On June 16, 2020, Therapro hosted a very popular webinar presented by Dr. Kate Barlow on the topic of Oral Motor Treatment Strategies. In past blog posts, we reviewed great takeaways from the webinar, as well as strategies for assessments that Dr. Barlow shared with viewers. Dr. Barlow also covered some effective treatment strategies during the webinar, as attendees reviewed: 

This seminar provided great ideas on how to provide intervention strategies to children with oral motor difficulties. TH

Well presented course, instructor passionate and knowledgeable. As a PT I appreciate the information, insights, and learning content that was presented. JW

Kate is passionate about helping families and children with feeding issues. She presents a variety of strategies and explains why and how these strategies support positive outcomes. The strategies presented can also be implemented in school based practice which is a challenging setting to service and document feeding therapy. ME

Thanks – it was very helpful! Many great takeaways that I will implement in my practice right away. ML

In this post we will take a look at the treatment strategies shared by Dr. Barlow during the Oral Motor Treatment Strategies webinar.

Dr. Barlow gave useful background information to help viewers understand the “why” when planning treatment. For example, she spent time reviewing type 2 muscle fibers – did you know that most of the muscles used for swallowing are type 2 muscle fibers? Given this information, it is easy to understand why it is so important not only to use resistance but also to increase the resistance and workload when planning treatment for oral motor strengthening. Dr. Barlow also reviewed that age and cognitive consideration should be taken into account when deciding on a treatment plan. Check out some of these other effective treatment ideas that Dr. Barlow covered: 

• To work on lip closure, try an activity as simple as blowing kisses! This is an easy strategy in which all members of the family can easily participate – without any tools!
• For lip and tongue awareness, Dr. Barlow shared the clever idea of putting a spoon in a cup of ice water for a few hours. The cold spoon can be used in a number of ways to help bring awareness to these areas.
• For tongue lateralization, Dr. Barlow shared some strategies using handheld munchables.
• Dr. Barlow also covered some tools that can be used in oral motor treatment.  For example:
  • Bubbles and blow toys are fun ways to develop lip strength.
  • Lip Bloks are a helpful tool when working on tongue retraction.
  • Z-vibes can be used for so many things like developing cheek strength, working on lip closure, and developing lip and tongue awareness.
  • Straws are a fun tool that can be used to work on  lip closure and tongue retraction.

Check out the full video to watch Dr. Barlow demonstrate some of these great treatment strategies and demo some tools she uses in her own treatment!

On June 16, 2020, Therapro hosted an overwhelmingly popular webinar presented by Dr. Kate Barlow on the topic of Oral Motor Treatment Strategies. As one viewer stated:

“This was a totally amazing webinar on oral motor feeding. I learned so much information, and Kate was a wonderful speaker.” DSM

Dr. Barlow is an Assistant Professor at American International College (see her full bio here).   In part one of this blog series we recapped some great takeaways from Dr. Barlow’s June 16 webinar; one of those takeaways was that all children should be screened for feeding disorders.  In this blog post we will dive deeper into the screening and assessment strategies Dr. Barlow shared with viewers during the webinar.  

Dr. Barlow shared great tips, resources, and strategies for appropriately screening and assessing feeding disorders, noting that a good assessment is the driving force behind a good treatment plan. Dr. Barlow identified key areas to assess: lip closure and strength, reaction to gum massage, posterior cheek strength, tongue range of motion and strength, jaw strength, motor planning, and sensory assessments when appropriate. Dr. Barlow shared a decision tree that she created, explaining that it is a great way to ensure all relevant areas are covered during the screening and assessment process. With this she highlighted key questions to ask caregivers during the screening process, like the three Ps: “pain, past medical history and poop.” Other recommended questions to ask included: 

• Is the child eating more than 10 foods?
• How is the child being fed?
• Where does the child eat?

Dr. Barlow’s experience in the area of pediatric feeding was clearly evident in some great pointers she offered when assessing feeding difficulties. For example:

• Always ask about teeth brushing because of the correlation between difficulties with brushing teeth and difficulties with feeding.
• Be sure to check that the child’s nutrition is adequate even if they are at an appropriate weight. 
• Monitoring oxygen saturation, temperature changes, and respiratory rates during feeding can give you clear indicators of difficulty during feeding.

Viewers left this webinar with an awareness of how crucial it is to understand the deficit areas that are causing the feeding problem. That understanding is a key piece in developing an appropriate treatment plan. We will discuss Dr. Barlow’s treatment recommendations in part three of this three part recap of the Oral Motor Treatment Strategies webinar.

 A recommended resource for evaluating sensory based difficulties is the The Sensory Processing Measure. The home form is completed by a child’s parent or caregiver and provides norm-referenced standard scores for two higher level integrative functions-praxis and social participation-and five sensory systems – visual, auditory, tactile, proprioceptive, and vestibular.

On Tuesday night Therapro was happy to host an overwhelmingly popular webinar presented by Dr. Kate Barlow on the topic of Oral Motor Treatment Strategies.  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.  

A great resource for information on these topics 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!