TalkTools Straw #7

Straw #7 is the second to the last one in the TalkTools straw hierarchy kit. Matthew used this straw for 3 months, from April through June.

It must have been harder to drink with this straw as he didn't transition to this straw as easily as he did with the previous one. It seemed longer than coily straw #6. But as with the others in the straw hierarchy kit, he used the straw daily for most of his drinks, even at school. I sent one straw and cup to his preschool daily for him to use at snack time. He eventually warmed up to this straw and could drink a whole cup of orange juice, lemonade, or chocolate almond milk without any issues.

In the beginning of July, we started with straw #8. On straw #8, I noticed he regressed back to a pattern of suckling (straw resting on tongue when the tongue is too far forward then moves forward more, rather than back, when sucking on the straw) instead of sipping (using lips only). We went back to straw #7 for a day to see if we had moved on too quickly. He did just fine for the most part and easily corrected with verbal cues from me (as seen in the video). The speech therapist whom we work with in NACD suggested that we move on to straw #8 with more manual support and a tactile cue such as a lip block or medical tape 1/4-inch from the drinking tip.

TalkTools Straw #6

It's hard to tell if straw #6 is shorter than straw #5. Because of its coils, straw #6 doesn't stick out of the cup as far as straw #5. Matthew had an easier time drinking from this straw mainly because he didn't need to hold the cup out as far.

I also ordered two extra #6 straws as back-ups to replace the ones with internal residue build-up. Matthew easily transitioned from the previous straw to this one as they were the same diameter. Like the previous straws, he used this straw for most of his drinks including chocolate almond milk, orange juice, apple juice, and water everyday. The straw was sent to his preschool as well for him to use at snack time.

I'm not sure if I had mentioned it in any of my previous TalkTools straw posts but Matthew is on straw therapy as recommended in his NACD program. So we also used the straw as part of a set of oral motor stimulating activities specified in his daily program.

Matthew started on straw #6 during the Christmas break. He could've moved on to straw #7 after a month but I kept him on this straw for almost 3 months because there was so much going on that I just kept forgetting to move him on to the next straw in the hierarchy. It didn't hurt to keep him on the straw longer anyway. The instructions only discouraged from moving on to the next straw within a few days, which would be too fast of a transition. As of April this year, he was on straw #7.

TalkTools Straw #5

Straw #5 was the same diameter as straw #4. However, straw #5 was a little longer than the previous straw and used without a lip block.

There was noticeably less reminding on my part to use lips only, no tongue protrusion, when drinking. I had ordered two extra #5 straws, anticipating Matthew to be on straw #5 for at least a couple months. Since he uses the straw for most, if not all, his drinks including water, orange juice, apple juice, and chocolate almond milk everyday, residue build-up in the straw was expected no matter how well it was rinsed through after every use. I also sent a straw to his preschool for him to drink with at snack time.

He was on straw #5 for almost 3 months. He "graduated" to straw #6 during the Christmas break.

TalkTools Straw #4

"Use your lips, not your tongue." That was what I'd say when we started with Straw #4 in the beginning of June. I doubt many parents have to give their children specific (and odd) instruction on how to drink with a straw.

Straw #4 is relatively a shorter straw and has a smaller diameter than straw #3. The smaller diameter makes straw #4 a challenge. In the beginning, I used a lip block (as shown in the photo) to control how much straw tip goes into Matthew's mouth.

The lip block, which was positioned 1/4-inch from the tip of the drinking tip, was essential as a tactile prompt to seal his lips around the straw. Without the lip block, he sometimes shifted to suckling or wrapping his tongue under the straw as his natural urge is to let a longer straw tip into his mouth. A longer length of straw in his mouth (more than 1/4-inch) makes it easier to suckle.

Without the lip block, verbal prompts or reminders "use your lips, not your tongue" and my fingers positioned 1/4-inch from the drinking tip were necessary to get a similar effect as having the lip block in place. Then I re-read the instructions and learned that I was supposed to cut the straw close enough to the first loop so that the loop served as a lip block. So I cut the straw and did away with the yellow rubber lip block.

After 4 months of using straw #4, I have noticed better and stronger lip closure. Along with this physical progress, I have noticed clearer articulation of single speech sounds. Stringing sounds together is still a work in progress though.

I don't doubt that the straws have been helping Matthew develop a stronger oral foundation for speech but his progress in speech is really a combination of the right amounts of speech therapy, reading sight words, oral stimulation techniques (including use of the TalkTools straw kit), and articulation practice. Other oral stimulation techniques include using a z-vibe and offering food that require a lot of chewing or brings more awareness to the mouth such as pickles, grilled chicken, grilled steak, fresh cut apples, lemon sorbet, and so on.

Since the end of September, he easily and successfully (no leaking) drank 4 ounces of milk or juice with straw #4 in one uninterrupted sitting and with less prompting. He has moved on to straw #5!

TalkTools Straw #3

Ever since starting straw therapy with Matthew, I've been trying to offer drinks using his therapy straw only so he gets as much practice with it as possible.

Longer than straw #1 and straw #2, I was worried that Matthew would have a hard time drinking with it.

I was wrong. Not the first time he has proven me wrong. He can get the juice or water from the cup all the way up the long straw into his mouth, which may not seem like a big deal for any typical person, but in my eyes, that's good "sucking" power! The lip block is set at 1/4-inch from the tip of the straw and it is a tactile prompt for Matthew to use his lips to suck from the straw instead of wrapping his tongue underneath it (suckling like a baby would with a bottle nipple).

When drinking, I always hold his cup anyway to keep the straw in place so the length wasn't an issue for him. And we still used the take 'n toss plastic cups even if the straw was more than double the height of the cup.

He was on straw #3 from mid-April to the end of May. Moving forward with straw #4!

TalkTools Straw #2

We used straw #2 of the TalkTools Straw Hierarchy kit from the beginning of March to mid-April this year. Straw #2 is a curvy purple straw. I've seen this straw at Target in the party supply section and at a local party supply shop. So if we lost this straw or it broke, then it would be easy enough to replace.

The lip block on the straw is very effective at keeping just 1/4-inch of straw for Matthew to practice a proper lip seal around the straw instead of wrapping his tongue around it and suckling. Two lip blocks came with the TalkTools straw kit but I think they can also be bought individually from TalkTools or possibly from other online stores that sell therapy supplies for oral-motor activities.

Between this straw made of a harder plastic than straw #1 and the lip block, (and better supervision from me) Matthew had no opportunity to chew on this straw like he did with straw #1.

Either the take 'n toss cup with a straw lid or the sip tip cup generally seems to work. There is little risk of a little spill through the hole in the lid if the cup is tipped at an extreme angle since the straw is loose-fitting through the lid. It's usually not an issue though since I hold the cup and straw for Matthew.

The drink of choice: Motts for Tots apple juice. He prefers not to drink water or milk with this straw.

Here's a short video of Matthew using straw #2.


Related posts:
TalkTools Straw Hierarchy Kit
TalkTools Straw #1

TalkTools Straw #1

Straw #1
It's a blue straw with a duck that serves as a built-in lip block - to prevent too much of the straw to be in the mouth. Before starting, I trimmed the duck end of the straw to 3/4-inch, which was how much straw he usually had in his mouth when drinking from any straw.

He started with straw #1 after Christmas as part of his individualized NACD (National Association for Child Development) program. He was on it for 2 months. He would've been on it for much less time if I had been more consistent with it and if I didn't run into a problem.

The Dilemma

He bit the straw tip and flattened it. He did the same to the spare #1 straw in the kit. I tried to save the straws by re-rounding them. I was successful the first few times then the tips of the straws started cracking, making them unusable.

I cut off the duck and improvised with a makeshift lip block. But then I realized that cutting the length was probably not ideal. It made it easier for Matthew to drink with the shortened straw but it probably wasn't ideal for the objectives of straw therapy.

Moving On
After consulting with the speech therapist via our NACD coach, I got the green light to move on to the next straw. At that point, he was drinking with only 1/4-inch straw tip in his mouth, which meets one of the criteria for moving on to straw #2.

Straw #2 started at the beginning of March.

Related post:
TalkTools Straw Hierarchy Kit

TalkTools Straw Hierarchy Kit

Tongue protrusion and low muscle tone (also known as hypotonia) are common among individuals with Down syndrome. Is it because of an enlarged tongue? Is it because of hypotonia (low muscle tone)? Contrary to the belief that it is because of an enlarged tongue, I have come across some literature that low muscle tone leads to tongue protrusion. I mentioned this in my previous post "On Tongue Protrusion". The article "Tongue Protrusion" by Karen Henderson SLP, explains it and provides suggestions to promote tongue retraction. (The article is available as a .pdf file online. Google Tongue Protrusion Karen Henderson).

Hypotonia affects all the muscles in the body. The tongue is a muscle. We have mouth muscles that allow us to move our mouths, chew, and keep our mouths closed to keep our tongue in. Without hypotonia, our mouths are naturally closed when we're not talking or eating. With hypotonia, it seems that natural tendency is for the jaw to remain open and tongue thrust to occur.

The TalkTools Straw Kit is one of the tools to inhibit tongue thrust. The idea is to improve mouth and tongue tone through a hierarchy of drinking straws that encourage utilization of various targeted mouth/ tongue muscles.

There are 8 straws. Each straw is different in length, diameter, and form and intended to address certain areas of the tongue. The straws also promote lip closure.

I had considered finding similar straws at dollar stores instead of buying this kit. But it would be too troublesome and time-consuming for me. I also wouldn't have the instructions that come along with the kit.

I recently learned that when drinking out of any straw, even one not in the TalkTools straw kit, only about 1/4-inch of the straw should be in the mouth for proper lip closure and straw drinking. With a lot more than that in the mouth, Matthew starts to suckle the straw instead therefore not encouraging the right muscles to improve tone and promote lip closure.

Matthew started with the straw kit right after Christmas. We are about to move on to straw #3.

Keep in mind that there are many other ways to improve muscle tone and awareness. Chewing (chewy food) is one way to make the mouth muscles work and get that tongue moving around. I listed other tips in "On Tongue Protrusion".

Do you use the TalkTools straw kit? What has your experience been with it?

Related post:
On Tongue Protrusion

TalkTools Horn Kit

The TalkTools horns kit is used by some speech therapists to help improve oral-motor tone and target skills such as lip rounding, lip closure and tongue retraction. The kit we have includes a set of 12 horns rated according to difficulty level. Each horn works on specific speech sounds and even drooling control.

We are on horn #3 and I started this program with Matthew when he was 30 months old. But it hasn't been easy keeping up with this. Sometimes Matthew just isn't in the mood for the horn so we skip it. He's more interested in blowing bubbles so I go with what motivates him more. For now, we're stuck on horn #3 (the orange horn in the above picture). At this point, it's hard to say if this has really helped with lip closure and tongue retraction or if the other activities we do help more.

Do you have the Talktools horn kit? What do you think? Has it helped or not?


Related post:
On Tongue Protrusion