties truly makes sense when considering the prevalence of feeding difficulties and the role that nutrition plays in a child’s ability to attend and participate in all of their daily activities.  

Pediatric Feeding Disorders: Evaluation and Treatment

A great resource for information on oral motor and feeding treatment is a book published by Therapro: Pediatric Feeding Disorders Evaluation and Treatment.  It covers topics ranging from the progression of feeding development, to the role of the gastrointestinal system in feeding difficulties, to the evaluation of feeding difficulties, along with a broad range of other feeding topics!  Stay tuned for future blog posts where we continue our review of Dr. Barlow’s webinar, exploring her tips and suggestions for screening pediatric feeding difficulties as well as some of her great treatment strategies! 

Clinical Tools for Treating Childhood Apraxia of Speech: Recap

Speech & Language, ,
Lisa Mitchell, M.S., CCC-SLP is an expert in Childhood Apraxia of Speech (CAS) and recently shared clinical tools for treating CAS

October’s Saturday Seminar speaker, Lisa Mitchell, M.S., CCC-SLP is an expert in Childhood Apraxia of Speech (CAS). She is a pediatric speech language pathologist, Clinical Director and co-owner of Clearly Speaking, a private practice in Hampton Falls, Dover and Londonderry, NH. Lisa has been recognized for extensive training and expertise in CAS by Apraxia-Kids.

On October 26th, Lisa shared her passion with attendees who are speech language pathologists, occupational therapists, OT students, and teachers, with her presentation entitled Armed and Ready for Monday Morning! 26+ Valuable Clinical Tools for Treating CAS (Childhood Apraxia of Speech) from A-Z. She organized her talk in a unique way that highlighted “Tips and Strategies for Treating CAS” in an A through Z format. She discussed some of her favorite publications including those by Pam Marshalla, such as Successful R Therapy, and Apraxia Uncovered.

Lisa explained that CAS is typically part of a broader diagnosis and is a challenging diagnosis to treat. She discussed the importance of collaboration with others on the team, i.e. OTs, who are working with the student on motor issues. Difficulty with motor planning can lead to errors in speech production. With a motor speech disorder, the student has difficulty achieving smooth movement from one sound to another. So, as the complexity and length of words increase, the student has more difficulty. As we can imagine, the child’s level of frustration increases when they are trying to talk.
Wind-Up Toys for reinforcers. Lisa touched on a controversial area for speech/language pathologists’ treatment – oral motor exercises. She discussed how using exercises not attached to speech for children with CAS, such as blowing whistles, bubbles, etc. will not help a child talk. However, using a whistle to help position the lips for speech is useful if the whistle is removed and the student is then given a syllable to produce using lip rounding.

Lisa is a gifted presenter and her passion for her CAS work is evident! She offered a hefty toolbox of ideas and strategies for treating CAS. With such a varied audience today, her tip that was very powerful and resonated with us all was that team collaboration, including parents, strongly benefits a child with Childhood Apraxia of Speech.

Here are some of the appreciative comments from those who attended Lisa’s seminar:

“Very insightful and great ideas for therapy. Enjoyed the insights on co-treating.” – Beth M., COTA/L

“I would recommend this seminar to a colleague. I would like to learn more
about collaboration of OT/PT/SLP – how to work together.” – Maria L., Speech/Language Pathologist

“Easily explained and well thought out.” – Tai M., Occupational Therapy Grad student

“Learned a lot and was easy to understand.” – Anonymous, Occupational Therapy Grad student

Thank you, Lisa!

Filomena Connor, OT, MS, OTR
October 26, 2019

School Daze! What are the Most Popular Back to School Products?

School-Based Practice, ,

Planning for “Back to School” assumes a high priority for parents, teachers, and therapists as July gives way to August. You’ve told us that you and your students LOVE these school /therapy items!  Start the new academic year with a bang using these items in your toolbox. Check them off your list!

Big Box of Scrambled Sentences- a great back to school product
Big Box of Scrambled Sentences
  • For students who focus better and calm with oral input, Topper Zilla is a winner.  It has a chew factor of 3, meaning it is designed for strong chewers. It is not only Godzilla-like strong, but soft as well. It is appropriate for any age, and includes a pencil.
  • To help build a child’s foundation for success with school tasks by improving strength of the trunk and upper upper body, and fine motor control, Upper Body and Core Strength Fun Deck is comprised of 52 fun activities at your fingertips. It also includes game ideas.
  • The Star Spacer helps students understand letter spacing, sizing, and alignment.  It is a simple, clever tool that works! By providing immediate results, the student gains confidence in his/her more legible handwriting. For Grades 1-5, and for older students with writing difficulty.
  • Use Learn to Move, Move to Learn! to plan group activities using 52 creative, theme-based lessons that utilize a sensory-integrated developmental sequence, this book is a must! All of the themes have 7 sensorimotor activities including warm-up, vestibular, proprioception, balance, eye-hand coordination, cool-down, and fine motor. The activities are geared to support young school-age children with diverse abilities.

Of course, we have plenty more “favorite and popular” back to school products – be sure to view the Therapro Back to School Catalog for hundreds more ideas to make this the best school year ever!

Topper Zilla - a must have on the back to school shopping list
Topper Zilla