This approach of Talk Tools plays a significant part in any comprehensive programme for speech and feeding.
Oral motor therapy VS Talk Tools Oral placement Therapy (OPT)
Oral motor therapy is an umbrella term that covers many alternative approaches. Talk Tools oral placement is one specific form of oral motor therapy. The Talk tools oral placement therapy is another tool within the SLT repertoire and is not meant to exchange other therapy approaches.
• It is not designed to be used alone and is used to work on underlying motor and sensory difficulties before other speech or feeding approaches are introduced.
• It is suitable for anyone who shows reduced mobility, agility, precision and endurance of the oral structure and musculature that adversely affects feeding and speech (Downs syndrome, autism, cerebral palsy, stroke and dyspraxia/dysarthria)
Underlying principles of Talk Tools Oral placement therapy
There are mainly three main factors affecting movements of the jaw, lips and tongue. They are:
– Dissociation
– Grading
– Fixing
These factors underlie the oral movements necessary for feeding and speech.
Dissociation
It is the separation of movements based on adequate strength and stability in two or more muscle groups.
Grading
Grading is the controlled segmentation of movements which are based on strength, dissociation and stability within the targeted muscle groups.
Fixing
It is an abnormal movement pattern which occurs secondary to reduced stability and is used to compensate for the lack of grading within a muscle group.
How does it work?
Initially, assessment is done by a Talk Tools trained therapist who examines the placement, motor and sensory difficulties. Then the hierarchy of activities are planned and implemented by the Talk tools therapist and the parents are advised to continue with home training for the same to target placement, motor or sensory difficulties based on the treatment plan.
The programs are based on the clear and functional outcomes with measurable criteria for success.
BUBBLE HIERACHY
Step 1: Pop the bubbles on lips.
Goals:
– To develop awareness of sensation on lips as a pre-requisite for lip closure for feeding, saliva control and speech.
– To achieve the lip closure from an open mouth posture, build understanding of cause and effect
Criteria for success:
The client can pop the bubble using lip rounding and protrusion by ten times.
Step 2- Blow or breath on the bubble
Goals:
-To associate abdominal exhalation with the movement of bubble.
-To develop controlled airflow for phoneme production.
-To develop jaw-lip dissociation
Criteria for success:
This exercise can be repeated by the client 10x times without a break
Step 3- Blow the bubbles off the wand
Goals:
-To improve controlled airflow volume
-To improve jaw- lip dissociation
-To develop strength and stability in orbicularis oris (muscle that helps in lip rounding)
Criteria for success:
This exercise can be repeated by the client 10x times without a break.
Step-4 – Blow a bubble through the wand.
Goals:
-To improve controlled, prolonged airflow.
-To improve jaw-lip dissociation.
-To improve lip rounding skills.
-To develop strength and stability in orbicularis-oris (muscle that helps in lip rounding)
Criteria for success:
This exercise can be repeated by the client 10x times without a break
Step 5 – For increasing distances, blow bubble
Goals:
-For improved controlled, elongated airflow.
-To develop jaw stability.
-To achieve jaw -lip dissociation.
-To develop lip rounding / protrusion skills.
-To develop tongue retraction skills.
-To develop jaw – lip -tongue dissociation skills.
Criteria for success:
This exercise can be repeated by the client 10x times without a break
Each step here can be task analyzed to smaller steps if necessary. Many therapists working at clinical level worldwide have been using Talk tools with great success. There is a large number of single client evidence and experience which shows it is successful when it is used correctly. The therapist who attend a Talk Tools course find that it shows a common sense approach to analyzing a therapeutic challenge and addressing it practically.
