September 2nd, 2014
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The Oral Motor therapy program used is called "Oral Motor Exercises for Speech Clarity" by Sara Rosenfeld-Johnson.  This is a specific program and involves many different types of exercises to address oral motor strength and skills needed for appropriate eating, drinking, and speech production. 

The tools used in this program have been determined as successful when presented in a specific hierarchy.  At this time all students participating in this program are using materials owned by the district.  If your child brings horns, straws, etc. home to do homework these need to be returned to school.  If a parent feels strongly that they would like to have their own set of tools for their child I can provide the ordering information.  All shared tools are disinfected and washed appropriately before switching to a different user.

If your child is using this program, the appropriate number of seconds for practice were determined by the success acheived at school.  Homework is designed to work at the highest level of success at a given exercise so that the muscles develop strength and muscle memory.  The correct number of seconds for each exercise can be found on the "Classroom Calendar" page.

Mrs. Henry and Mrs. Simpson would like to give a special "THANKS!" to the QUEST PTSO.  They have supported this program by purchasing some of tools needed for the program.  Thank you very much! 


The first, and most important step, before beginning oral motor exercises is to establish a proper sitting position. All exercises need to be done in the proper position.

The child needs to be sitting straight up with his/her head facing forward. The hips should be at a 90 degree angle. The knees should be at a 90 degree angle also. The feet need to be flat on the floor. Feet can not be crossed and under the chair or wrapped around the legs of the chair.

If you do not have a chair that is low enough for the child to touch the floor with flat feet use something such as a telephone book or stool under the feet so they are flat.

CORRECT POSTURE IS CRUCIAL!!!


Tongue Depressor Barbells

The purpose of this exercise is to improve lip closure and to improve the strength and muscle memory in the mentalis muscle to improve the production of the /r/ phoneme.

  1. Make sure the child is sitting with proper posture
  2. Have the child protrude the lips, like fish lips
  3. Move the tongue depressor to the lips and have the child close his/her lips
  4. The child must hold the tongue depressor with just the lips for the correct number of seconds
  5. The adult then removes the tongue depressor from the child'slips

If the child is using the teeth, take the tongue depressor out and try correct placement again.

As the child builds lip and mentalis muscle strength pennies are added to each side of the tongue depressor. Once the child has 8 pennies on each side and successfully holds the tongue depressor for 25 seconds, 3 times he/she has significantlyimproved and developed strength/muscle memory in the mentalis muscle for the production of the /r/ phoneme.


Horn Blowing Hierarchy

Horns are presented in a hierarchy that was designed to work on specific muscle groups in a specific order to increase muscle strength and muscle memory.  It is important to follow the specific instructions for horn blowing to develop the muscles in the necessary way. 

Specific horn "rules"

  • make sure the child is sitting in the proper posture
  • the adult must hold the horn
  • horn needs to be presented perpendicular to child's mouth in the middle of the lips
  • the child must be using the lips only, they can't bite on the horns
  • the adult must place the horn in the mouth, the child blows, then the adult removes the horn  (this is one trial)  this process repeats for each blow of the horn
  • the duration of the air flow is essential for developing the specific abdominal muscles
  • horns have specific durations of required air flow

The goals addressed by horn blowing include:

  • improving volitional airflow volume and duration
  • improving abdominal grading
  • reducing drooling
  • improving jaw stability
  • strengthening tongue and check muscles
  • improving lip closure and mentalis muscle strength
  • improving lip rounding/protrusion
  • improving tongue retraction and back of tongue side spread (needed for the /r/ sound)
  • improving jaw-lip-tongue dissociation to improve speech clarity
  • teaching awareness of musle placement for sound articulation
  • improving motor planning

Duration of air flow for specific horns:

  • horn 1- any duration
  • horn 2- 1 second
  • horns 3-4- 1 plus seconds
  • horns 5-8- 2 seconds
  • horns 9-10- 2 plus seconds
  • horns 11-14- 3 seconds

 


Straw Hierarchy

The straw hierarchies are designed to help improve lip rounding, tongue retraction, and jaw stability.

The child needs to be sitting in proper posture.  They cannot put the straw under the tongue, and only 1/4" of the straw can be in the mouth.  The parent can assist with holding the cup, but not the straw.

The straws that are used are for thin liquids.  The child needs to drink 4 oz with the target straw.

**When the child reaches straw #5 the directions are slightly different.  It is very important that the child is reminded to put only 1/4" of the straw in his/her mouth.  There is no lip guard for straws 5-8. 

**Also beginning at straw #5 the child drinks one sip at a time, not continuous sucking.  The child will draw the liquid up the straw.  With a sip in his/her mouth you will remove the straw.  Then direct the child to put his/her tongue tip on the roof of their mouth behind the front teeth.  Then tell the child to swallow the liquid while the tongue tip is elevated.  When he/she opens his/her mouth the tongue should still be in the same position.  Repeat this process for the entire drink. 


Nose Flute

The nose flute is used to establish and increase volitional airflow through the nasal passages.  This horn helps the child practice nasal exhalation to reduce mouth breathing. 

How to correctly place the nose flute:

  • the child needs to place the upper portion of the flute under his/her nose
  • then he/she needs to open his/her mouth and place the lower portion inside the lower lip- make sure there is a complete seal around the opened mouth and nose
  • have the child exhale firmly through the nose (this is called a sniff)
  • as the child masters generating the sound then he/she will work on prolonging the airflow

If the child has a cold and has mucous in the nasal cavity the child would put a tissue over the nose and "pretend" to blowing through the nose flute.  The tissue should puff out with the nasal sniffs.


Cheerios

This exercise works on lower lip retraction needed for producing the /f/ and /v/ sounds.

Place a cheerio on the bottom lip at the middle of the lip.  The child needs to bring the cheerio into his/her mouth using only the top teeth.  The top lip may not be used.

Once the child is able to do this properly with 25 cheerios then the child practices the same movement without the cheerio.  He/She pretends to get the cheerio.

The goals of this exercise include:

  • improving lower lip retraction
  • developing jaw-lip dissociation
  • teaching a new muscle memory pattern
  • teaching standard production of /f/ and /v/ phonemes

Oral Nasal Contrasts

These exercises are used to improve normal resonation patterns by improving velopharyngeal functioning.  In everyday terms- these exercises help reduce mouth breathing and improve nasal breathing.

Step 1- 10 repetitions of "hoo"- check to make sure there is no nasal emission of air by putting a mirror under the nose.  Then have the child say "hoo" pause for 1 second "m".  This pattern will be repeated 10 times without a break.  The pause between "hoo" and "m" is very important.  This allows the velum time to move to the proper position.  This pattern strengthens the muscles that allow the transition from oral airflow to nasal airflow.