Wednesday, December 12, 2012

Straw therapy follow up

I recently emailed Talk Tools with several questions after beginning their straw therapy program. I reviewed this with my Speech therapist, and we concluded that if your child is proficient in straw drinking prior to initiating straw therapy, then you may try to begin with straw #4. If straw #4 is too difficult, then back down to straw #3. If they have not used straws before, then begin with straw #1. We will change to #4 this week and see how it goes. Here is the response I received: Thank you for your question! When beginning the straw drinking hierarchy, you can either begin at straw #1 or #4. You are correct in making sure the child is only putting 1/4 of the straw in their mouth, this way the child is using good lip rounding and the tongue is retracted. It sounds like you might want to try straw #4 with your daughter. If she only puts 1/4 of the straw in her mouth, then you will not need to cut the straw (straw #1 and 4 are the only ones you can cut). If she is putting more than 1/4 of the straw tip in her mouth then you will need to cut the straw to 1/4 inch above the first twist. By straw #4 the tongue must be completely retracted in the mouth and the jaw is stable. She will not be allowed to suckle on straw #5. If you see a forward and backward movement of the jaw - then she is still suckling. The criteria for success involves: 1. No liquid leakage or air leakage between the lips. 2. The jaw should be relatively still/stable, indicating jaw-tongue independent movement. 3. Lips should be slightly protruded. 4. The child is able to drink 4 ounces of liquid in 2 min or less. If you give your daughter straw #4 - you will know if it is too hard - she will be struggling to suck liquid up - then you will return to #3 until she meets criteria. I hope this helps and let me know if you have any further questions! Monica Purdy, M.A., CCC-SLP Speech and language Pathologist Oral Placment and Feeding Specialist

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