10 Holiday Gift Guide Ideas (Speech and OT Therapist Approved!) 2024 Edition

The holiday season is a great time to find gifts that are not only fun but also help our little ones learn and grow. Toys and activities that encourage communication, language development, and motor skills, along with allowing young children to explore the sensory system can make a big impact. At this stage, kids are learning to express themselves and understand the world around them, so gifts that build on those skills are a perfect choice. Whether it’s an interactive storybook or a simple musical instrument, these kinds of simple gifts make learning feel like play. Plus, they’re a great way for parents and kids to connect while introducing important skills like communication and vocabulary. It can be difficult to decide which gifts to buy out of the many available. We compiled a short list of our favorite toys and games that we like to use in speech and occupational therapy and at home with our children!

1. Interactive Storybooks (Ages 0+)

Never Touch a …

These books have something to touch and feel on every page encouraging early interaction with books, and there is a book for every season or a book to fit every season.

Language goals/core vocabulary to incorporate: “animal, monster, or dinosaur noises (moo, baa, roar), touch + X, more, turn the page”

Poke-a-Dot Books

Encourage interaction on every page engaging early readers while targeting fine motor skills.

Language goals/core vocabulary to incorporate: “animal noises, push, more/all done”

2. Laugh and Learn Smart Stages Piggy Bank (Ages 1+)

Language goals/core vocabulary to incorporate: “open/close, nose, in/out”

Target fine motor skills and hand/eye coordination.

3. Musical Instruments (Ages 1+ supervised)

Simple instruments like tambourines, maracas, or xylophones encourage exploration of sounds and rhythms, aiding in listening skills.

Language goals/core vocabulary to incorporate: “bang, shake, more, nursery rhymes.”

Target fine motor skills.

4. Rainbow Spinning/Stacking toy (Ages 6 months+)

Language goals/core vocabulary to incorporate: “on/off, ready, set, GO!, more, down, colors.”

Target spatial concepts and motor skills.

5. Critter Clinic (Ages 2+)

Language goals/core vocabulary to incorporate: “open/close, Ouch, uh-oh, help + animal, animal sounds (meow, woof,) animal names.”

Target spatial concepts and imaginative play.

6. Vehicle sound puzzle (Ages 1+)

Language goals/core vocabulary to incorporate: “on/off, vroom, Whee-oo, chugga-chugga-choo-choo, ship, train, more.”

Targets fine motor skills: pincer grasp.

7. Hahahaland 2-in-1 Car and Ball Toy (Ages 1+)

Language goals/core vocabulary to incorporate: “colors, my turn/your turn, down, bang, hit + color, vroom”

8. Little Tikes First Slip and Slide (Ages 1+)

Sometimes it takes a little movement to get children vocalizing!

Language goals/core vocabulary to incorporate: “Ready, set, GO!, up/down, slide, more, whee,”

Target gross motor skills, balance and coordination, spatial awareness, and vestibular stimulation.

9. Melissa and Doug Food Cutting Play Set (Ages 2+)

Language goals/core vocabulary to incorporate: “cut + food, yum, yuck, eat, counting, I want + food.”

Target fine motor skills.

10. Tongues Out! (Ages 4+)

Language goals to increase core vocabulary: “Find + color, not + color.”

Target motor skills, social communication (taking turns), and negation (not blue).

Picky Eaters During Holiday Meals

Allegra Bereszniewicz M.S., CCC-SLP/QOM

This time of year can be tough when you have a child who is a picky or problem eater. It’s full of extended family gatherings where the bulk of the focus tends to be on eating specific, traditional foods. Not to mention the experience on a whole can be very overstimulating for your little ones (not to mention you!)

Here are some reasons that the holidays can be difficult for your child:

A lot of people- some your child may know and feel comfortable with and others that may be new and unfamiliar to them.
A new or different space- If you are traveling, just the act of getting to your destination can be overwhelming. If you are hosting--their familiar space and environment is now different, filled with a lot of people, noises and things (i.e. foods, decorations, etc.)
New and different foods- the foods being offered may be completely new or presented in a different way that is unfamiliar.
Certain expectations- although most family members and friends mean well, they sometimes have expectations on behaviors and eating habits that can create added pressure for your child.
Off-routine- Your day to day is typically pretty routine but during the holidays, routines tend to be relaxed and children don’t necessarily know what’s to come next.

Here are a few strategies to implement this holiday season:

Talk it through!- Use the time before and between holidays to really prepare your child for what’s to come. Share the holiday magic and make it fun and exciting but also informative so they know what to expect.
- Show them pictures and videos from previous years or relatives that they will see during the holidays to help them get ready.
- Do the same with what foods they can expect to see and smell during holiday meal times—show them pictures and maybe cook some dishes together in the weeks leading up to the holidays!
- Provide verbal and visual schedules to help them know what the day(s) will look like from an activity standpoint to help them prepare.
- Continue to talk everything through as it happens. For example, if you are in the car traveling to a relative’s house, talk about what they can expect when you arrive, who they will see and ask questions to check in for understanding!
Limit changes as best you can-This can be tricky so give yourself grace too!
- Try to maintain portions of your routine to help not to overwhelm your child—for example nap and meal times.
- Try offering food during typical meal times that are preferred and familiar foods that your child feels safe with.
- Ask them what safe and comforting toys they want to select for the trip to accompany them.
Adjust meals-
- Feel free to feed your child their typical meals or snacks prior to the “Holiday Meal” so that they are not hungry and frustrated by the time the main meal comes.
- During Family/Holiday meals encourage your child to sit with the family but try offering 1-2 preferred and familiar foods during this time so that not all the offered foods are new or novel!
- You can incorporate a “learning” plate into holiday meal times where the novel foods can be placed but your child is not “expected” to eat it. Instead they can learn about it from a sensory standpoint (i.e. smelling, touching, licking it) or how it was prepared or grown.
- Try to shift the focus of the holidays away from eating and instead spending time with those around you, that way your little one does not feel overly pressured to eat new or non-preferred foods, which can lead to difficult behaviors.

And one last thing, it’s only 1 day so give yourself grace if your child eats less than usual or is only eating mac and cheese. Enjoy the day and time with those you love!

Sensory Processing: Tactile System

Lacey Lubenow, MOTR/L, CLC

Purpose: The tactile system is responsible for receiving information from the environment through touch. It’s important in keeping us safe through the detection of potentially dangerous stimuli such as hot, cold, or sharp objects.

Function: The tactile system is composed of receptors that detect pressure, temperature, vibration, and texture in our external environment. The tactile system works alongside the proprioceptive system to communicate with the brain through sensory receptors throughout the body.

Why it’s important: As mentioned previously, the tactile system serves a lot of purposes, but none more important than safety. Without the tactile system, the body would be at risk of harm through things like heat exposure when cooking or bathing or cold exposure when outside in the elements. It also serves the purpose of emotional attachment (think skin to skin after birth), body position, and feeding and nutrition.

System Breakdown: Because the tactile sensory system is so vast, children who have difficulty with tactile processing may present with a combination of over or under responsive tendencies. Children who are over-responsive to tactile input may be resistant to self care tasks like hair brushing/cutting, nail trimming, tooth brushing, or face washing. They may have a hard time feeding, which can lead to picky eating habits. Children also may avoid or dislike messy play such as finger painting, sand play, or playing with food. Resistance to certain textures of clothing, socks, difficulty with tags or seams, or tight clothing can also be a sign of tactile over-responsiveness. Children who are under-responsive to tactile input may seek out various textures and use parts of their body that have more touch receptors including lips, tongue, and face to feel them. They may not recognize tactile input as easily and thus have a lack of awareness of when their face or hands may be dirty. They also may appear to have a high pain tolerance and seek out messy play opportunities rather than avoid them. Similarly to other sensory systems (proprioceptive and vestibular) children may also engage in active or rough play like running, jumping, or crashing into things.

OT Intervention: Every person is unique to their sensory processing needs. It only warrants intervention if it prevents participation in meaningful activities and impacts their quality of life. Regardless, tactile input is beneficial for children with and without sensory impairments. A sedentary lifestyle restricts the opportunity for engaging the tactile system and can lead to sensory processing difficulty purely due to a lack of exposure. Our sensory systems require frequent input to process information efficiently and effectively. Occupational therapists assist with creating a ‘sensory diet’ that is unique to each child’s needs to help them better process sensory information and promote improved regulation. Examples of activities that OT’s may use to promote exposure to tactile input include:

Water Play: Water is a great way to engage the sensory system without the feeling of being too messy.

Brushing Protocol: The Wilbarger brushing protocol is often used by OT’s to assist with desensitization of the tactile system using a specific brush on the skin. It can decrease over-responsiveness to clothing, food, and self care like hair or tooth brushing.

Deep pressure: A powerful tool that not only helps with regulation of the proprioceptive system, but the tactile system as well.

Exposing children to various textures through play over time will assist in desensitization of an over-responsive tactile system. If a child is under-responsive, providing and educating them with safe sensory opportunities that allow them to feed their sensory system through rough or messy play is equally as important.

Sensory Processing: Vestibular System

Purpose: The vestibular system is responsible for sensing the direction of our body in space; up, down, backward, forward, spinning, and speed. It plays a critical role in our balance and coordination and can act as a powerful tool in regulation.

Function: The vestibular system is made up of structures within the ear which include three semicircular canals and two otolith organs. Hair cells, crystals, and fluid provide the brain with information about head movement and position. Children can be over-responsive to vestibular input, making them sensitive to excessive or specific types of movement. They can also be under-responsive, requiring increased movement to remain engaged.

Why it’s important: The vestibular system provides us with important information pertaining to balance, orientation, coordination, eye control, and security in movement. It can be thought of as an internal GPS and without it, movement would be very difficult, if not impossible.

System Breakdown: Children with vestibular processing difficulties may present with resistance to change in position. This can look like fear or avoidance of swinging motions or refusal to partake in activities that involve climbing, jumping, or going upside-down. This would be considered over-responsive to vestibular input and result in sensory avoidant behavior. Children with these tendencies are often perceived as overly cautious. If the child is under-responsive to vestibular input, we would see just the opposite and they would be seeking out that sensory input for regulation; running, jumping, climbing, rocking, and fidgeting, which is often summarized as difficulty remaining still.

OT Intervention: Each person is unique to their sensory processing habits. It only warrants intervention if it prevents participation in meaningful activities and impacting their quality of life. Regardless, vestibular input is beneficial for children with and without sensory impairments. A sedentary lifestyle restricts the opportunity for engaging the vestibular system and can lead to sensory processing difficulty purely do to a lack of exposure. Our sensory systems require frequent input to process information efficiently and effectively. Occupational therapists assist with creating a ‘sensory diet’ that is unique to each child’s needs to help them better process sensory information and promote improved regulation. Examples of activities that OT’s may use to promote exposure to vestibular input include:

Swings: There are many different types of swings available and therapy gyms often have more than one to assist with various needs. However, regardless of the type of swing, they all target the vestibular system.

Climbing equipment: Rock walls, jungle gyms, and slides are all great pieces of equipment that can frequently found in a therapy gym to promote engagement of the vestibular system.

Bouncing: Trampolines and exercise balls are useful tools that make bouncing easier and fun.
Inverted exercises: Yoga, bars, and exercise balls are great tools to move the body upside-down, which is a great way to target the vestibular system.

10 HOLIDAY GIFT GUIDE IDEAS (SPEECH AND OT THERAPIST APPROVED!)

Toys and games that promote language, social communication, sensory regulation and fine motor skills

Looking for holiday gifts for little ones can be HARD, there are so many options that may make it difficult for parents or loved ones to find a gift that will keep a child engaged while also targeting some skills they are working on in therapy. We compiled a (short) list of some of our favorite toys and games that we use in speech and occupational therapy to help encourage expressive and receptive language, build core vocabulary, develop fine motor skills and explore our sensory system to help you navigate gift giving this season. Something these toys have in common are that they are simple and promote interactions, which from a social communication level--we love! These are for the most part very low-tech and allow room for the caregiver to model and encourage language while playing!

“Learning Resources Spike the Fine Motor Hedgehog” (ages 18 months +): Language goals/core vocabulary to incorporate: “in/out, colors, my turn, pull, push.” Targets fine motor skills and hand/eye coordination.
“Melissa and Doug Pizza Party Wooden Play Food Set” (ages 3+): Language goals/ core vocabulary to incorporate: “more + food, counting, eat, I want + food, yummy, yuck!, cut.”
“B-Toys- Interactive Red Barn” (Ages 2+): Language goals/core vocabulary: “Ready, set, GO!, down, up, push, open, close, animal names + sounds, ball, roll, slide, spin, peek-a-boo!” Target spatial concepts, following 1-2 step directions and fine motor skills.
"Melissa and Doug Slice and Bake Cookie Set” (ages 3+): Language goals/core vocabulary to incorporate: “more + flavor/color, on, off, help me, hot, cut, open.” Target spatial concepts (i.e. put it on top, take it off, cut.”
“Magna-Tiles” (ages 3+): Core vocabulary to incorporate when requesting additional tiles: “More + color, colors, shapes, up, down, on, off.” Can incorporate special concepts and following directions.
“Melissa and Doug Take Along Tool Kit Wooden Construction Toy” (ages 3+): Language goals/core vocabulary to incorporate: “bang bang, boom, turn, help, on, off, in, out and dump.” Targets fine motor skills with turning gears and tools.
“Ocean and Sand Sensory Bin” (ages 3+): Language goals/ core vocabulary to incorporate: “uh-oh, hide, my turn, shake shake, dig + animal names.” Targets fine motor skills, imaginative and sensory play skills.
“Melissa and Doug Examine and Treat Pet Vet Play Set” (ages 3+): Language goals/core vocabulary to incorporate: “Ouch! Boo-boo, help, open, shot, look!, dog, cat, meow, woof + body parts.”
“Melissa and Doug Magnetic Matching Picture Game” (Ages 3-5): Language goals/ core vocabulary to incorporate: “on, off, up, down, go, stop, swing, vroom, drive, bus, + farm animals.” Target spatial concepts, matching and following 1-2 step directions.
“Let’s Go Fishin” (ages 4+): Language goals to increase core vocabulary: Open/close + Colors. Fine motor skills: pincer grasp. Social communication: working on taking turns.

Sensory Processing: Proprioceptive System

Purpose: The proprioceptive system is responsible for obtaining information about the body's position in space.

Function: Proprioceptors are small sensory receptors that are located within muscles, tendons, and joints. Information is received from proprioceptors when these structures pull, press, bend and straighten. When these receptors are pulled, pushed, bent, or stretched, information is sent to the brain to provide us with a sense of body awareness, motor planning, and coordination. A breakdown with processing this information can be caused by damage or dysfunction to sensory receptors, nervous system pathways, or areas of the brain responsible for interpretation.

Why It’s Important: The proprioceptive system provides us with important information for participation and completion of everyday tasks such as washing our hair, brushing our teeth, getting dressed, or eating/drinking. Without these receptors providing information, these tasks would become much more challenging or even impossible.

System Breakdown: When children have difficulty processing proprioceptive input it can often present as clumsiness or being uncoordinated. Children may seek out more input if they have a low proprioceptive threshold, which can present as rough play (crashing), deep pressure (hugs), or big movements (running, jumping, pushing, pulling, heavy lifting, climbing). If they’re over responsive to proprioceptive input, then children tend to be more cautious in their movements and avoid physical activities.

OT Intervention: Everyone processes sensory information differently and it doesn’t necessarily warrant intervention unless it prevents a child from participating in meaningful activities that impact their quality of life. Proprioceptive input is beneficial for children both with and without processing difficulties. A sedentary lifestyle restricts children’s opportunity to engage in proprioceptive activity and can ultimately result in sensory processing difficulty solely due to lack of exposure. Our sensory systems require frequent input and exposure in order to be able to process information efficiently and effectively. Occupational therapists assist with creating a ‘sensory diet’ to improve children’s ability to process sensory information that is unique to their needs. Some examples of activities that OT’s may use to promote exposure to proprioceptive input include:

Fine Motor: pinching, pulling, or squeezing playdough or putty, opening/closing objects, or manipulating velcro strips.

Gross Motor (frequently referred to as ‘heavy work’): jumping jacks, pushing/pulling/carrying heavy objects, building a fort, climbing on a jungle gym.

Oral Motor: blowing bubbles, chewing gum, eating certain foods like jerky or licorice.

Weighted objects such as vests, blankets, or lap pads can be helpful as deep pressure stimulates the release of serotonin and encourages the parasympathetic response, which assists with regulation by providing feedback for body awareness, decreased anxiety levels, and improved attention.

May is Better Speech and Hearing Month

These days, every month seems to represent something different to celebrate and May celebrates better speech and hearing!

Our goal is to highlight the many different areas and specialties speech language pathologists play across the lifespan for our patients. Unless you have a personal experience with speech therapy or a speech pathologist, you may not be aware of all the “hats” we can wear.

Let’s focus on pediatrics, speech pathologists treat a variety of speech and language disorders including apraxia, articulation disorders, phonological disorders, voice disorders, traumatic brain injuries, intellectual disabilities, social communication disorders, late language emergence, auditory processing disorders, fluency disorders and written language disorders. We also treat feeding and swallowing disorders including dysphagia, picky/problem eating and orofacial myology disorders.

…Just to name a few!

Let’s dive into a few that are common for our therapists to treat at Gro.

Childhood Apraxia of Speech- or CAS is a neurological pediatric speech sound disorder where the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits (i.e. abnormal reflexes or tone). CAS may occur as a result of a known neurological impairment (i.e. brain damage) or independently. Think of it this way: the child knows what they want to say but has trouble coordinating the precise movements of the articulators to get the message out.

Articulation Disorders- these fall under the umbrella term “speech sound disorders” and focuses on speech errors in production of individual speech sounds such as distortions or substitutions of a sound.

Phonological Disorders- these fall under the umbrella term “speech sound disorders” as well but these are predictable, rule-based errors that affect more than one sound such as fronting (saying “tat” instead of cat), stopping (saying “dun” for sun) or final consonant deletion (saying “go” for goat).

Augmentative and Alternative Communication- or AAC is an area of clinical practice that supplements or compensates for impairments in speech-language production and/or comprehension including spoken and written modes of communication. AAC is an umbrella term that can use any equipment, tool or strategy to improve functional communication for people. Some forms of AAC include signs, gestures, line drawings, written words, picture communication boards and speech-generating devices.

Voice Disorders- occurs when voice quality, pitch and loudness differ or are inappropriate for an individual’s age, gender, cultural background or geographic location. Voice disorders are categorized under 2 main categories including Organic and Functional. Organic voice disorders include structural and neurogenic and are defined as a physiological voice disorder that is a result from alterations in respiratory, laryngeal or vocal tract mechanisms. Structural organic voice disorders are a result from physical changes in the vocal mechanism such as alterations in vocal fold tissues (i.e. edemas or vocal nodules) and/or structural changes in the larynx due to aging. Neurogenic organic voice disorders are a result from problems with the central or peripheral nervous system innervation to the larynx that affect functioning of the vocal mechanism such as vocal tremors, spasmodic dysphonia or vocal fold paralysis. Functional voice disorders are a result from inefficient use of the vocal mechanism when the physical structure is normal, such as vocal fatigue, muscle tension dysphonia or aphonia, diplophonia or ventricular phonation.

Traumatic Brain Injuries- or TBIs are a form of nondegenerative acquired brain injury resulting from a bump, blow or jolt to the head/body or a penetrating head injury that disrupts normal brain function. TBIs can cause mild, moderate or severe brain damage that can result in speech, language, swallowing or auditory processing disorders.

Intellectual Disabilities- or ID is characterized by the onset in the developmental period (before age of 22 years), significant limitations in adaptive behavior and significant limitations in intellectual functioning. The diagnosis of an ID is not made by a speech pathologist but children with IDs may benefit from speech, language and/or auditory processing therapy to help improve functional communication in the child’s daily life.

Late Language Emergence- this is often referred to as a “late talker” and is characterized by a delay in language onset with no other diagnosed disability or developmental delay in other cognitive or motor domains. Late language emergence is diagnosed when language development trajectories are below age expectations. Children may have expressive language delays only or they may have mixed expressive and receptive delays. Children with expressive language delays often exhibit reduced vocabulary and delayed sentence structure and articulation. Children with mixed expressive and receptive language delays will show a delay in oral language production and language comprehension.

Fluency Disorders- the most common fluency disorder is “stuttering,” which is an interruption in the flow of speaking characterized by specific types of disfluencies including the repetitions of sounds, syllables and monosyllabic words (i.e. “Look at the b-b-baby” or “Let’s go out-out-out”). Disfluencies can affect the rate and rhythm of speech and may be accompanied by negative reactions to speaking, avoidance behaviors, escape behaviors and physical tension.

Pediatric Feeding and Swallowing Disorders- This is an umbrella term so let’s break it down a little:

Feeding- is the process involving any aspect of eating or drinking including gathering and preparing food and liquid for intake, sucking or chewing and swallowing. A pediatric feeding disorder is defined as “impaired oral intake that is not age-appropriate and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction.” It may be associated with oral motor and oral sensory function and includes behaviors such as refusing age-appropriate or developmentally appropriate foods or liquids, accepting a restricted variety or quantity of foods or liquids, displaying disruptive or inappropriate mealtime behaviors, failing to master self-feeding skills expected for developmental levels, failing to use developmentally appropriate feeding devices or utensils and experiencing less than optimal growth.

Swallowing- is the complex process during which saliva, liquids and foods are transported from the mouth into the stomach while protecting the airway. It consists of 4 phases: oral preparatory phase, oral transit, pharyngeal and esophageal. A swallowing disorder is called “dysphagia” and can occur in one or more of the 4 phases of swallowing and can result in aspiration (the passage of liquid, food or saliva into the trachea).

Long term consequences of feeding and swallowing disorders can include food aversion, oral aversion, aspiration pneumonia and/or compromised pulmonary status, undernutrition or malnutrition, dehydration, GI complications (i.e. motility disorders, constipation and diarrhea), poor weight gain, ongoing need for gastrointestinal or parenteral nutrition and prolonged feeding and swallowing problems into adulthood.

Orofacial Myology Disorders- or OMDs are patterns involving the oral and orofacial musculature that interfere with normal growth development, or function of orofacial structures, or call attention to themselves. OMDs can be found in children, adolescents and adults and can co-occur with a variety of speech and swallowing disorders. See our OFM blog post for an in-depth dive into this one 😉

That was A LOT!

Keep in mind that these are only a handful of disorders and diagnoses that speech pathologists can treat. Most SLPs have a passion for a few different areas but as you can imagine we can’t be experts in all of the areas so it’s important to find the right provider for you or your child’s needs!

(Reference: American Speech Hearing Association Patient Portal- Clinical Topics https://www.asha.org/practice-portal/clinical-topics/)

World Down Syndrome Day and Total Communication

Down syndrome or Trisomy 21 is a genetic syndrome marked by a 3^rd copy of the 21^st chromosome. This additional genetic material alters the course of development and causes the characteristics associated with Down syndrome (ndss.org). There are common physical traits associated with those that have Down syndrome including low muscle tone, small stature and an upward slant to the eyes. BUT it’s important to remember that each person with Down syndrome is different and may or may not possess these common characteristics, typically someone with Down syndrome carries more common characteristics with their parents and family members.

March 21^st is World Down syndrome day because it’s the 21^st day of the 3^rd month to signify the uniqueness of the 3 copies of the 21^st chromosome. On this day every year we celebrate those with Down syndrome, share awareness about all the things people with Down syndrome CAN do and fight for more opportunities and inclusion (i.e. quality education, good health care, a paying job, autonomy in making decisions and a voice).

I became a speech pathologist because of my experiences with people with Down syndrome, in particularly my youngest sister, Christina. I saw at a young age the importance of speech and language therapy in her life. Our family attributes Christina’s ability to communicate verbally to her speech therapist she saw from age 3-22 years old.

It’s important to remember that every child is different and comes to us with a unique set of skills and difficulties. Speech and language therapy looks different for everyone despite maybe having the same diagnosis. Typically, children with a diagnosis of Down syndrome may have feeding, swallowing, speech and/or language difficulties and can benefit from skilled speech and feeding therapy. It’s important to find a therapist that is trained and skilled in pediatric feeding and swallowing if there are feeding concerns and a therapist trained in pediatric speech and language disorders if there are speech or language concerns. Although both fall under the scope and practice of a speech pathologist, they are different and not all therapists have experience in both areas, it’s important to ask your therapist their level of experience if you have concerns!

Our main goal of speech/language therapy is to give each child the skills to communicate with their peers, family members and teachers. Each person has a voice with unique thoughts, dreams and aspirations even if they have difficulty communicating it. At Gro, our role is to use total communication strategies to help each person express themselves. This can look different for each person and we take time to develop communication skills, not just speech skills.

Sometimes this looks like verbal speech and other times it looks like augmentative and alternative communication (AAC) strategies. Our end goal for therapy is to give everyone an opportunity to meaningfully communicate with others despite their disability. There are many different forms of AAC, which will be explained more in depth in another post but common forms include sign language, writing, picture exchange communication systems (PECS) and a speech generating devices (i.e. applications that allow a person to communicate via electronic voice generation).

As a speech pathologist it is our job to help a family and child every way possible by providing a robust, language rich environment that supports language and communication development in all forms. No one uses verbal speech to communicate all the time (think of how often we communicate via text or facial expressions) and it’s important to support, nourish and develop ALL types of communication for our children.

In celebration of those with Down syndrome please join us in wearing your crazy socks today! The crazy or mismatched socks tradition is meant as a conversation starter, when people see your mismatched socks and ask why, you can take a minute to explain the significance and share acceptance and inclusion of people with Down syndrome.

Where is your tongue “parked”?

Let’s talk about where your tongue is “parked” or resting whenever you are not talking or eating. Our tongue should “live” in the roof of our mouth, nestled between our teeth. This means your tongue tip is on the incisive papilla (those bumps right behind your top middle teeth) and the middle and back of your tongue is resting on the roof of your mouth.

This position allows for optimal palatal, upper and lower jaw growth and development, it also allows for easy and natural nasal breathing (which we will talk about the benefits in another post). Our tongue acts as a natural “palatal expander” and allows the maxillary dental arch to form in a flat, U-shape vs. a high arched palate.

When our tongue is resting low and fronted in our mouth, the palate starts to form into a high/vaulted and narrow shape. It’s important to remember that the floor of our nasal cavity is the roof of our mouth. Therefore, if our palate is vaulted and high it may impact the ability to easily breathe through our nose. A low and fronted tongue also can affect dentition and your bite.

This is why our office works SO closely with our local airway-centric dentists and Ear Nose and Throat doctor. We are in close collaboration with both offices because what we do in the orofacial myology realm overlaps so much. Our local airway centric pediatric dentist will typically screen children and identify any suspected tethered oral tissue ties (aka tongue, lip or cheek ties), high/narrow palate or potential airway concerns. The children then are referred to us to complete a comprehensive orofacial myology assessment where we assess function (see Orofacial MyoWHAT?!?). We work with the dentist to determine an individualized plan regarding myofunctional therapy, if a release is needed and when and if appropriate to start palatal expansion. Palatal expansion is an important part of the myo puzzle because there has to be room for that tongue to rest on the roof of the mouth.

Why do we work with an ENT doctor? In our assessment if we find that the patient is primarily breathing through their mouth we need to figure out if it’s possible for the person to breathe through their nose. It may be difficult due to enlarged tonsils, adenoids or nasal obstructions so we refer to an ENT to assess the patient’s airway, typically prior to starting myofunctional therapy. Once the airway is “cleared” and it’s determined there is no obstruction then we get to work at establishing a new oral “habit” where we have to re-teach the tongue where to rest. This is done through weekly therapy and daily “homework” and can be completed in 6 months if we have a motivated patient!

Orofacial MyoWHAT?!

Here at Gro we see A LOT of kids and adults for orofacial myology assessment and therapy but what exactly does that mean? Just to confuse everyone further, there are multiple terms for orofacial myology, which all mean the same thing another popular term is orofacial myofunctional therapy.

First off, the short definition of an orofacial myology disorder (OMD) is “the study and treatment of the oral and facial muscles as they relate to speech, dentition, chewing/bolus collection, swallowing, and overall mental and physical health.” (Sandra R. Holtzman)

At Gro, we are all speech language pathologists trained in orofacial myology assessment and therapy. That means when we see a child or adult for speech, articulation, feeding, language or voice therapy we are also looking at them through our “myo” eyes. During an assessment we are looking at how the tongue, oral and facial muscles and bones are affecting speech, feeding, swallowing, breathing and sleep.

A big part of our assessment is determining if there is a “tongue tie” but actually we are looking to see if where your tongue is attached on the floor of your mouth is affecting any speech sounds or intelligibility (the ability for others to understand you), your ability to nasal breathe, how your chewing and preparing the food in your mouth, your tongue position when swallowing and your quality of sleep. Over the next few blog posts we will dive deeper into how your tongue, oral and facial muscles affect each of these areas.

It’s all about FUNCTION!! We are always looking at how function is impacted. If we see a Grade 4 tongue restriction (i.e. most severe) but there is no functional implication, then we will not recommend a release! To be honest this rarely occurs but it is important to remember that function drives our clinical decision making.

Orofacial myology therapy (OMT) is where we really get to work. We can release the tongue but that’s only going to fix a small portion of the “problem,” you’ve lived however many years with your tongue resting on the floor of your mouth and with limited range of motion. OMT is like physical therapy for your tongue, its job is to teach new habits. These include teaching correct tongue resting position (more to come on this!), strengthening all 8 tongue muscles to easily be able to demonstrate lingual-mandibular differentiation (which is the fancy term for moving your tongue separately from your jaw), chewing and preparing your food so that it’s safe to swallow (which can reduce reflux and aspiration risks!), correct tongue position when swallowing foods and drinks and easily producing sounds that may be affected by the tongue’s limited range of motion.

Be prepared because it’s a lot of work! Because of the nature of OMT we typically look for children to be at least 5-6 years old and able to follow directions because it is a lot of active exercises to complete. We assign weekly homework that consists of exercises that are to be completed daily and when the patient is motivated and on top of it, therapy can be done in 6-12 months but benefits will last a lifetime!

What if your child is younger and you are noticing OMD signs or symptoms?! Stay tuned on more information about this and how this falls into the oral motor/feeding realm!