Friday, November 20, 2009

Funny straws as a therapy

The use of straws as a therapeutic tool is very popular among parents with kids with Trisomy 21. Because they help with the tongue protrusion which is very common in kids with Trisomy 21 because of the low tone in their mouth (jaws, cheeks, tongue and lips). Tongue thrust in other problem that kids with Trisomy 21 may have. "Tongue thrust (also called "reverse" or "immature" swallow) is the common name given to orofacial muscular imbalance, a human behavioral pattern in which the tongue protrudes through the anterior incisors during swallowing, speech and while the tongue is at rest."

Tommy doesn't have most of the oral motor issues that may occur because of the syndrome. But he has tongue thrust because of two factors: Trisomy 21 and heritable genes. Tongue thrust is in my family, for this reason, we have been very proactive in monitoring Tommy's oral motor function since he was evaluated at his 8 month. Tongue thrust becomes a problem because it alters the oral-facial structure (teeth and mouth) if it is not treat it to break the habit. Therefore, speech problems may occur in some cases.

According to Sara Rosenfeld-Johnson, the founder of, "The use of straws in speech therapy is not uncommon. For many years straws have been an important utensil in feeding and lip rounding exercises. On the client's level the straws themselves are viewed as fun and the food is experienced as a reward... Exactly what is straw drinking? Normal straw drinking requires complex movement from the jaw, lips and tongue. Through the coordination of these movements a vacuum draw is created. Each of our speech sounds are made with a different combination of these graded movements."

We introduced the straw cup to Tommy by the end of his 8 months. His OT and I thought he was too young to start with a straw cup, but I decided to give it a try. Tommy took the straw training cup right away, he didn't need training to learn to suck through the straw. It was a good sign because it proved that the low tone in his mouth is very mild. We have used several types of straw cups to strength Tommy's tongue. Now, the therapeutic treatments we are using are the Straw Kit - TalkTools® and the ARK's Lip Blocks™.

Sara Rosenfeld-Johnson describes the straw kit as a hierarchy of straws progresses through a matrix that advances from multiple sips to single sips and then from thin liquids to thickened liquids while varying the straw's diameter, overall length and the structural complexity via elbows, curves, twists and placement of a lip block."

"ARK’s Lip Blok™ comes in three different lengths: the 3/4 inch standard size, 1/2 inch, and 1/4 inch. By varying liquid consistencies, these Lip Bloks™ supplements therapies for increasing sensory awareness, symmetry, coordination, graded control for liquids, jaw stability, and lip, tongue, and cheek function."

We replaced the straw # 1 from the Straw Kit - TalkTools® for the Lip Blocks®™. Tommy wasn't adapt to the straw # 1 and it was difficult to use it for every drinking, specially, if we had to go out. The Lip Block™ adapts very well to the Munchkin straw cups.  Tommy takes all his drinks using the Lip Block™, which will help to strength his tongue faster. We have seen improvement in Tommy's lip closure while drinking from the Lip Blocks™. His tongue also looks more retracted. It will take a couple of month to complete the straw program, but it is easy to use and adapt to the kid daily routine. 

The use of the Lip Block and the Straw kit is being supervised by our Speech therapy.

1 comment:

Anonymous said...

my daughter saids its more for shipping the the lipbloker where could i get one off line im in nj